Contact Tracing and Next Steps

Tag Archives: Public Health Departments

Contact Tracing and Next Steps

Contact Tracing During COVID-19

States move toward reopening, public health decisions continue to be in the spotlight.

As curves plateau and state economies continue to struggle, people around the country are asking: when will we get back to normal? Public health and government officials, however, focus on how we return to normal. As of May 1, more than half of US states began reopening businesses and easing previously strict orders and mandates. Although, what we remember as normal before this pandemic will not be how states reopen right away. 

In order to contain this public health crisis, experts consider how to safely move toward reopening. Testing, tracing, and self-isolating will be key in taking the next steps. Communities will rely on four building blocks to combat COVID-19: contact tracing, testing, and eventual COVID-19 treatments and vaccines. These building blocks work together for an effective plan to return to society. Public health professionals will focus on where the virus is in communities and how to continue to reduce the spread. 

What is Contact Tracing?

Contact tracing is a public health strategy designed to contain the spread of an infectious disease. The idea works by tracing and contacting each person who may have been in contact with an individual who tests positive for an infectious disease. By informing individuals when they may have been in contact with a positive case, we can monitor and advise others appropriately (e.g self isolate if they also show symptoms). The concept is fundamental to public health and even more important during the current pandemic. In the U.S., we are fortunate to have strong local health departments. The staff at health departments work as quiet soldiers day in and day out to keep our communities safe. When our everyday lives aren’t at risk of infectious disease, we don’t even realize the work being done by local health departments.

The Importance of Tracing Positive COVID-19 Cases 

Johns Hopkins School of Public Health recently released a report on COVID-19 contact tracing in the United States. The report estimated each positive COVID-19 person can infect 2 to 3 other people, on average. This leads to an alarming statistic: if one person spreads the virus to three others, the first positive case can turn into more than 59,000 cases in 10 rounds of infections.

How Does Contact Tracing Work?

In addition to providing immunizations to the public, county health departments ensure communicable diseases such as STD, HIV, and tuberculosis (TB) do not spread in communities. They do this by helping infected individuals and tracing all contacts. For example, when someone tests positive for TB, health department staff are responsible for tracking and contacting all people who that person has been in contact with. The staff’s focus is to make sure each individual is safe and not positive for TB. If connected people show symptoms of the disease, appropriate actions will be advised, such as self-isolation. Electronic Health Records designed specifically for public health have contact tracing functionality for TB built into their software. During the normal course of life, an individual can come in contact with hundreds of people. The EHR software enables staff to efficiently contact and track positive cases, decreasing the chance of widespread infection. 

Contact tracing can quickly isolate people who are or may be infected to stop the spread while allowing healthy people to engage in society. COVID-19 tracing efforts by public health departments will be critical as we reintegrate back into society. Additionally, if there is a second wave of COVID-19, preparing contact tracing measures now enables more effective action in the future.

How States are Already Working Towards Reopening

States, such as Maryland, have released extensive reopening plans to the public. Governor Larry Hogan recently stated that when moving toward reopening, his administration is working to “move rapidly, but not recklessly.” Maryland’s building blocks include testing and having a plan for enough personal protective equipment. They have additionally worked hard to prioritize their contact tracing workforce. COVID-19 Link, a new platform to be used for robust contact tracing operations, will help collect information about people who test positive for COVID-19 and anyone they have come in contact with. Maryland has expanded their workforces to 1,000 contact tracers who will be trained on this platform using data from the region’s health information exchange (CRISP). Public Health EHRs connect to Health Information Exchanges, including CRISP, to provide real-time data, which is crucial during an epidemic. 

Public Health Workers, We’re Here for You.

We know county local health department staff are on the frontlines of finding answers about COVID-19 and doing hard work of contact tracing. As an Electronic Health Record provider focused on public health, we understand the importance of your work. Thank you, healthcare heroes! If there is any way that we can be a resource to you during this time, please reach out to us today

Opioid Crisis and Your EHR … a Follow-Up

Opioid Crisis

The opioid crisis in America is so severe, we believe each must do what he or she can to wrestle the epidemic into submission, and as an EHR vendor, one of our abilities lies in using this very blog space to trumpet statistics and resources. So, although we addressed this topic last October, [see “3 Ways (+11 bonus) EHR Data Helps Calm the Opioid Crisis”], please join us now for a deeper and even more sobering look.

In the NEW YORK magazine article “The Poison We Pick”, author Andrew Sullivan reports these alarming statistics (broken out as bullets for greater impact beyond the prose style; all words below in italics are his):

  • More than 2 million Americans are now hooked on some kind of opioid, and
  • Drug overdoses from heroin and fentanyl in particular – claimed more American lives last year than were lost in the entire Vietnam War.
  • Overdoes deaths are higher than in the peak year of AIDS, and
  • Far higher than fatalities from car crashes. . .
  • Opioids will kill another 52,000 Americans this year alone –
  • And up to half a million in the next decade.
  • (Americans) consume 99 percent of the world’s hydrocodone and 81 percent of its oxycodone.
  • We use an estimated 30 times more opioids than is medically necessary for a population our size.
  • Nationwide, between 1999 and 2011, oxycodone prescriptions increased sixfold.

Staggering.

Normally, one could say, “Put that in your hash pipe and smoke it,” – if the metaphor weren’t so close to the (deadly) home of this issue.

Moving beyond the personal front of ransacked homes and lives, the opioid crisis is ransacking the insurance industry and U.S. economy.  “The Centers for Medicare & Medicaid Services (CMS) reports, “The CDC estimates that prescription opioid misuse, opioid use disorder (OUD), and opioid overdose cost the U.S. economy over $78 billion in 2013 in the form of higher healthcare and substance use disorder treatment costs, excess criminal justice costs, and productivity losses borne by employers.” (“Healthcare Payer Strategies to Reduce the Harms of Opioids”; whitepaper, January 2017.)

Particularly for Behavioral Health  and Public Health agencies:  if you and your agency have not yet done the hard work to jump to a cloud-based EHR system, the fallout from the opioid crisis alone should be reason enough to get moving now.  We agree:  taking this leap is daunting and requires fortitude, but as countless customers on the other side of the EHR cloud can attest:  the landing is soft and so worth the effort.

In regards to the opioid crisis:  THIS IS WAR.  As Sullivan states, “The quantum leap in opioid use arrived by stealth.”  Behavioral Health and Public Health agencies cannot afford to allow this stealth bomber to annihilate its communities.  These agencies on the front lines, in particular need a stalwart work-horse/war-horse of a record and reporting system as their primary arsenal against the opioid foe.

Talk with other agencies who have battled before you to cross into the well-equipped command post of a cloud-based EHR.  Agencies who report “this billing system is so robust, the claims just auto-post,” or report that the simplicity of Patient Consent forms via a good EHR saves critical patient check-in time, (not to mention provider scanning time).

Choose an EHR that is federally compliant and will go into battle before you, behind you, and is in a support role all around you – and take back the territory served by your agency.

In the battle against opioid abuse, we have no time to lose – only lives.

The Effects and Hazards of E-cigarettes (Guest Blog by Rebecca Williams, MHS, PhD)

e-cigarette poison control center calls

“The Effects and Hazards of E-cigarettes: How and Why Public Health Departments Should Inform Patients Now”
Because there is still the effect of “the jury is out” about the very specific long-term effects of e-cigarettes, it’s important that public health advocates and doctors communicate with their patients about counteracting the marketing that they’ve seen, that this is a “safe product.” To educate them that “we don’t know that this is safe product” – and that there is a mounting body of research evidence that shows that they are not, and that particularly flavored e-cigarettes may be dangerous, and certain flavors may be particularly dangerous. For example, the 2016 Surgeon General’s report on e-cigarettes and youth had an entire 24-page chapter just briefly summarizing the research evidence about the health harms and risks involved with e-cigarettes and their ingredients.
 

There have been cases of children drinking candy-flavored e-liquids (because they are candy-flavored and they don’t know what they are) and dying. Over the course of two to three years, calls to poison control centers have gone from 1-2 calls per month to 200+ calls per month a few years ago.
 
I once watched a friend try to refill her e-cigarette: she didn’t have it perfectly upright, and when she opened it, it spilled all over her hand. I urged her to get up and go wash her hands. I told her, “You need to lock that stuff up at home, because you have toddlers. That is dan-ger-ous!”
 
There is not enough promoted about those kinds of dangers. There are warnings that nicotine is addictive, but they don’t warn about potential poisoning issues and the potential health risks involved with e-cigarette liquids. The FDA is waiting for more research evidence to support more specific warnings.
 
From what I’ve seen with Electronic Health Records and Federally Qualified Health Centers (and the work that my cancer research network has done), there are still a lot of researchers and public health advocates working to trying to get doctors to consistently ask their patients about (traditional) smoking. It will be even longer before asking about e-cigarette use is standard, as well, partly because we don’t have solid answers for doctors to give their patients. EHR companies can help start these conversations by providing assessment tools and educational resources that medical personnel could use as prompts to ask patients about quitting smoking or asking about e-cigarette usage.
 
While we are waiting for the FDA to come out with specific guidelines for doctors, doctors should be talking to their patients about e-cigarette use: educating them that it may not be as safe as they expect, that there are health risks involved, and that switching from smoking to e-cigarette usage is not equivalent to quitting smoking altogether.
 
The safest option is to quit.
 
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Rebecca Williams, MHS, PhDRebecca S. Williams, MHS, PhD
Research Associate, School of Medicine, UNC-Chapel Hill, Cancer Prevention and Control

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This blog is an excerpt from an extensive interview Dr. Williams granted Patagonia Health. Watch for this full expert interview to be published soon!

When battling Flu season, EHR technology can help!

vaccination

During a press conference held on February 15, 2018, both Health and Human Services (HHS) Secretary Alex Azar, and Centers for Disease Control and Prevention (CDC) Acting Director, Anne Schuchat, stressed that this year’s flu season “continues to be extremely challenging and intense” and that “all indications are that flu activity remains high and is likely to continue for several more weeks.” For the past few weeks, the entire nation has been under attack.
 

Clinicians have to do a lot, so how can healthcare agencies step up their game when it comes to combating outbreaks or other emerging health concerns?  By using Electronic Health Records EHR technology that is equipped to face the challenges.  Then managing the process becomes as simple as 1 – 2 – 3!

     

  1. Easily track trends and pinpoint where the FLU is hitting your communities the hardest

A good GIS Health Mapping system, integrated with Electronic Health Record (EHR) data, allows the health department to see actionable data in real time. This can be an effective tool to plan outreach and communicate need/strategy with community stakeholders.

     

  1. Execute an outreach plan – message all community members to let them know where they can get vaccinated

Communication tools built-in to the EHR can automate mass messaging to community members.  This tool can be utilized to education members of the severity of the flu situation as well as where they can get a flu shot.

     

  1. Administer and easily document vaccines given to all patients that walk through your doors

A good EHR will have an Immunization feature that can improve the patient intake process and reduce the data entry efforts required by nurses. Inventory management and bar code scanning software can provide further automation.
 

With this technology at hand, health agencies can improve the management process of an epidemic such as this year’s flu outbreak. If you don’t have the support you need from an EHR, it’s not too late to get a plan in action.  Here’s how.
 

To keep current on the flu outbreak, check out the CDC’s Weekly reports.  And remember, to help prevent the spread of flu, avoid close contact, stay at home if you’re sick, cover your mouth and nose, wash your hands regularly, avoid touching your eyes, nose or mouth, and practice general good health habits.
 

Family Planning Clinics Kick Off the New Year with Cervical Health Focus

Cervical Health Awareness Month

Family planning clinics are promoting Cervical Health Awareness Month – and we all should applaud!
 

Per, the National Cervical Cancer Coalition:  “Nearly 13,000 women in the United States are diagnosed with cervical cancer each year, but the disease is virtually always preventable with vaccination and appropriate screening (Pap and HPV tests).”
 

We should stand up and applaud:  in a world of constant cancer diagnoses, the words “virtually always preventable” are a rare commodity and should be everyone’s vision.  Family planning clinics who are keen to jump on that visionary health-train should be interested in creating a clinic-culture which utilizes every tool in their clinic toolbelt for Education, Screening, and Vaccination.
 

Education

It cannot be said enough: “Knowledge is power.”   Educating the populous of a clinic about significant and broad-spectrum health issues should be a priority – one which extends beyond hanging public service posters in waiting areas and restrooms.  Family planning clinics serious about reaching their clients, therefore, should be utilizing every communication tool available to broadcast accessibility to resources and support groups.
 

Screening

Screening for cervical cancer is usually included in a woman’s annual exam.  Wide-spread screening of a clinic’s population should be a direct result of a clinic focusing on education.   For information regarding screening, check out the links below:

Information of Cervical Cancer Screen in from the American College of Obstetricians and Gynecologists

(Spanish version HERE.)

National Cancer Institute

(Spanish version HERE.)

Centers for Disease Control and Prevention (Infographic)

(Spanish version HERE.)

Per the CDC, every female client of a clinic within the ages of 21-65 should receive regular screening tests.
 

Vaccination

Finally, the NCCC makes the recommendation on their Cervical Health Awareness fact sheet, “Ten Things to Know about HPV and Cervical Cancer” that all boys and girls get the HPV vaccine at age 11 or 12. However, the same fact sheet acknowledges “HPV infections are usually harmless. . .and most are cleared naturally by the body in a year or two.”  Clinics who care should engage their clients in an educated discussion regarding vaccination.  Should vaccination be selected as a course of action, the vaccination is given in two (or sometimes three, depending upon the age of the recipient) doses.   A clinic which utilizes an EHR with an immunization application and a client communicator application is strategically poised to manage the dosing series with effectiveness. . .  all of which will guide the clinic toward being part of the promotion of greater cervical health. . .and have a claim to saying:  “We are doing our part to realize the vision of cervical cancer being ‘virtually always preventable.’”
 

And that’s something we call all applaud.  May the focus of January bring continuing good health through the rest of the year!