Hospitals put their digital contact-tracing tools to the test
WHEN A HEALTHCARE WORKER tests positive for COVID-19, it kicks off a labor-intensive process inside the hospital to track down which colleagues they’ve interacted with and therefore could be infected, too.
The process, which applies to all infectious diseases, is largely bootson-the-ground and tasks staff with reviewing work schedules and asking people to recall whom they’ve interacted with.
That sounds like a promising activity to automate, but so far, that hasn’t been the case. “It really is a manual (process), looking back on schedules and assessing what the workflow of the individual is,” said Jamie Harkins, senior vice president of quality, safety and risk management at Peoria, Ill.-based OSF HealthCare.
After an employee tests positive for COVID-19 at OSF, a contact tracer team tracks down which other staff members might have been in close proximity to the employee while they were infected. The information is shared with OSF’s occupational health team, which alerts relevant employees about the COVID-19 exposure and next steps, based on an assessment of whether the exposure was high or low risk. The risk assessment relies on rapidly changing guidelines from the local public health department and the Centers for Disease Control and Prevention.
To streamline the process for reaching out to employees who had lowrisk exposures, OSF developed a system using email notifications that can be pushed to employees from within the health system’s quality management software. Employees with low-risk exposures are mainly provided an alert and education materials. A high-risk COVID-19 exposure would warrant direct outreach and asking the employee to report symptoms for 14 days.
While contact tracing has existed for decades, technology companies in recent months have released tools they say can help support the time- and labor-intensive process.
Apple and Google in the spring released software tools for public health agencies to build exposure notification apps. The basic idea was for the agencies to build apps using the companies’ application programming interfaces, which can identify devices near each another and alert users if they’ve been near someone later diagnosed with COVID-19.
Apple and Google billed
“It really is a manual (process), looking back on schedules and assessing what the workflow of the individual is.” Jamie Harkins, senior vice president of quality, safety and risk management at Peoria, Ill.-based OSF HealthCare.
the project as “privacy-preserving contact tracing” since it’s opt-in and doesn’t collect identifiable data. The project has been met with skepticism as health authorities question whether apps provide useful information and the public’s concern grows over tech companies getting involved with health efforts.
On a smaller scale, employers— including hospitals and health systems—have started rolling out software tools that track the time workers spend in close proximity with one another to aid internal tracing.
“I’m not quite sure what value they bring,” said Dr. Georges Benjamin, executive director of the American Public Health Association. Traditional contact-tracing practices emphasize testing and monitoring employees who have been exposed to a specific infection, but these new tools screen all employees. That could raise possible privacy concerns, he said.
Flagler Health+ in St. Augustine, Fla., is getting ready to deploy a contact-tracing tool. It’s part of HealthySite+, an app it developed with digital health company Healthfully to provide employees with COVID-19 education, daily symptom screening, telemedicine visits and other services to manage bringing them back to work.
The app’s contact-tracing feature uses Bluetooth to spot when two mobile devices with the app downloaded—so, presumably two employees—are within roughly 6 feet of one another. The app also records the amount of time that two devices spend near each other.
After an employee tests positive for COVID-19, that proximity information will be shared with Flagler Health+’s infection prevention team. The app can automatically alert employees of a possible exposure, but Flagler Health+ doesn’t plan to enable that feature.