Apr. 14, 2020
What-if questions can torment a doctor making coronavirus retest decisions: What if a patient’s initial negative test was a false negative, and he or she needs a second test? What if they don’t need it, and a retest would use up a scarce test kit and treatments that other patients need?
Such challenges led Piedmont Healthcare in Atlanta to establish a paper-based decision tree for ordering COVID-19 retests, and researchers at the Georgia Institute of Technology turned it into an automated digital tool. Piedmont further developed the tool and has now built it into the hospital’s electronic medical record, where it influences the ordering of retests.
A user can answer their “ifs” by clicking through questions, and the “if-this-then-do-that” algorithm makes recommendations for best courses of action, ranging from immediately treating a patient for COVID-19 to retesting to consulting a specialist. The final decision remains with the physician.
The questions are deceptively simple, but the recommendations are not always obvious. That reflects the algorithm’s usefulness to fill gaps in thinking about the new sickness, which can confront clinicians with surprises.
“If a patient has not had close contact with positive patients and the first test came back negative, a physician may think the patient does not need to be retested. But actually, the patient may need a second test because they are in intensive care and also have suspicious chest X-rays,” said Georgia Tech graduate research assistant April Yu, who converted the decision tree into a digital tool.
“One of our big worries in using a brand-new test like the coronavirus test is that it will miss real cases, and this tool helps prevent that,” said Dr. Bronwen Garner, who helped develop the original decision tree and is an infectious disease specialist at Piedmont Healthcare. “It also helps reassure physicians when they get a negative result that it is probably a true negative.”
Suspenseful decision-making
A physician’s reaction to an initial negative test can mean life or death because the physician not only decides on follow-up testing but also on treatment pathways and quarantine.
“If you make a misstep in the thought process, it can lead to cascading impacts not only for the patient but also for healthcare professionals and family members, who may be exposed to the patient,” said Pinar Keskinocak, William W. George Chair and Professor in Georgia Tech’s Stewart School of Industrial and Systems Engineering. “This tool is meant to help doctors easily stay on the decision tree path.”
Michael O’Toole, executive director of Piedmont Healthcare’s quality improvement department, originally pictured doctors getting an automated version of the decision tree to use on their phones. O’Toole called Keskinocak, and she tapped Yu, a member of her research group.
“Literally within four hours they had it ready for us. It was incredible,” said O’Toole, a Georgia Tech alumnus who studied industrial and systems engineering.
“It was a very pleasant surprise,” said Dr. Garner, who is also a Georgia Tech graduate. “Automated tools are better than a paper format because they’re in the same format as orders in our electronic system. We get notifications in real time instead of having to remember to check a piece of paper.”
The tool is in place in the system where doctors order retests and is specific to Piedmont’s workflow. It may not be directly transferable to other health care systems.
Piedmont Healthcare simplified the logic even more, and the hospital built its own custom alerts to guide physicians on retesting. For cases that are more ambiguous, Piedmont Healthcare’s final version of the tool also gives physicians inside the hospital guidance to consult with their in-house infectious disease specialists.
If-this-then-retest
In her original version, Yu had turned the decision tree criteria into a short panel of questions with yes and no answers. It took her six iterations to arrive at her final version.
Yu’s version asked whether the patient:
- has a relevant ailment
- previously tested positive for coronavirus
- is now in an intensive care unit
- has worsening lung conditions
- shows telltale lung damage in imaging
- has been diagnosed with a different ailment
- the patient has had contact with someone else who tested positive for coronavirus.
On the back end, the algorithm guided the user through risks of coronavirus presence based on the answers.
“The steps were easy to follow, and the answers were color-coded for urgency with white, yellow, and red,” said Keskinocak, who also directs Georgia Tech’s Center for Health and Humanitarian Systems.
One bright yellow answer read: “This patient needs re-testing 24 hours after the initial test!” And there were further recommendations on how to handle the case.
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Also read: Advice on DIY masks
Writer & Media Representative: Ben Brumfield (404-272-2780), email: ben.brumfield@comm.gatech.edu
Georgia Institute of Technology
Apr. 13, 2020
Georgia Tech Arts is still seeking projects for the 2021 ACCelerate: ACC Smithsonian
Creativity and Innovation Festival in Washington, DC. All Georgia Tech students, faculty, and staff are invited to apply by May 1, 2020.
Even if you do not have a finished project exploring the intersection of science,
engineering, art, design, and technology, we encourage you to speak with Es
Famojure at esther.famojure@arts.gatech.edu about your concepts.
Learn about Georgia Tech's 2019 participants for some inspiration.
The festival brings together all institutions included in the Atlantic Coast Conference to
celebrate creativity and innovation with a specific focus on science, engineering, arts, and
design. It will be held April 9 -11, 2021 at the Smithsonian National Museum of American
History.
Submit your project for consideration by May 1, 2020 to be considered.
News Contact
Es Famojure
esther.famojure@arts.gatech.edu
Apr. 13, 2020
What-if questions can torment a doctor making coronavirus retest decisions: What if a patient’s initial negative test was a false negative, and he or she needs a second test? What if they don’t need it, and a retest would use up a scarce test kit and treatments that other patients need?
Such challenges led Piedmont Healthcare in Atlanta to establish a paper-based decision tree for ordering COVID-19 retests, and researchers at the Georgia Institute of Technology turned it into an automated digital tool. Piedmont further developed the tool and has now built it into the hospital’s electronic medical record, where it influences the ordering of retests.
A user can answer their “ifs” by clicking through questions, and the “if-this-then-do-that” algorithm makes recommendations for best courses of action, ranging from immediately treating a patient for COVID-19 to retesting to consulting a specialist. The final decision remains with the physician.
The questions are deceptively simple, but the recommendations are not always obvious. That reflects the algorithm’s usefulness to fill gaps in thinking about the new sickness, which can confront clinicians with surprises.
“If a patient has not had close contact with positive patients and the first test came back negative, a physician may think the patient does not need to be retested. But actually, the patient may need a second test because they are in intensive care and also have suspicious chest X-rays,” said Georgia Tech graduate research assistant April Yu, who converted the decision tree into a digital tool.
“One of our big worries in using a brand-new test like the coronavirus test is that it will miss real cases, and this tool helps prevent that,” said Dr. Bronwen Garner, who helped develop the original decision tree and is an infectious disease specialist at Piedmont Healthcare. “It also helps reassure physicians when they get a negative result that it is probably a true negative.”
Suspenseful decision-making
A physician’s reaction to an initial negative test can mean life or death because the physician not only decides on follow-up testing but also on treatment pathways and quarantine.
“If you make a misstep in the thought process, it can lead to cascading impacts not only for the patient but also for healthcare professionals and family members, who may be exposed to the patient,” said Pinar Keskinocak, William W. George Chair and Professor in Georgia Tech’s Stewart School of Industrial and Systems Engineering. “This tool is meant to help doctors easily stay on the decision tree path.”
Michael O’Toole, executive director of Piedmont Healthcare’s quality improvement department, originally pictured doctors getting an automated version of the decision tree to use on their phones. O’Toole called Keskinocak, and she tapped Yu, a member of her research group.
“Literally within four hours they had it ready for us. It was incredible,” said O’Toole, a Georgia Tech alumnus who studied industrial and systems engineering.
“It was a very pleasant surprise,” said Dr. Garner, who is also a Georgia Tech graduate. “Automated tools are better than a paper format because they’re in the same format as orders in our electronic system. We get notifications in real time instead of having to remember to check a piece of paper.”
The tool is in place in the system where doctors order retests and is specific to Piedmont’s workflow. It may not be directly transferable to other health care systems.
Piedmont Healthcare simplified the logic even more, and the hospital built its own custom alerts to guide physicians on retesting. For cases that are more ambiguous, Piedmont Healthcare’s final version of the tool also gives physicians inside the hospital guidance to consult with their in-house infectious disease specialists.
If-this-then-retest
In her original version, Yu had turned the decision tree criteria into a short panel of questions with yes and no answers. It took her six iterations to arrive at her final version.
Yu’s version asked whether the patient:
- has a relevant ailment
- previously tested positive for coronavirus
- is now in an intensive care unit
- has worsening lung conditions
- shows telltale lung damage in imaging
- has been diagnosed with a different ailment
- the patient has had contact with someone else who tested positive for coronavirus.
On the back end, the algorithm guided the user through risks of coronavirus presence based on the answers.
“The steps were easy to follow, and the answers were color-coded for urgency with white, yellow, and red,” said Keskinocak, who also directs Georgia Tech’s Center for Health and Humanitarian Systems.
One bright yellow answer read: “This patient needs re-testing 24 hours after the initial test!” And there were further recommendations on how to handle the case.
Here's how to subscribe to our free science and technology newsletter
Also read: Advice on DIY masks
Writer & Media Representative: Ben Brumfield (404-272-2780), email: ben.brumfield@comm.gatech.edu
Georgia Institute of Technology
Apr. 27, 2017
WHEN: June 7-9, 2017
WHERE: UN City, Copenhagen
WHAT: Panels and interactive sessions focusing on topics such as:
- Global Health Emergencies
- Innovation and Influencing Markets
- Strengthening Health Supply Chains
TO REGISTER ONLINE please visit chhs.gatech.edu/conference/2017/registration.
*As the 2017 conference will be hosted at the United Nations City, it will be free of charge. All attendees must be registered online prior to the event and must present an official form of government-issued photo ID to enter the UN City conference venue.
OVERVIEW:
The HHL Conference is pleased to announce the opening Keynote address from Dr. Richard Brennan, Director of Emergency Operations, Emergencies Programme, World Health Organization (WHO) in geneva, who led the Ebola Response from October 2014 to January 2016 as the Director at the WHO HQ. Dr. Brennan now oversees WHO’s response to health emergencies globally as part of the new Emergencies Programme which brings together several departments to streamline WHO’s role in emergencies globally, from prevention and preparedness to response, and from humanitarian emergencies to disease outbreaks. See full bio here.
Each year the Conference on Health & Humanitarian Logistics (HHL) provides an open forum for the discussion of challenges and new solutions in disaster preparedness and response, long-term development and humanitarian aid, and global health delivery. This neutral platform encourages learning and collaboration within and across institutions; promotes system-wide improvements in organizations and the sector as a whole; identifies important research issues; and establishes priorities in terms of strategies, policies and investments.
Speakers and participants in the event come from across global health and humanitarian sectors, from governments, NGOs, foundations, private industry, and academia, and share diverse perspectives in health and humanitarian challenges. The agenda features keynote addresses, panel discussions, focused interactive workshops, oral presentations, lunchtime group discussions, and interactive poster sessions covering a broad set of research topics and applications.
Submissions were accepted for 3 categories this year: interactive workshops, oral presentations, and posters, which explore challenges and solutions for building efficient and effective supply chains for health and humanitarian challenges. Particular topics of interest include public private partnerships, innovative uses of data or technology, and creating sustainable supply chain systems.More information about these sessions is available here. The final list of presentation, workshop sessions, and posters will be online at the links here as they are confirmed.
2017 Conference Co-organizers:
- Özlem Ergun, Northeastern University
- Jarrod Goentzel, Humanitarian Response Lab, MIT
- Etleva Kadilli, UNICEF Supply Division, Copenhagen
- Pinar Keskinocak, CHHS, Georgia Tech
- Julie Swann, CHHS, Georgia Tech
- Luk Van Wassenhove, Humanitarian Research Group, INSEAD
2017 Speakers and presenters include representatives from:
Bill & Melinda Gates Foundation, Centers for Disease Control & Prevention, (CDC), Central Medical Stores Trust of Malawi, Chemonics International, DHL, Earthquake Reconstruction & Rehabilitation Authority (ERRA) Pakistan, GS1 Nigeria, Global Scientific Solutions for health, Imperial Health Sciences, John Snow Inc., Laerdal Global Health, Logistimo India, Medecins Sans Frontieres, National Medical Stores Uganda, National Primary Health Care Development Agency of Nigeria, Nexleaf Analytics, North Star Alliance, Partnership for Supply Chain Management, UCLA, Vienna University of Economics and Business, UNICEF Supply Division, UN World Food Programme, UPS, World Health Organization, USAID, and more.
News Contact
Meghan Smithgall
Center for Health & Humanitarian Systems (CHHS)