COVID-19 Screening with an Electronic Health Record Template @ Veterans Affairs Puget Sound Health Care |

This local electronic health record (EHR) note template was launched by Veterans Affairs (VA) Puget Sound Health Care on March 5, 2020 to integrate COVID-19 screening into primary care daily workflows and inform patients about plans of care.

Veterans Affairs Puget Sound Health Care System

Informatics specialists and clinical leaders developed a COVID-19 screening template to adapt to rapidly changing guidelines and reserve testing and emergency resources for those most in need.
Using the template, clinical staff record risk factors and symptoms for COVID-19 and categorize the patient into one of four groups. Each category includes plan of care guidance as well as up-to-date CDC recommendations and state health authorities when appropriate.
Primary care staff screened veterans calling about symptoms or who had upcoming face-to-face appointments. Through partnering with internal informatics and clinical teams, VA Puget Sound quickly created a screening template within the EHR that could be customized to fit local needs.

In a 5 week period from March 5 to April 8, 2020, clinicians used the Puget Sound template to screen 1,338 patients. Approximately 31% of patients were considered to have COVID-19 with 88% rated clinically stable. (These data are not considered formal research per VA policy, see project challenges).

The template supplied data to a daily dashboard on COVID-19 for the entire facility and provided information for daily briefings to the primary care team. Furthermore, primary care leadership leveraged it to track screening and testing volumes.

After presenting the template to the Veterans Health Administration (VHA), a similar EHR template note was adopted at 124 other VHA facilities.

Patients exhibiting less symptoms or those who were at lower risk were likely not captured by this template although their exclusion allowed resources and care to be provided to those who were deemed unstable and at risk.
Not everyone who was screened received a COVID-19 test, thus the authors could not formally conclude the screening note’s accuracy. In addition, they would need data on the prevalence of COVID-19.

Deeds, S. A., Hagan, S. L., Geyer, J. R., Vanderwarker, C., Grandjean, M. W., Reddy, A., & Nelson, K. M. (2020, September). Leveraging an electronic health record note template to standardize screening and testing for COVID-19. In Healthcare (Vol. 8, No. 3, p. 100454). Elsevier.

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Tacoma, WA