Using Technology to Enhance Infectious Disease Screening During an Outbreak

Abstract

<h3>Background</h3> From September 2018 to August 2019 New York City experienced a measles outbreak in which 649 cases were identified. During the peak of this outbreak in April 2019, the New York Department of Health emphasized that hospitals should perform enhanced screening to quickly identify and isolate patients with measles. In order to effectively screen for measles the Infection Prevention Department within a large health system partnered with several other hospital departments to design and implement a digital measles screening tool. <h3>Methods</h3> An anonymous screening tool was created using a free and publicly available digital survey application. The tool was administered by hospital personnel to patients near facility entrances, and it asked questions about measles symptoms, vaccination history, exposure history, and place of residence. The tool followed an automated question algorithm that led to one of two outcomes: masking the patient and immediately contacting clinical staff for further assessment; or allowing the patient to proceed forward. Security officers and other front line staff were provided with tablets or computers and educated on how to use the tool. Infection Prevention staff routinely electronically monitored use of the tool and provided feedback over the three month enhanced screening time period to ensure compliance. <h3>Results</h3> Approximately 59,435 patients were surveyed using the digital measles screening tool from 4/25/19 through 8/4/2019. Of these patients, 91 (0.15%) flagged as high risk and required further evaluation by clinical staff to rule out measles. None of these 91 patients were later diagnosed with measles. No cases of confirmed measles were reported at the screening sites during the intervention time period. <h3>Conclusions</h3> The results of the intervention indicate that digital survey applications are effective alternatives to paper screening tools during an outbreak due to ease of use by non-clinical staff and remote compliance monitoring capabilities.