Mount Sinai Develops Employee Medical Contact Tracking Database to Mitigate Spread of COVID-19 and Improve Safety

Newswise — Article Title: Development and implementation of a centralized, cloud-based employee medical contact tracking database and predictive modeling framework in the COVID-19 pandemic

Log: The Lancet Digital Health, November 2022

Authors:

  • Kristine B. Rabii, MSc., CIC, Infection Surveillance Officer, Infection Prevention and Control Program at Mount Sinai Beth Israel & NYEE
  • Waleed Javaid, MD, FACP, FIDSA, FSHEA, epidemiologist and director of infection prevention and control at downtown Mount Sinai
  • Ismail Nabeel, MD, MPH, MS, FACOEM, Deputy Medical Director of Employee Health, Safety and Wellness for Mount Sinai Health System

Conclusion: At the onset of COVID-19 in March 2020, New York City was the epicenter of the pandemic, with over 6,000 cases per day and over 1,000 deaths per day. New York City’s health systems and hospitals have faced increasing demands on staff and resources, amid rising numbers of COVID-19 cases among employees. To address the need for agile contact tracing and exposure investigations to mitigate the spread of COVID-19 among hospital staff, Mount Sinai researchers created the Employee Health COVID-19 REDCap Registry – a digital framework based on the cloud using the Web Research Electronic Data Capture application —to track and reduce the spread of the virus in Mount Sinai’s health system, including 8 hospitals and more than 400 outpatient practices.

The database was built with an “event-based” model, where each exposure or “event” was recorded uniquely without deliberately linking it to previous events for the same person or department. This ability allowed Mount Sinai to associate certain events where cluster investigations were needed to identify the pattern of disease spread. This specific design choice for the digital framework also adjusted and responded to significant changes in the COVID-19 disease with the spread of the Delta and Omicron variants.

The REDCap Employee Health COVID-19 Registry provided: collection of employee health data using secure and user-friendly online forms; contact tracing information for employees monitoring the workflow; qualitative analysis of interviews with employees; analysis and integration of genomic sequencing; and the potential of machine learning in future exposure research.

To date, there have been over 50,000 employee interviews and over 500 framework reviews. The platform’s scalable design created dynamic flexibility to incorporate evolving information and expertise around virus transmission, and helped facilitate changes in clinical recommendations regarding COVID-19.

How: The Employee Health COVID-19 REDCap Registry was available through internet-enabled devices, such as mobile devices and desktop computers, with remote access that allowed integration across all Mount Sinai Health System hospitals and clinics. Web forms enabled rapid tracking of employee health services because they could be completed on personal devices and submitted instantly. The employee health department‘s contact tracing interface captured information regarding employee demographics, length of quarantine, personal protective equipment used, and recent COVID-19 testing. Employee Health Services created an exposure matrix to rate reported exposure risk (low, medium, or high). The matrix describes the risk ratings based on the type of exposure; the staff coded the exposure according to the scale. This scoring method could potentially serve as a classification model for supervised machine learning to predict exposure outcomes, the researchers said.

Results: Through the REDCap COVID-19 Employee Health Registry, Mount Sinai Employee Health Services was able to reduce case follow-up times from days to hours. For example, after an employee reported symptoms of COVID-19 to their supervisor, Employee Health Services was able to: follow up with the employee’s manager, conduct the initial contact tracing interview and send the employee home to self-isolate within three hours. Contact tracing of this case led to the detection of an emerging cluster within the department and the direction of transmission was determined by incorporating genomic sequencing data provided by the Mount Sinai Genomics Laboratory.

Why research matters: The development of this tool has provided a robust infrastructure for research on COVID-19. He helped recruit employees during the early stages of the pandemic for the donation of immunogenic plasma and enabled Mount Sinai to determine occupational and non-occupational risk factors for the spread of COVID-19. The Employee Health COVID-19 REDCap Registry provides an easily deployable framework for institutions around the world to successfully control a deadly disease during a pandemic, leveraging a platform available anywhere in the world.

Says Kristine B. Rabii of Mount Sinai about the research: Our goal was to showcase the creativity of Mount Sinai Health System teams and demonstrate that these tools can be used by any organization. We were able to leverage the information collected to track the evolution of COVID-19, using platforms that are not proprietary or hosted in electronic health records. The tools we had at the start of the pandemic did not meet our needs, so our different teams collaborated to create new tools.

Says Dr Waleed Javaid of Mount Sinai about the research: This article describes Mount Sinai’s leadership in rapidly developing a cloud-based database that has helped limit the spread of COVID among our staff and patients. We want to share our knowledge and methodology with everyone, so other healthcare institutions can set up similar shareable databases to protect our communities from dangerous pandemics.

Says Dr Ismail Nabeel of Mount Sinai about the research: We iteratively and meticulously built an agile and responsive system that held its own as evolving variants of the COVID-19 virus wreaked havoc on communities. Our efforts have led us to develop a reliable, customizable and scalable COVID-19 tool that can be shared around the world to protect our very special healthcare heroes on the frontlines and beyond.

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See the full paper here.