Infection Surveillance System Targets Disease Hotspots – From COVID-19 to Influenza

An analytics company that draws on data entered into skilled nursing facilities’ electronic medical records (EMRs) launched an infection surveillance system designed to capture signs of infection early – whether from COVID-19 or influenza – and slow outbreaks.

Real Time Medical Systems, which is based in Linthicum Heights, Md., launched its DiseaseWatch data collection service in mid-June. It provides health care providers and SNFs with a centralized platform informed by EMR data.

The platform is currently being used by the Institute for Health Metrics and Evaluation, an independent population health research center at the University of Washington, Real Time executive chairman Dr. Scott Rifkin told Skilled Nursing News on June 19. The institute creates models used by the White House, the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) and others, he said.

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DiseaseWatch paints a fairly comprehensive picture of a SNF’s ongoing disease situation because it draws from information entered into the EMR – which most SNFs have, Rifkin told SNN – rather than Minimum Data Set (MDS) information or billing data.

“So at 10 o’clock, you’re looking at 8 a.m.’s data,” he said. “It’s that recent. So a director of nursing can say, ‘Hey, I’ve got a hotspot in my building.’ Or people in operations for a chain can say, ‘Look, two of my buildings, one in Oklahoma and one in Minnesota, are hotspots. I’d better get on the phone and talk to those buildings and make sure we’re doing all the right things.’ It’s like a fire alarm … you want it to go off when there’s a little bit of smoke.”

Real Time’s software is in more than 1,000 buildings in 42 states across the U.S., with over 120,000 patients. In April, it announced that Montgomery County in Pennsylvania would use the analytics firm’s surveillance system in the county’s nursing facilities.

The DiseaseWatch system is different from that surveillance system, however, in that it draws on all of Real Time’s data resources by putting the product into a platform, “very much a turnkey kind of solution” for a nursing home company of any size, or even an association, according to Rifkin.

“What we’ve got now is a very convenient tool that anyone can use to find the hotspots three to five days before testing,” he said. “The big advantage to that is that if you can start testing and tracing and isolating people a few days earlier, you have less people to test and trace and isolate.”

Testing has emerged as one of the key factors in containing the spread of the virus in the nursing home setting. In Colorado, Vivage Senior Living found that by aggressively testing its staff members and sending those who were COVID-19 positive home, cases plummeted.

“What we’ve learned is that, as we told people to go home if they’re positive, the number of new cases has gone down, down, down — down to zero in most of the facilities,” Dr. Nicole Ehrhart, director of the Columbine Health Systems Center for Healthy Aging at Colorado State University, who worked with Vivage on the testing, told SNN in May.

Nursing home associations in given states have been particularly interested, Rifkin said, which he believes is a good thing.

“We believe that the industry needs to be at the forefront of being the solution to the COVID issues,” he argued. “We don’t want the government to tell us necessarily how to handle prevention and everything else. Either the industry is going to take the lead or the government will take the lead, and we want the industry to take the lead. So to that end, we’ve reached out to a bunch of state associations and said: ‘Look, we’d be happy to make this available to your entire membership.’”

The goal is to then go to different states together to talk about how to be the solution, about the funding needed at different levels, and about how SNFs can provide the ability for members to pick up hotspots early through the technology. All the while, the data will be housed at Real Time and available to associations without being part of a state system, Rifkin said.

“This COVID issue is not going away overnight,” he told SNN. “And the other thing to remember is that the way public health departments are going to look at epidemic [and] pandemic risk is going to be different for the next 10 years – at least. So these are the kind of things state associations are going to be working on with their own membership and in partnership with their own health departments.”

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