William Osler Covid Testing Centres

Project background 
In response to the Covid-19 pandemic William Osler Health Systems established Covid testing centres on parking lots near their Peel and Etobicoke hospitals. 

Patients arrive by car for these tests. The swab tests are carried out by clinical staff located in large marquees erected in the lot. The clinical team has administrative and registration support, also situated in the marquee. 

On arrival in the parking lot, patients were given a paper form which they are asked to complete before the test takes place. The paper form collected demographic data as well as a limited dataset relating to their symptoms. 

Challenges 
Many of the completed paper forms were illegible or exceedingly difficult to read and therefore transcribe. Significant hospital resource was being spent in validating and correcting data from the paper forms, meaning long delays in adding patients to the Meditech EMR. 

Moreover, there was also a significant risk that the subsequent test results were not being returned to patients because of these poor data quality issues. 

Project requirements 
Core requirements 
Savience were approached by William Osler to work with them and to rapidly develop a solution that achieves the following: 

  • Provision of an electronic version of the current paper-based data collection form 
  • Uploading of the captured data from the form into Savience Clarity 
  • Allows the patient arrival to be marked in Savience Clarity 
  • Patient registrations from Savience Clarity to go back into William Osler’s Meditech solution 
  • Production of printed encounter sheets 

Secondary requirements 
Email collection and gaining patient consent 
The electronic form being used must ask patients to provide an up to date email address and to give consent to register for the MyChart patient portal. The collection of patient email addresses has been problematic for some time. 

Test results 
The results of the Covid swab tests will be available to patients through the MyChart portal, made possible by collecting email addresses on the form. 

Project solution 
Savience electronic questionnaires 
The Savience electronic form module enables the design and production of online questionnaires on behalf of any Savience client. 

Savience has deployed this facility to produce a data entry form to meet all the Covid testing requirements listed above. 

The form mirrors the dataset from the manual, paper-based forms and captures the information required to support the testing centres and complete the registration into Meditech. 

Savience already use the electronic form capability to support several NHS based modules, including electronic clinic outcome or clinic noting forms (eCOF). These are installed in sites across the island of Ireland. 

The electronic forms are also deployed at Lennox and Addington Hospital, Napanee, Ontario where they are used to support diabetic clinic treatment plans and to receive feedback about new services offered. 

Deployment of the Covid testing centre solution is deployed on public facing servers, located outside of the William Osler IT infrastructure. 

System security 
A public facing website need not be created on the William Osler infrastructure. The online test centre form is hosted on a fully compliant and secure site with all communication protected via SSL links. 

Cloudflare’s Anycast network protects the site from any denial of service attacks. Patient data is not stored on this infrastructure. 

QR codes at the testing centres 
Savience recommended that large format QR codes are displayed in the parking lots at the William Osler testing centres. Patients are prompted to scan the QR code with their mobile phones, which in turn directs them to the URL where they can access the online form. 

Data from the electronic form is captured and made available to Savience. A timed routine in Savience Clarity collects this information and adds the patient details to Savience Clarity. 

The entry made to Savience Clarity for the patient is set against the appropriate location to ensure it is only visible to the appropriate test centre staff. 

Patients are displayed on Savience Clarity and listed according to the time that the form was completed. 

Savience Clarity in the testing centres 
Savience Clarity displays a list of all patients currently waiting for a test that have completed a form. 

These patients are identified by location. Specifically, only patients who have arrived and completed questionnaires at Etobicoke will be displayed to Savience Clarity users at Etobicoke. Similarly, with patients and staff attending or located at Peel. 

When the patient arrives in the testing bay, they are marked as “arrived” on Savience Clarity by the staff at the testing centre. 

Meditech scripting 
Once a patient has been processed, their registration is scripted back to Meditech, using the referred patient pathway for new patients or by creating a new encounter for existing patients. 

The scripting process is facilitated via our robotic process automation platform, Boston WorkStation. 

Lab ordering and printing 
Scripted registrations from Savience Clarity to Meditech also generates the necessary printed encounter sheet. 

Early project results 
Results for July 2 – 4th inclusive 

The South Fletcher Sportsplex test centre 

1207 patients used the electronic forms 

1186 patients provided email addresses, gave consent, and agreed to register to MyChart 

The Etobicoke test centre (situated at Humber College) 

1344 patients attended 

1268 patients provided email addresses, gave consent, and agreed to register to MyChart

Findings and conclusion 
Savience instantly understood William Osler’s requirements and in turn very quickly designed, built, tested and delivered a solution that addressed all the client’s needs. 

From initial approach and discussions to the solution being rolled out live across both testing centres only took a matter of days. 

William Osler now has a solution that has drastically improved the quality of data captured around the patient testing process. In turn, this has delivered significant savings in both staff resource and the time taken to get patients registered in Meditech. 

An additional bonus benefit has been the volume of patient email addresses collected because of the introduction of the electronic form. The collection of email addresses and receiving patient consent is always a long difficult and labour-intensive process. As a by-product of the main solution, practically 2,500 patients have provided this data in just 2 days! 

From a patient’s perspective, once the test has been performed, they are then able to log into their MyChart account to view the associated results when available. 

Feedback from patients on the new cell phone centred approach has been extremely positive, with comments suggesting they have found the solution design to be intuitive, very easy to use and uncomplicated. 


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