Iranian national COVID-19 electronic screening system: experience to share

Amir-Behghadami, Mehrdad; Janati, Ali

doi:10.1136/emermed-2020-209806

Cited by 20 publications

(16 citation statements)

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“…6 In Iran, during the COVID-19 pandemic, an on-line screening system results in specific advice sent to the user by SMS, including referral to the appropriate health centre. 7 …”

Section: Discussionmentioning

confidence: 99%

Online forward triage during the COVID-19 outbreak

2020

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Health systems face major challenges during the COVID-19 pandemic with new information and challenges emerging daily and frequently changing guidelines. Online forward triage tools (OFTTs) provide useful information, direct patients and free physician resources.We implemented an OFTT targeted at the current pandemic, adapted the content and goals and assessed its effects. The OFTT was implemented on 2 March 2020 and modified regularly based on the revised testing criteria issued by the Swiss Federal Office of Public Health. After testing criteria liberalised, a chatbot tool was set up on 9 April 2020 to assess urgency of testing, referral to available testing sites and need for emergency care.In the first 40 days of the OFTT, there were more than 17 300 visitors and 69.8% indicated they would have contacted the healthcare system if the online test had not been available. During the initial week of operation, using the conservative testing strategy, 9.1% of visitors received recommendations to be tested, which increased to 36.0% of visitors after a change in testing criteria on 9 March 2020. Overall, since the implementation of the tool, 26.27% of all users of the site have been directed to obtain testing. The Chatbot tool has had approximately 50 consults/day.Setting up an OFTT should be considered as part of local strategies to cope with the COVID-19 pandemic. It may ease the burden on the healthcare system, reassure patients and inform authorities. To account for the dynamic development of the pandemic, frequent adaptation of the tool is of great importance. Further research on clinical outcomes of OFTT is urgently needed.

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“…6 In Iran, during the COVID-19 pandemic, an on-line screening system results in specific advice sent to the user by SMS, including referral to the appropriate health centre. 7 …”

Section: Discussionmentioning

confidence: 99%

Online forward triage during the COVID-19 outbreak

2020

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“…However, during the COVID-19 outbreak, health care organizations are establishing different strategies and leveraging several health information technologies to improve pandemic management [ 13 ]. One of the technology-based tools that can support the standard management of patients during the current pandemic is the EHR [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Using Electronic Health Records to Mitigate Workplace Burnout Among Clinicians During the COVID-19 Pandemic: Field Study in Iran

Esmaeilzadeh¹,

Mirzaei²

2021

JMIR Med Inform

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Background The COVID-19 pandemic spread worldwide in 2020. Notably, in the countries dealing with massive casualties, clinicians have worked in new conditions characterized by a heavy workload and a high risk of being infected. The issue of clinician burnout during the pandemic has attracted considerable attention in health care research. Electronic health records (EHRs) provide health care workers with several features to meet a health system’s clinical needs. Objective We aim to examine how the use of EHR features affects the burnout of clinicians working in hospitals that have special wards for confirmed COVID-19 cases. Methods Using an online survey, we collected data from 368 physicians, physician assistants, and nurses working in six hospitals that have implemented EHRs in the city of Tehran in Iran. We used logistic regression to assess the association between burnout and awareness of EHR features, EHR system usability, concerns about COVID-19, technology solutions, hospital technology interventions, hospital preparedness, and professional efficacy adjusted for demographic and practice characteristics. Results The primary outcome of our study was self-reported burnout during the COVID-19 pandemic. Of the 368 respondents, 36% (n=134) reported having at least one symptom of burnout. Participants indicated that the leading cause of EHR-related stress is inadequate training for using technology (n=159, 43%), followed by having less face-to-face time with patients (n=140, 38%). Positive perceptions about the EHR’s ease of use were associated with lower odds of burnout symptoms. More interventions, such as clear communication of regulations; transparency in policies, expectations, and goals regarding the use of technology in the clinical workflow; and hospital preparedness to cope with the challenges of the pandemic, were associated with lower odds of burnout. Conclusions The use of EHR applications, hospital pandemic preparation programs, and transparent technology-related policies and procedures throughout the epidemic can be substantial mitigators of technology-based stress and clinician burnout. Hospitals will then be better positioned to devise or modify technology-related policies and procedures to support physicians’ and nurses’ well-being during the COVID-19 pandemic. Training programs, transparency in communications of regulations, and developing a clear channel for informing clinicians of changes in policies may help reduce burnout symptoms among physicians and nurses during a pandemic. Providing easily accessible mentorship through teleconsultation and 24-hour available information technology support may also help to mitigate the odds of burnout.

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“…However, the result is much higher than the seroprevalence estimated in California, USA, which was between 2.49% and 4.16%[12]. Besides, if we want to compare the outcome of serological methods with that of molecular tests (RT-PCR) in Iran, the results of molecular tests have reported a lower prevalence of 12% - according to the report of the Ministry of Health of Iran by the end of October, 4,599,554 tests were performed, of which 545,286 were positive [13]. The reasons for this discrepancy include the ease of access to antibody testing, low cost, and the desire of clients for cheaper and more accessible methods and false-negative results in molecular testing [14, 15].…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiological Study of Novel Corona Virus (CoVID-19) in Tehran, Iran

Tabanejad

Darvish

Boroujeni

et al. 2021

Preprint

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A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread to all countries of the world, including Iran. Although new anti-coronavirus antibodies in patients may be identified by immunological methods with sufficient sensitivity and specificity, the conclusive diagnosis of the disease is by the molecular RT-PCR process. We used a population-based seroepidemiological survey to quantify the proportion of the exposed population with SARS-CoV-2 antibodies and evaluated whether the antibodies are a marker of total or partial immunity to the proportion of the population that remains susceptible to the virus. This cross-sectional study was conducted to investigate the seroprevalence of CoVID-19 in Tehran, the capital of Iran, between April and end of October 2020. Specimens of clotted and heparinized blood (2ml) were collected from the patients. The serum and plasma were separated and stored at − 80LJ°C until use. We examined serum anti-SARS-CoV-2 IgG and IgM antibodies from 1375 in-patients admitted to our hospitals using ELISA kits. In total, 1375 participants were enrolled in this study, and SARS-CoV-2 antibodies were detected using IgM-IgG antibody assay in 291 patients. Among the seropositive patients studied, 187 were men (64.3%), and 104 were women (35.7%) (P<0.05). The mean age of the patients was 49±8.4 years; the majority (27%) were in age group 31-40 years. Also, the lowest frequency of cases was reported in the age group of 1-10 years (P <0.05). We determined the seroprevalence of SARS-CoV-2 for IgM or IgG antibodies to be 21.2%. Diabetes mellitus was the most common underlying disease among SARS-CoV-2 patients [P=0.05; Odd Ratio=1.61(0.90-2.91)]. Conventional serological assays in SARS-CoV-2 cases, such as the enzyme-linked immunoassay (ELISA) for specific IgM and IgG antibodies, have a high-throughput advantage and minimize false-negative rates that occur with the RT-PCR method. This study determined the seroprevalence of SARS-CoV-2 antibodies to be 21%. Control of diabetes among other cases factors shall play important role in management and control of COVID-19.

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Iranian national COVID-19 electronic screening system: experience to share

Cited by 20 publications

References 1 publication

Online forward triage during the COVID-19 outbreak

Online forward triage during the COVID-19 outbreak

Using Electronic Health Records to Mitigate Workplace Burnout Among Clinicians During the COVID-19 Pandemic: Field Study in Iran

Seroepidemiological Study of Novel Corona Virus (CoVID-19) in Tehran, Iran

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