Systematic lab testing and comprehensive dashboards support better decisionmaking.
By Brad Bostic
At the beginning of May, the US death toll from covid-19 exceeded 70,000 people, a casualty count that statistical models initially projected would not be reached until August 2020.1 After nearly 2 months of major societal shifts designed to help slow the spread of covid-19, many Americans are eager to return to some sort of normalcy in their daily lives. But is the nation ready?
Employers are looking for efficient ways to implement return-to-work policies that keep workers and customers safe. In light of the potentially disastrous economic consequences of keeping the economy mothballed much longer, significant pressure is mounting to open wide swaths of the economy, often in the face of uncertainty due to reports of rising infection rates.
Governors and mayors have struggled over the decision to lift lockdowns and reopen nonessential businesses or continue to enforce stay-at-home directives. Such government officials face the painful task of determining how best to tackle the urgent need to restart local economies, while acknowledging the reality that easing social distancing guidelines could result in a spike of infections.
During these unprecedented times, making the call on how to safely reopen the economy can resemble a game of roulette. Employers and public officials are being faced with these challenges for the first time in their careers, and they often lack the insight required to make fully informed decisions. While health risks are unavoidable, reopening America responsibly can occur with the help of a national, real-time lab test management and local SARS-CoV-2 infection risk-measurement system.
Accurate Insight Needed for Timely Decisionmaking
The moment that covid-19 was officially declared a pandemic, the demand for accurate, timely insight surged. Such hunger for information was initially satisfied through public reporting websites provided by such research institutions as Johns Hopkins University, or by such novel initiatives as the Covid-19 Tracking Project.2 While the reports of such organizations offer utility of a sort, they are largely based on public health reporting processes that are inherently protracted and inconsistently applied, resulting in data that may be subject to human error and often trail current conditions by a week or more.
Publicly accessible dashboards such as these are useful for keeping track of historical trends and outcomes, such as the number of patients who tested positive over a certain period, or the number of reported deaths in a specified region. Data of this sort are helpful for keeping the general public informed, and for reinforcing the importance of social distancing in addition to other protective measures. However, most such dashboards lack the timely, localized details and predictive insights that healthcare providers, public officials, and employers need in order to implement plans fast enough to contain and effectively mitigate further infections.
Guiding the Economic Restart
Public health outcomes reporting that is tabulated after the fact leaves planners at a disadvantage due to the inherent delay in receiving the reports. Additionally, the lack of localized fidelity in the reporting—which is often provided at a state level—further compounds the issue.
In order to implement informed policy decisions that will permit the reopening of local economies while simultaneously continuing to flatten the covid-19 infection-rate curve, policymakers, public health officials, and healthcare providers alike need access to real-time insight based on accurate, timely lab test results. Through the effective application of lab testing data and predictive analytics at the local community level, government leaders and health officials can make informed decisions in support of methodically restarting the economy and adapting to the ‘new normal.’
Employers face the same dilemma as government leaders and healthcare authorities as they aim to reopen offices safely. Business leaders need a systematic approach to coordinate the implementation of approved testing guidelines using accredited labs that deliver accurate test results in a timely manner.
Additionally, to support return-to-work initiatives, mobile health passport capabilities that include easy input of symptoms and employee credentialing based on lab test results can be extremely useful to keep employees safe and confident that they are working in an environment that promotes the highest degree of employee safety. To accomplish these objectives, access to real-time, local test result trends and individual testing for employees residing in hotspots is critical.
Making use of current local testing data enables analysts to develop predictive insights about pertinent trends in the rate and location of novel coronavirus infections affecting local economies. Through real-time test result insights, local authorities and company leaders can continuously monitor whether the rate of coronavirus infections is accelerating or decelerating within local businesses, communities, counties, or states.
Analysis of test results can also enable authorities and business leaders to track the number of people who have been exposed to the covid-19 virus, as evidenced by the presence of antibodies, and predict the areas that are most likely to become hotspots. By effectively predicting where there will be an increase in demand for care resources such as intensive care unit beds, community leaders can prepare for the increased demand up to 14 days in advance.
A National Predictive Risk-Tracking Solution
The path toward reopening local economies appears daunting for both public health officials and employers. In order to encourage adherence to data-driven return-to-work testing guidelines, it will be critical that authorities have real-time access to locally relevant lab test insights, as well as to mobile health passport capabilities, including privacy-centric contact tracing.
Efforts are under way to address these needs. A coalition of laboratories with more than 20,000 lab ordering locations has come together to combat the spread of covid-19 by contributing to the compilation of a ‘local risk index’ via www.cv19dashboard.org.3 Participants in the coalition include physicians’ offices, patient service centers, hospitals, reference laboratories, and independent laboratories—all together encompassing approximately half of all covid-19 testing sites nationally. With laboratory data compiled at the county and subcounty level, the local risk index traces the acceleration (or deceleration) in the percentage of those tested who receive ‘detected’ (that is, positive) results from a SARS-CoV-2 test (Figure 1).
The CV19 lab testing dashboard provides local lab testing insights that include state, county, and subcounty views of the local risk index, covid-19 testing rates, deidentified test results (detected, not detected, or inconclusive), and key demographic filters for those tested (age, gender). Such insights can be used to understand where covid-19 infection is accelerating, to identify where local resources are most likely to become strained in the next 5 to 21 days, and to prepare before additional resources are required (Figure 2).
The national CV19 dashboard is being made available without charge to public health, public policy, healthcare, and laboratory decisionmakers as a way to identify the spread, deceleration, or resurgence of the novel coronavirus in America’s communities. The dashboard calculates rates of infection on a daily basis, and compares those daily findings to the epidemiological baseline of 1% positivity in each local area. With this information, policymakers grappling with reopening their local economies can become informed about current trends before they make decisions that will ultimately affect millions of lives.
For employers, the CV19 dashboard initiative has led to a robust employer solution, the hc1 Workforce Adviser, which brings together lab testing and the local risk index in a unified CV19 command center to help employers systematically support the ongoing health and safety of employees who are returning to the workplace (Figure 3).4 The Workforce Adviser enables employers to effectively monitor and manage their compliance with guidelines consistent with national and local best practices, so that they can safely return employees to work.
Workforce Adviser uses secure processes that are compliant with the privacy and security requirements of the Health Insurance Portability and Accountability Act of 1996. Lab test results are securely organized by employee and by worksite, and trends are displayed in easy-to-use dashboards. Automatic alerts and email push notifications can be established, and triggered by an event or metric, according to the user’s preference.
In Workforce Adviser, the local risk index advises employers about daily covid-19 testing trends in the local communities where their employees reside and work, in order to inform their safe return-to-work decisions. The solution is priced per employee per month, and scales based on the number of employees in order to keep the cost affordable for both small and large companies.
In moving forward to establish the ‘new normal’ and reinvigorate the safety and health of communities—and the United States as a whole—diagnostic lab testing will play a vital role. Lab testing will serve to arm community leaders, businesses, and government officials with the information they need to address the health threats presented by covid-19.
As America’s regional and national economies reopen, the adoption of lab testing solutions will streamline the reemergence of economies and save lives. Leveraging the power of diagnostic lab testing and comprehensive dashboards will inevitably enable leaders to make the best decisions possible for bringing the United States back stronger and more prepared to tackle future health threats. l
Brad Bostic is chairman and CEO of hc1. An innovator in the bioinformatics and Cloud technology markets, he has been building and leading high-growth companies for more than 2 decades. Bostic has been named to Becker’s Hospital Review list of top entrepreneurs in healthcare and the Indianapolis Business Journal’s 40-under-40 list of business leaders.
1. Covid-19 resources [homepage, online]. Seattle: Institute for Health Metrics and Evaluation, University of Washington, 2020. Available at: www.healthdata.org/covid. Accessed May 21, 2020.
2. The Covid Tracking Project [homepage, online]. Washington, DC: The Covid Tracking Project, 2020. Available at: www.covidtracking.com. Accessed May 21, 2020.
3. CV19 lab testing dashboard powered by hc1 is fastest to identify emerging local spread and control of covid-19 [press release, online]. Indianapolis: hc1, 2020. Available at: www.prweb.com/releases/cv19_lab_testing_dashboard_powered_by_hc1_is_fastest_to_identify_emerging_local_spread_and_control_of_covid_19/prweb17071514.htm. Accessed May 21, 2020.
4. hc1 Workforce Adviser [online]. Indianapolis: hc1, 2020. Available at: www.hc1.com/workforce-advisor. Accessed June 12, 2020.
Featured image: The CV19 dashboard incorporates a ‘local risk index’ compiled from lab testing data to inform users about covid-19 infection rates in nearby communities.