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

由于新冠肺炎，对慈善诊所-国家的医疗安全网-的需求现在比以往任何时候都大，需要更多的能力来帮助抗击疫情对他们社区的影响。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，特别是越来越多的电话请求信息、转诊、与新冠肺炎相关的临床护理，以及与新冠肺炎无关但受到新冠肺炎影响的临床护理。患者电话的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，并由于诊所超负荷而增加了急诊室的利用率。除了暴露风险外，当工作人员不能适当地对电话请求进行分类和管理时，健康和财务结果也会受到影响。这项研究的目的是评估创新技术工具HelplineSOS的有效性和可行性，该工具提供去中心化的电话分流解决方案，以便慈善诊所能够快速响应与新冠肺炎相关的非紧急呼叫。该项目将由501c3非营利性组织Sotento Inc.进行，其使命是在当地研究经理和电话分流系统专业专家的支持下，以拯救更多生命的方式帮助处于公共卫生突发事件第一线的组织。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(减少高风险诊所就诊，让工作人员负担更好地在其他地方回答的问题，以及分流离开急诊室)，2)确定像这样的新技术的可接受性和适用性。这项研究是在HelplineSOS的成功试点和概念验证部署之后进行的。慈善诊所网络佐治亚州慈善护理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部署的可行性。预计项目成果将有助于采取措施减轻新冠肺炎对公共卫生、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，并已通过使用基金会的智力优势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.