How the Montgomery County Hospital District is using technology to respond to COVID-19

Local government agencies across the U.S. have been forced to completely re-evaluate operations in the face of the COVID-19 pandemic and it’s been no different for us here at Montgomery County Hospital District in Texas. MCHD was established in 1977 to provide healthcare to the indigent residents of Montgomery County. In the years since, MCHD has added operation of the county’s 911 ambulance service, and management of the county’s public health department offering a variety of community and professional education programs. We currently serve a population of over 600,000 residents.

Over the last few months, we’ve worked hard to determine what processes need to be put in place to protect our employees and especially our EMS personnel. Luckily, over the last year, we’ve been building out our first agency-wide online forms with the help of Laserfiche and DocuNav, our solution provider. Had COVID-19 hit six months ago, we would have had to ramp up a lot faster, but luckily the timing of our implementation was perfect.

As with many organizations, the pandemic has changed our operations drastically and these new technologies have been a huge part of making business continuity possible. With departments shifting to work from home, we had to ensure the various departments could continue accessing necessary information while still maintaining HIPAA compliance.

Employee Symptom Tracking

As part of our efforts to protect the health of our essential employees — including doctors, nurses and paramedics — spread across Montgomery County, we rolled out new electronic forms to help track employee temperature and symptoms.

Specifically, the form enables employees to log their temperature and any symptoms they may be experiencing. Employees are required to do the screening every 12 hours, so if employees work for 12 hours, they log information at the beginning and end of their shifts. Our EMS professionals who work 24 hour shifts must do the screening three times. We have this information connected on the back end to our scheduling system to monitor who has missed their check-ins, so supervisors can follow up with those employees. Should employees report symptoms, they receive a message on next steps. The forms also enable dynamic case scenarios, so instructions may differ depending on the individual’s department or role.

If a fever is reported, we have the ability to look at past reports for comparison. To protect employee privacy, only infection control officers have access to individual data, while command and executive staff can see totals and trends by business unit. This form took about a week to get up and running, and has helped to mitigate the risk of spread as well as show our employees that we are committed to a safe work environment.

Easing the Burden of Case Investigation and Monitoring

The county has also been following up on hundreds of confirmed COVID-19 patients, as well as their close contacts. We created a solution that automates the collection and reporting of data related to these cases. People who have been in close contact of confirmed COVID-19 patients can fill out a form online to report symptoms. Additionally, we use these tools to provide electronic testing vouchers for county residents who qualify for subsidized testing.

By allowing people to register and self-report online, instead of having to assign epidemiologists to make twice-a-day phone calls (which they used to do), symptoms can be updated instantly online. We also have the ability to create reports that provide critical insights into the health of the county while protecting patient privacy in accordance with HIPAA.

Innovating with Telemedicine and Planning for the Future

Montgomery County District Hospital is in the planning stages of offering telemedicine appointments through a mobile app. As part of the telemedicine process, an automated workflow that we created supports the collection, centralization and protection of patient information, signed consent forms and charts in the repository, helping us to provide continuity of care. MCHD already had the repository set up with security settings in place, so we are able to comply with HIPAA requirements.

Using these new tools, we have been able to roll out new forms and automated processes in a matter of weeks, without adding additional staff or investing significant amounts of resources. It has been exciting to see the success of using electronic forms and business process automation across the organization. While things have taken a slight shift in focus, we’re still working on projects that will take us beyond COVID-19. We’re lucky to be able to continue process improvement while simultaneously maintaining ease of use for everyone.

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Shawn Henners is the electronic business process manager for the Montgomery County Hospital District.