CinC - Omicron Response - Data and Digital Information Sessions - Regional Coordination Centre Sess

COVID-19 Care in the Community Omicron Response – Data and Digital Information Session Community Coordination Centre Session 5 Week commencing March 7th 2022

COVID-19 Care in the Community Purpose/ Agenda No.

Agenda Item

1

Introduction

2

Current State

3

Release Timeline

4

Risks and Issues

5

Question and Answer Session

6

Next steps and close

Current State and Release Timeline

COVID-19 Care in the Community Omicron response phases We are here

1

Phase 1

• Begin shift to self service and automation • Low proportion of positive cases using self service tools • Clinical care delivered by primary care teams, supported by the local care coordination hub • All steps taken to support cases to isolate in their usual place of residence, with alternative accommodation options across the regions identified and being utilised • Preparedness activities progressing, including scaling community connector service, bringing forward tagged provider funding where appropriate • Community providers designated as a critical workforce

2

Phase 2

3

Phase 3

• Transition to cases using self service and automation

• Majority of positive cases are self managed

• Other people with lower clinical risks, but with welfare needs may still require support through the welfare response

• Clinical care is focused on those with high needs

• Clinical care delivered by primary care teams, supported by the local care coordination hub for those with a requirement for ongoing clinical care • Support for positive cases to isolate in their usual place of residence. Alternative accommodation options across the regions are identified and being utilised, with some areas becoming stressed

• Wraparound health and welfare support services will focus on those with high needs • Support for positive cases to isolate in their usual place of residence and unlikely there will be alternative accommodation capacity available for cases that are unable to safely isolate at home

• Close engagement with all of government providers to ensure access to services is provided from a range of entry points

• Lower risk individuals and households with welfare needs may present through other channels/services (such as community providers) as case numbers reach very high levels

• Community providers designated as a critical workforce

• Community providers designated as a critical workforce

COVID-19 Care in the Community Performance Issue Update The primary focus of the last week has been on improving the consistency of system performance.

Product / Issue

Description

Assisted RATs

Issues with handling of assisted RATs

Resolved

NCTS and CCCM

Interface issues

Resolved

SMS Service

The SMS service was down on Saturday, 5th March.

Resolved

CCCM Tasks

Tasks not saving in CCCM

Resolved

A number of Cases with mobile numbers are not being sent the text message advising that they are positive and sharing the COVID-19 Contact Tracing Form link in Cases in ‘Not Informed’ Queue a timely manner, resulting in them ending up in the queue for Cases who have not been informed

Status

Users have reported intermittent issues with the Request a RAT site

Error with Incorrect Day Zero

We have received reports that the Day Zero date was showing incorrectly in CCCM

Resolved. Monitoring.

Contact Phone Number

Instances where contact phone numbers were not coming through and displaying on CCCM but were available on the NCTS

Resolved. Monitoring.

Performance issues were impacting the speed of CCCM records being created from an NCTS case and resulted in a queue

Fixed applied, Performance has improved. Monitoring Fixed applied, Performance has improved. Monitoring Fixed applied, Performance has improved. Monitoring

CCCM Queuing

Case Events not creating Cases Case Events are not auto-creating Cases for PCR tests

Resolved

Duplicate Household Contacts

Duplicate Household Contact records being generated from the completion of the COVID-19 Contact Tracing Form

Fix in progress.

COVID-19 Contact Tracing Form Errors

Reported difficulties accessing or using the COVID-19 Contact Tracing Form

Fix in progress.

Infectious periods are being calculated incorrectly

Fix in progress.

In some instances, new Cases are being auto-assigned to PHUs instead of Reach Aotearoa

Fix in progress.

COVID-19 Contact Tracing Form Errors New Cases mistakenly autoassigned to PHUs

We are managing ongoing reports of Tasks not being removed from the Dashboard once they are marked as Completed. We are actively working on resolving this issue and will provide an update in due course.

Resolved

Request a RAT website

CCCM Dashboard Performance

Notes

Day Zero cannot be updated through CCCM, and any changes to this will have to be updated in the Symptom Onset field in NCTS by a Hub team member.

We continue to monitor this and if any issues arise, the workaround is manual Case creation.

This may occur when there are multiple Cases within the household completing the form.

Work is underway to clear the duplicates and the teams are working to resolve this issue going forward.

Support lines have been advising people to ensure they notify their contacts and workplaces/education settings that they are a Case, to continue isolating, to refer to the Health Hub for further guidance, and to seek medical or welfare support if they need it.

The NITC is working to move these Cases through the system according to their relevant pathways.

COVID-19 Care in the Community Technology to free up health sector capacity We are rapidly making changes to the technology of the Covid-19 response to address the challenges posed by Omicron. The table represents the key technologies and the target dates for readiness (subject to operational approval).

Operational Use Date 28 February

Deliverable Shortened self-serve contact tracing form “Predicted Isolation End Date” sent to CCCM from NCTS Automatic Closure of Disease Contacts when the person becomes a Case Disable Disease Contacts in CCCM from NCTS:

Targeting 9 March

Isolation Release Notification NCTS case closure Risk Score for Call Prioritisation Self-serve positive case contact tracing reminder text message

Later this week

Enhancements to RAT reporting Clinical portal access in CCCM

Future Updates / WIP

Enhanced digital daily checks of Covid cases for those on active management Third Party and On-behalf RAT reporting

COVID-19 Care in the Community Risk Score for Call Prioritisation The COVID-19 Care in the Community team and the Data and Digital Directorate have developed a population-based risk stratification tool (the Risk Score for Call Prioritisation, or, Risk Score for short) that will be part of the COVID-19 digital platform when a positive case is identified.

•

The tool helps to identify who needs to be prioritised for contact for the first assessment which determines whether their COVID-19 care needs to be supported with active care management or the self-service pathway.

•

The tool will support Care Coordination Hubs by prioritising outreach from the hub to those who have not responded to the initial text outreach to indicate that they are positive for COVID-19.

•

In this first version, the Risk Score should not be used for clinical decisionmaking. As we develop future versions the model, we will continue to undertake additional peer reviews to validate the model.

•

The tool is a simplified model using age, ethnicity and vaccination status data to inform risk of hospitalisation due to COVID-19. This uses 0, 1 or 2 doses.

Booster information will be included in future versions of the model. This model has been developed and evaluated using local data.

While the majority of people notified that they have COVID-19 will complete the online self-assessment tools which gathers information around co-morbidities and other health conditions, many people will not, leaving the Care Coordination Hubs unaware of the persons underlying conditions and current symptoms.

The Risk Score can be used here to sort and prioritise people for call back.

COVID-19 Care in the Community Shortened GP notification from NCTS

Old Notification Community COVID Case Information - COVID Clinical Case Module available Date Reported: Symptom onset date: Patient requires assistance with : Null Coordination of clinical care allocated to: Community Care Facility : Patient’s Location: Null Number of members in patient’s bubble: Additional Information on clinical care is available on your regional HealthPathway COVID-19 Case management in Adults pathway The patient may make contact for telephone consultations and this is being encouraged for continuity of care

New Notification

Raised Issues Sector feedback generated features and updates

COVID-19 Response Raised for Sprint 22.6 – Approx. delivery March 18th What does this mean for me as a GP accessing CCCM via PMS?

Issue Description

The Update

What does this mean for me as a HUB USER?

Currently no dashboard view that shows details of clinically high risk patients/cases of concern.

A 'clinical dashboard' for cloud CCCM/BCMS users will have specific clinical symptom columns to highlight cases of concern for overview management.

I will be able to easily and quickly identify patients under active management with any clinical concerns or deteriorating conditions, as identified/monitored from their regular health check monitoring.

Not being able to search for an apply an address to someone's account using ESAM, so their (case's) correct location of isolation can be provided back to NCTS

The address field on page 3 of the person information will update the address field to be a search box that validates the provided address with eSAM.

As a CCCM user, I will be able to search for an apply an address to update someone's location of isolation and have that provided back to NCTS.

NZePS data is not currently linked to patient CCCM record.

The update will enable medications prescribed in the last 6 months from NZePS to be listed in the initial assessment.

People have lots of ways they prefer to be contacted - the current list of options is not sufficient.

An additional 'Other' option will be added to the Preferred Contact Method drop-down on Page 3 of Person Information in CCCM. This will unlock the box and the user can fill in the preferred method there.

The Discharge/Full Summary is currently not user friendly.

The discharge/full summary will be refreshed to be made more legible and appropriate to community care of COVID.

Acuity filter currently only allows for one number to be filtered at a time.

Update the filter to be 'equal to or greater than'

GPs accessing CCCM via HealthLink are getting constant script errors, which is significantly impacting the user experience.

This needs to stop in order to improve the user experience.

As a care provider, I will be able to see NZePS data about my patient in the initial assessment, saving me time and data (re)entry effort.

I will be able to update the preferred contact method to whatever suits the patient best.

I will be able to recieve in my PMS Patient Outbox an appropriate discharge/full summary for my patients.

I will be able to filter for patients with acuity rating X and above.

I will not receive constant script errors when accessing CCCM via HealthLink.

Questions & Answers Session

Drop in and Training Session

COVID-19 Care in the Community Drop – in Sessions and Training Session Type

Covid Clinical Care Module Virtual Training Sessions (General Practice Specific)

Date / Time

Access

Tuesday 12:00 -13:15 (weekly) Hosted via Teams: HERE Wednesday 17:30 -18:15 (weekly)

CitC Hub End-To-End Training Sessions (CCCM and NCTS)

Wednesday 15:00-16:00 (weekly) Hosted via Teams: HERE Tuesday 15:00-15:30 (weekly)

Covid Clinical Care Module Support Drop-in Sessions

Hosted via Zoom: HERE Wednesday 10:00 -10:30 (weekly)

Thursday 10:00-10:30 (weekly)

Thursday 15:00 -15:30 (weekly)

COVID-19 Care in the Community Webinars and Q&A Sessions: Session Type

Date / Time

Northern Regional Coordination Centre session

Tuesday 11:00-11:30 (weekly)

Southern Regional Coordination Centre session Te Manawa Taki Regional Coordination Centre session

Central Regional Coordination Centre session

Wednesday 11:30- 11:00 (weekly) Thursday 11:30 - 12:00 (weekly)

Friday 11:30 - 12:00 (weekly)

Access Hosted via Teams: HERE Hosted via Zoom: HERE

Hosted via Zoom: HERE

Hosted via Zoom: HERE

COVID-19 Care in the Community Training Materials Training Material Description

The Quick Reference Guide provides an overview of the key tasks you will complete the CCCM.

The Full Training Guide provides a detailed step by step guide of the tasks you can complete within the CCCM.

Care in the Community NCTS User Guide

Access

CCCM Quick Reference Guide

CCCM Full Training Guide

CitC Hub Training Guide

Next Steps and Close

Appendix

COVID-19 Care in the Community 4/5 Overview of System Information Flow

COVID-19 Care in the Community Care management pathways

Care needs assessed by

Most cases will able to self-manage and will follow the yellow and blue self-management pathways.

Cases requiring more clinical support will receive active clinical management following the red pathway.

Active clinical management pathway Coordinated through care coordination hubs and local healthcare providers

Online self-assessment Primary care assessment

Supported self-management pathway

Hub coordinated assessment

Local support over the phone or in person if online not an option

Online self-management pathway Self-managed using online tools Positive test

Assessment

Care pathway escalates and de-escalates as needed

COVID-19 Care in the Community Case management pathways Test

Notification

Supported selfmanaged pathway Local support over the phone or in person if online not an option

+ve

Notified of result by care coordination hubs or local healthcare provider

Most cases will able to self-manage and will follow the yellow and blue self-management pathways.

Cases requiring more clinical support will receive active clinical management following the red pathway.

Assessment

Supported assessment • Clinical assessment • Contact tracing • Welfare needs (flags to MSD)

Self-managed using online tools

Text notification of result with initial instructions

Release

Support escalates and de-escalates as needed

Release according to current public health guidelines

Can escalate care by: • Telehealth • Primary healthcare provider • 111

Release notification

Active clinical management

Self-management vs supported pathway Cases on self-management must be: • able to use online self-service AND • unlikely to need additional health support

Online selfmanagement pathway

Support

coordinated through care coordination hubs and local healthcare providers

Online self assessment • Clinical assessment • Contact tracing • Welfare needs (flags to MSD)

Can escalate care by: • Telehealth • Primary healthcare provider • 111

Release text

COVID-19 Care in the Community Assessing healthcare needs

Cases will self-manage by default but can escalate to active clinical management if indicated by their selfassessment, their primary healthcare provider’s assessment, or contact coordinated by their care coordination hub Key

Primary care notified by Healthlink

Primary care assesses their enrolled higher risk patients and enter details in CCCM

Primary care assessment

National Contact Tracing Solution COVID Clinical Care Module (was BCMS)

New NCTS case

Primary care Case notified by text of result and initial instructions

Patient journey

Online self assessment • Clinical assessment • Contact tracing • Welfare needs

Selfassessment

+ve Hub assigns case to provider who develops care plan based on information from: • Online self-assessment • Telehealth • Primary care

New CCCM case

Risk score based on: • Age • Ethnicity • COVID vaccination

Hubs coordinate contacting higher risk cases who haven’t been assessed by self or primary care

Hub coordinated assessment

Self-management • Patient continues to self manage • Patient can escalate if needed by telehealth, primary healthcare, or 111

Active clinical management De/Escalating as needed: • Automated • General practice • Public health • Hospital

COVID-19 Care in the Community Most cases will be able to self-manage with online support but more clinical support is available for those who need it. The level of healthcare support increases and decreases with need

Enabling self-management Online guidance • • • • •

COVID-19 Health Hub Unite Against COVID-19 Health Navigator Ministry of Health Regional resources

Telehealth • • • •

Healthline Public health units Other regional telehealth Can escalate care as needed

Primary healthcare • • •

Pharmacy Primary healthcare providers for enrolled patients Can escalate care if needed

Critical care

• Urgent care and escalation to hospital level care if needed • Hospital level care is available for those that need it because most are able to self-manage at home

Community care hubs provide local wraparound health and welfare support

COVID-19 welfare line 0800 512 337 Can help cases (who can’t manage with help from friends and family) with: • Access to food and essential items • Mobile data to keep in contact with friends and whānau • Support for personal care or daily tasks • Talking to your employer about your leave or pay • Getting mental health support, or support with family or sexual violence.

Other support • • •

Accommodation Financial support – such as the Short-term Absence Payment and COVID-19 Leave Support Scheme (Work & Income) Whanau Ora.