RAPID: Decentralized Telephonic Triage System for Charitable Clinic COVID-19 Crisis Response

由于COVID-19，对慈善诊所（国家卫生保健安全网）的需求比以往任何时候都大，需要额外的能力来帮助应对大流行对社区的影响。但与医院系统和大型临床网络不同，慈善诊所缺乏人力或技术基础设施来管理巨大的需求，特别是与COVID-19有关的信息、转诊、临床护理和与COVID-19无关但受其影响的临床护理的电话请求数量不断增加。患者呼叫的大量涌入导致不必要的高风险就诊，以解决适合远程医疗的问题，并由于诊所超载而增加了急诊室的利用率。除了暴露风险外，如果工作人员不能适当地分类和管理电话请求，健康和财务结果也会受到影响。本研究的目的是评估创新技术工具helpinesos的有效性和可行性，该工具提供分散的电话分诊解决方案，使慈善诊所能够快速接听与COVID-19相关的非紧急电话。该项目将由非营利组织Sostento Inc.执行，该公司的使命是在当地研究经理和专门从事电话分诊系统的专家的支持下，以拯救更多生命的方式帮助处于公共卫生紧急情况前线的组织。该项目的关键研究问题是：1)探索该技术产生患者和系统行为结果的能力（减少高风险的诊所就诊，让员工负担其他地方更好地回答的问题，以及从急诊室分流），以及2)确定诸如此类的新技术的可接受性和可采用性。这项研究是在对helpinesos进行成功的试点和概念部署验证之后进行的。乔治亚慈善护理网络，一个慈善诊所网络，已经确定了更多的诊所采用该工具，并参与了一项研究，以确定该技术的有效性和在全州范围内部署的可行性。预计项目成果将有助于采取措施减轻COVID-19对公共卫生、社会和经济的负面影响。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Due to COVID-19, the demand on charitable clinics, the nation’s health care safety net, is now greater than ever, and additional capabilities are needed to help combat the impact of the pandemic on their communities. But unlike hospital systems and large clinical networks, charitable clinics lack the human or technological infrastructure to manage the tremendous demand, specifically the increased volume of telephonic requests for information, referrals, clinical care related to COVID-19, and clinical care unrelated but impacted by COVID-19. The influx of patient calls has led to unnecessary high-risk visits to the clinic for issues appropriate for telemedicine, and increased emergency room utilization due to clinic overload. In addition to exposure risk, health and financial outcomes are impacted when staff cannot appropriately triage and manage telephonic requests. The goal of this research is to assess the efficacy and feasibility of an innovative technology tool, HelplineSOS, to offer a decentralized telephonic triage solution so that charitable clinics can rapidly answer non-emergency calls related to COVID-19. The project will be conducted by Sostento Inc., a 501c3 nonprofit whose mission is to help organizations on the frontline of public health emergencies in ways that will save more lives, with the support of a local research manager and experts with specialization in telephonic triage systems.The critical research questions of this project are 1) to explore the ability for the technology to produce the patient and system behavioral outcomes (reduce high risk clinic visit, burden staff with questions better answered elsewhere, and triaging away from ERs), and 2) to determine the acceptability and adoptability of a new technology such as this. The research follows a successful pilot and proof of concept deployment of HelplineSOS. The Georgia Charitable Care Network, a charitable clinic network, has identified additional clinics to adopt the tool and participate in a study to determine efficacy of the technology and feasibility for a state-wide deployment. It is expected that project outcomes will enable approaches that mitigate the negative effects of COVID-19 on public health, society, and the economy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.