Evaluating and Enhancing Health Information Technology for COVID-19 Response Workflow in a Specialized COVID-19 in a Medically Underserved Community

项目总结/摘要 COVID-19大流行暴露了美国医疗保健系统的漏洞， 这是对医院恢复能力的严峻考验联合国系统面临着与联合国系统各方面有关的巨大挑战， 灾害医学，包括预防，如遏制战略，以防止蔓延;准备，如 确保测试和个人防护设备的充足供应;以及应对措施，如预测 激增事件，并确保足够的人员配备、空间和供应。一个强有力的灾难医学反应需要 医院参与快速，基于证据的决策，需要做出资源决策 分配、病人护理和其他因素。不幸的是，即时数据可能不容易访问， 迅速变化的环境和不确定性使决策更加复杂。健康信息 技术（HIT）有潜力加强紧急流行病响应，但在 数据的可用性和有效列报，这是广泛记录的。拟议项目将审查 通过医院复原力、决策和人为因素的透镜， 布鲁克林大学医院（UHB）的工程，一个资源较低，但高度影响COVID-19安全- net医院位于纽约布鲁克林，将作为主要站点。哥伦比亚大学欧文 医学中心（CUIMC）将作为目标1的次要研究中心，以提供比较点。拟议 研究将通过以下方式解决有效应对流行病的关键障碍：（1）确定信息和数据 当地医院决策者的需求和（2）围绕决策任务的特征化工作流程。的 这一初步评估的结果将被用于为新型命中信息技术解决方案的设计和原型设计提供信息， 现有的系统和技术，有可能支持决策和医院的弹性， 流行病研究的第一阶段，包括目标1和2，将是一个发现过程，其中研究 小组采访并观察了UHB和CUIMC应急响应小组的成员， 反应该小组还将采访为决策提供必要投入的关键线人 过程和谁接收输出，如临床部门的主任。第2阶段（目标3）将研究 方法和工具如何支持UHB应急管理响应小组的信息和工作流程 需求将开发一组原型，包括仪表板，可视化和数据集成工具。 研究小组还将调查是否建立了可组合（拖放）界面平台， MedWISER可用于制定解决方案，以满足信息需求并增强决策。的 最终目标是促进开发一个更强大的平台，以满足信息需求， 加强决策能力和复原力，以应对大流行病造成的巨大压力。

Project Summary/Abstract The COVID-19 pandemic has exposed vulnerabilities across the United States healthcare system and provided a serious test of hospitals’ resilience. The system has faced formidable challenges associated with all facets of disaster medicine, including prevention, such as containment strategies to prevent spread; preparation, such as ensuring sufficient supplies for testing and personal protective equipment; and response, such as anticipating surge events and ensuring sufficient staffing, space, and supplies. A robust disaster medicine response requires hospitals to engage in rapid, evidence-based decision-making where decisions need to be made on resource allocation, patient care, and other factors. Unfortunately, just-in-time data may not be readily accessible, and decision-making is further complicated by rapidly changing circumstances and uncertainty. Health information technology (HIT) has the potential to enhance the emergency pandemic response but has shortcomings in terms of usability and effective presentation of data, which are widely documented. The proposed project will examine local COVID-19 response through the lens of hospital resilience, decision-making, and human factors engineering at University Hospital of Brooklyn (UHB), a lower-resource, but highly impacted COVID-19 safety- net hospital located in Brooklyn, New York, which will serve as the primary site. Columbia University Irving Medical Center (CUIMC) will serve as a secondary site for Aim 1 to provide a point of comparison. The proposed research will address a critical barrier to effective pandemic response by (1) identifying information and data needs of local hospital decision-makers and (2) characterizing workflow around decision-making tasks. The results of this initial evaluation will be used to inform the design and prototyping of novel HIT solutions leveraging existing systems and technologies that have potential to support decision-making and hospital resilience to pandemics. Phase 1 of the research, consisting of Aims 1 and 2, will be a discovery process in which the study team interviews and observes members of the UHB and CUIMC emergency response teams central to pandemic response. The team will also interview key informants who provide necessary inputs into the decision-making process and who receive the outputs, such as directors of clinical departments. Phase 2 (Aim 3) will investigate how methods and tools support the UHB emergency management response team’s information and workflow needs. A set of prototypes will be developed that include dashboards, visualizations, and data integration tools. The study team will also investigate whether an established composable (drag and drop) interface platform, MedWISER, can be used to fashion solutions to address information needs and enhance decision-making. The ultimate objective is to facilitate the development of a more robust platform to meet information needs and enhance decision-making capabilities and resilience in response to the formidable strain imposed by a pandemic.