The use of decision support for inpatient rehabilitation during the COVID‐19 pandemic: Responding to a rapidly evolving health care crisis

Abstract

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has abruptly affected how health care is provided. The pressing issues for many organizations in response to the COVID-19 pandemic include identifying infection control standards, staffing and equipment needs, establishing care protocols, minimizing staff exposure, and ensuring staff is educated on latest updates. As clinical guidelines, testing protocols for diagnosis, and treatment regimens continue to evolve, it has become increasingly difficult for health care providers to keep up with the new information. This pandemic has affected all levels of care including postacute care services such as inpatient rehabilitation facilities (IRF). IRFs also have unique challenges such as how to safely provide rehabilitation for these patients. Decision support is a common concept in clinical informatics. As defined by the Health Information Management System Society (HIMSS), clinical decision support is “a process for enhancing health-related decisions and actions with pertinent, organized clinical knowledge and patient information to improve health and healthcare delivery.” The primary focus is to present the user with information to better inform them during decision making to improve patient safety and outcomes. Decision support can take many forms such as rules and alerts that appear based on user actions. The use of standardized order sets that have the relevant orders for a particular diagnosis or condition is a common example. Another example is the presentation of key information on a computer screen in the electronic health record (EHR) or on a printed report. Decision support can be a useful strategy to help alleviate many of the challenges seen with the rapidly evolving information regarding COVID-19. Although there are examples of the application of decision support in response to COVID-19 in acute care settings, this article focuses on the application of decision support in an IRF. The purpose is demonstrate the use of decision support to aid in the screening, diagnosis, and evaluation of patients with COVID-19 in an IRF as well as informing providers of the latest information related to COVID-19.