A new tool developed by a Weill Cornell Medical College researcher can enhance patient care and surveillance in Ebola treatment centers in Western Africa, where the risk of disease transmission and bulky personal protective equipment prevent the use of computers and other electronic devices at the bedside. The spreadsheet tool puts accurate, up-to-date clinical information in the hands of providers, literally: It synthesizes a patient’s medical data to generate customized, printable lists that can be carried through the treatment facility to improve care delivery. It is freely available from the website of Weill Cornell’s Institute for Disease and Disaster Preparedness.
|Dr. Nathaniel Hupert.|
The tool meets a critical need for tracking a patient's clinical information (such as laboratory test results) and movement through different treatment areas without depending on electronic devices, which are prohibited in “hot zones” that require healthcare workers to wear extensive protective gear, according to Dr. Nathaniel Hupert, who created the tracking tool with Dr. Lewis Rubinson, associate professor of medicine at the University of Maryland School of Medicine. The spreadsheet can be easily updated and summarizes medical and laboratory data so clinical staff are fully aware of patients' status while in the center. The tool also provides summary data to estimate the number of Ebola cases in the community – as well as other infectious diseases such as Lassa fever and malaria – and track their spread, assisting healthcare officials with coordinating local care delivery and regional disease surveillance.
"The tool helps fill a gap in generating accurate, up-to-date information for healthcare providers working in regions lacking basic infrastructure," says Dr. Hupert, associate professor of healthcare policy and research at Weill Cornell. "It streamlines data collection and display, so at the click of a button, healthcare staff can generate concise, daily reports of a patient's whereabouts and lab results." Most Ebola treatment facilities have a computer capable of running a spreadsheet program and a printer, which are all that are required to run the new tool.
The project began in response to a request from a treatment center in West Africa where volunteers knew of Dr. Hupert's previous federally funded work in clinical resource modeling for emergencies and emerging infections. "People generally expect their own doctors to know who they are, what their clinical course has been, and what their latest test results show; our hope is that this tool will be useful in helping the overburdened healthcare staff currently working in Ebola treatment centers provide the same level of care for their patients," Dr. Hupert says.
The tool is tailored to the unique features of these centers. Data entry is organized by the different treatment areas in each facility (which are separated by suspected, confirmed, and convalescent cases), and the tool allows users to generate customized, unit-specific printed reports that they can carry into these areas on each shift, getting around the electronics ban. Clinicians exiting the "hot zone" may then communicate updates and changes in patient status verbally to other workers in areas with computer access so that the tool can be kept up to date for the next round of clinical care. As this is a work in progress, Drs. Hupert and Rubinson encourage users to adapt the tool to best meet their needs, and welcome any enhancements that may improve its usefulness.
"We hope that the tool, which is currently in use, will complement other information technologies being introduced in the field and will accomplish two important goals: helping front-line workers do their daily jobs, thereby helping to mitigate the spread of Ebola," Dr. Hupert says.