Flexible, Rapidly Configurable Health Information Technology for Pandemic Response

Karim Keshavjee, Dalla Lana School of Public Health; Yalini Senathirajah, Dalla Lana School of Public Health; Wendy Nelson, Dalla Lana School of Public Health

Electronic health records (EHRs/EMRs), are central to healthcare delivery. During a pandemic, EHR technology must adapt to unpredictable changing disease definitions, new manifestations, daily discoveries, and emergent needs, including coordination with public health experts.  Currently, making changes or new functions in EHRs can take hours to weeks, and must be done by vendor or in-house programmers, taking time, with potential miscommunication between clinicians and IT staff. This can hamper timely responses in adapting EHRs for rapid patient risk assessment and treatment. The time lost can be critical in a pandemic.

We will test an innovative ‘composable’ EHR add-on drag/drop platform which gives nonprogrammer clinicians or public health end users the ability to adapt the health IT themselves, rapidly (in minutes) letting them create and share new tools, interfaces, data, and visualizations. It supports rapid EMR changes by clinicians as clinical protocols evolve, with automated data gathering. Realistic simulation scenarios of emergent pandemic conditions will be used to test the technology with clinicians and public health experts to assess usability and fit to task, and further explore its reception and feasibility via in-depth interviews/surveys with other stakeholders, including equity-deserving patients, and decision makers from policy, IT, management, and vendor personnel. This will evaluate perceptions, feasibility, new functions needed (especially re: equity), policy or other changes needed, and likely effects on future pandemic readiness.  The innovation also has benefits for usability and clinician efficiency so there is a solid rationale for its use in non-pandemic times, in place for future emergencies.