County discovers power of pen in pandemic planning
Department officials knew that if an actual flu pandemic occurred, they would need to treat as many residents as possible—as quickly as possible. To help achieve this state of readiness, county officials held a preparedness drill last fall, which typically is just prior to when flu season begins.
To streamline the process of treating thousands of people quickly, the department used digital pen and paper technology invented by Anoto Group AB. A growing number of hospitals and nursing homes around the country are using the technology, which automatically converts handwritten information into digital files in just seconds.
The digital pen and paper technology came in particularly handy during a drill in which the department issued real doses of the year’s seasonal flu vaccine, free of charge, to volunteers from the public. The ultimate goal of the exercise was to achieve a vaccination rate established by the U.S. Centers for Disease Control and Prevention (CDC). Based on the county’s process rate from the exercise to pilot-test the digital pen and paper system, county officials found that the rate indeed was possible.
A total of 267 patients from the general public filled out personal health surveys with the special pens. The details from each survey determined whether the patient should be seen by a nurse for further screening prior to receiving the vaccine. The pen was able to capture patients’ information, process it immediately and alert a nurse.
A pandemic of any magnitude has the potential to change lives, which is why the Solano County Health and Social Services Department has invested in providing the public with free flu shots. The process of providing free flu shots offers the department a realistic simulation of the logistics involved with dispensing mass numbers of vaccine doses in a pandemic situation. The innovative digital pen and paper technology offers the speed, ease of use and efficiency needed to safely process patients.
“Solano County Public Health is constantly working to prepare for public health emergencies, including the very real possibility of a pandemic flu,” said Robin Cox, health education manager for Solano County Public Health, a division of the Solano County Health and Social Services Department. “This technology gave the county health care professionals the critical patient information in real time to ensure that they were able to administer the flu vaccine to patients who would not have an adverse reaction. They were also able to assess the geographic locations that need additional communication of the U.S. Department of Health’s message.”
Quick collection of data was critical
The Solano County team spent weeks preparing for the flu vaccination event, and team members called upon the services of 101 county employees, including doctors, nurses, health educators, the county public information officer and numerous county line staff.
Arthur James, president of San Jose, Calif.-based IS2BE, customized the digital pen and paper technology for the program. James provided approximately 100 pens and developed the survey templates.
During the event, 267 members of the public participated and were screened, with 265 receiving vaccinations. Officials deemed two patients potentially allergic to the vaccine and therefore did not administer the vaccine to those two individuals.
The data collected during the screening process was critical in helping nonmedical staff determine whether the patient would need to be screened a second time by a nurse, allowing proper pre-vaccine injection protocol to flow. In this landmark trial, the speed with which health officials processed patient information played an essential role in Solano County achieving its objective of vaccination. A contributing factor was that the digital pen and paper system was able to immediately collect and process the health history and contact details of each patient in real time.
Fewer data errors
For the preparedness drill, the Solano County Health and Social Services Department had three key objectives: Promote the availability of the free flu vaccine; promote the community health event; and promote the importance of safely administering the vaccine to county residents.
As part of the safety goal, officials created a survey to capture patients’ medical history and contact information as well as guide the patient in a workflow question-and-answer process. In the end, the department was able to evaluate how well it marketed the event while also determining how well its targeted marketing messages reached the community.
To provide enough room for the elaborate operations involved in the preparedness drill, officials decided to hold the event at the Solano County Fair Grounds.
The first order of business for county officials was to establish a proper screening protocol. The protocol involved two screening processes. The first process involved nonmedical screening personnel who would distribute approximately 100 digital pens and health surveys printed on digitally encoded paper. The survey was developed in a way that would guide the patient through a series of comprehensive workflow questions and answers. The questions needed to be answered and documented prior to anyone being given the vaccine.
Thanks to the digital pen and paper, the participants could supply important details of their own medical history—such as allergies—as well as their addresses and contact details. The staff noted that fewer data errors occurred when participants filled out their own surveys.
Additionally, the use of digital pen and paper reduced the need for data entry and hastened the speed at which survey data could be processed. The patient’s data could be downloaded immediately from the digital pen and used by nonmedical screeners to decide whether to send the patient for further screening by a nurse.
The final process entailed another check-in with the participant before the actual administering of the vaccine by the nurses. Nurses conducted the second screening process because they are better-qualified to determine whether or not a patient could have an adverse reaction to the vaccine.
Medical intelligence developed
Using the digital pen and paper, the county exceeded the goal of seeing 250 patients an hour. The digital pen and paper technology allowed for easy collection of data that could be used and processed immediately. County officials also discovered that the digital pen and paper caught errors by nonmedical screeners who may not have correctly directed patients to see a nurse due to their answers on the digital form, in real time. As the digital pen’s data was downloaded on site, the nurse would be alerted immediately that the patient would need further screening prior to receiving the flu vaccination.
Additionally, the pen and paper technology enabled county officials to analyze the data collected and develop helpful medical intelligence, such as the fact that approximately 15 percent of the public would need to go through a secondary screening. Equipped with this knowledge, officials could staff accordingly for a real pandemic.
Also important was the ability to seamlessly integrate participant addresses captured from the pen with a Google Maps program to see how effectively officials promoted the event in each city and area within the county. By identifying the areas of the county where residents did or did not show up to receive the free flu vaccine, county officials gained valuable insight for future marketing and promotional efforts.
Most importantly, simulating the process of quickly dispensing the vaccine to a large number of residents gave county officials confidence that they could respond quickly and effectively to a flu pandemic.
Michael Frenn is the EMS agency administrator for Solano County and is president-elect of the Emergency Medical Services Administrators Associations of California.
The Solano County Health and Social Services Department employs more than 1,262 employees working in 22 offices throughout Solano County and is organized by seven program service areas.
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