Standing up technology in the middle of a pandemic can seem overwhelming, but the right partner can ease the burden, expedite the process and provide support for an overburdened staff.

Over the last few weeks, the Twistle team has been partnering with health systems across the country to deploy COVID-19 pathways:

  • Helping communities with screening and exposure concerns
  • Helping staff members track and monitor symptoms 
  • Helping COVID-19 positive patients (who are well enough to self-monitor from home) 

1. What are my colleagues at other institutions doing?

Over 80% of patients testing positive (or presumptive) can be sent home with active, consistent monitoring. At Providence St. Joseph Health patients are given a thermometer and pulse oximeter and asked to check in using Twistle 3 times per day. PSJH recognized early on that scaling telehealth infrastructure was going to be just as critical as scaling hospital infrastructure. With Twistle, they saw nurse-to-patient ratios grow from 1:15 to 1:65 within the first week of usage, and this is still growing. At St. Joseph Mercy, clinicians and staff are being surveyed and monitored when exposure concerns are present, Twistle is already rolled out or being rolled out this week at Ascension Health, Christiana Care and PSJH Hospitals to monitor staff and COVID-19 patients in their homes and minimize the impact on facilities and staff.

2. We don’t have time and with very limited resources, how can we possibly implement this?

In just 5 days, Providence St. Joseph Health designed, tested and deployed COVID-19 monitoring pathways in King County, and continues to expand the deployment to PSJH hospital sites and partner hospitals throughout the country. COVID-19 pathways are triggered based on positive or presumptive positive patient encounters. These triggers will automatically happen based on an order or HL7 feed, keeping clinicians and staff in their routine workflows with no additional steps. Patients are invited to Twistle’s patient engagement platform, which consists of a text message and a secure link. The secure link allows patients to navigate to a secure web browser where they’re able to fill out and submit the self-monitoring surveys (based on surveillance protocol). Patients are sent text reminders and can even be nudged if a response isn’t collected. The surveys are automatically scored (based on risk) and will trigger an alert to the care team if results warrant follow-up.

3. What are the alternate solutions?

We’re finding that most of our partners are using call centers or trying to adapt their EMR/systems of record. In the case of Providence St. Joseph Health, after an early attempt to use their existing patient portal, the PSJH team recognized that portal adoption and communication would not scale in order to meet the demand and speed of the growing crisis and quickly pivoted to using Twistle’s COVID-19 pathways.

Twistle is working to support as many health systems as possible and is currently able to stand up COVID-19 pathways in as little as 5 days. As the crisis grows we hope to continue to support and force-multiply the strained front line staff and tackle this pandemic together.