Moving Faster than the COVID-19 Pandemic: The Rapid, Digital Transformation of a Public Health System

Abstract

Background Queensland, Australia has been successful in containing the COVID-19 pandemic. Underpinning that response has been a highly effective virus containment strategy which relies on identification, isolation, and contact tracing of cases. The dramatic emergence of the COVID-19 pandemic rendered traditional paper-based systems for managing contact tracing no longer fit for purpose. A rapid digital transformation of the public health contact tracing system occurred to support this effort. Objectives The objectives of the digital transformation were to shift legacy systems (paper or standalone electronic systems) to a digitally enabled public health system, where data are centered around the consumer rather than isolated databases. The objective of this paper is to outline this case study and detail the lessons learnt to inform and give confidence to others contemplating digitization of public health systems in response to the COVID-19 pandemic. Methods This case study is set in Queensland, Australia. Universal health care is available. A multidisciplinary team was established consisting of clinical informaticians, developers, data strategists, and health information managers. An agile “pair-programming” approach was undertaken to application development and extensive change efforts were made to maximize adoption of the new digital workflows. Data governance and flows were changed to support rapid management of the pandemic. Results The digital coronavirus application (DCOVA) is a web-based application that securely captures information about people required to quarantine and creates a multiagency secure database to support a successful containment strategy. Conclusion Most of the literature surrounding digital transformation allows time for significant consultation, which was simply not possible under crisis conditions. Our observation is that staff was willing to adopt new digital systems because the reason for change (the COVID-19 pandemic) was clearly pressing. This case study highlights just how critical a unified purpose, is to successful, rapid digital transformation.

Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

“…16 Many digital health innovations were introduced during Australia's successful response to the pandemic. 17,18 The first COVID-19 case in Australia was identified in January 2020. Cases peaked in July 2020 with 10,224 notifications, after which public health measures were successful in minimizing the spread.…”

“…For example, the development of new technologies was time pressured Additionally, the application provided analyses to identify vulnerable populations and several predictive analytical models and data visualizations. 18 An example of these visualizations is provided below in ►Fig. 2…”

“…However, this could not be scaled up to meet demand during the pandemic, and Microsoft Teams was rapidly implemented to fill this need due to policy directions, requiring fast-paced development. 18 Traditional methods for health technology development rely on an iterative process between developers and users which takes time. To improve development time, pair programming was used to develop DCOVA.…”

“…This required users and clinical informaticians to work together with developers in real time. 18,31 The use of this innovative process enabled the successful development of tools in a rapid time frame. Data standards and interoperability need to be addressed at a broader level.…”

“…Fig.2Real-time heat maps of COVID-19 public health order using Digital Corona Virus Application (DCOVA) data (source Metro North, 2021) 18. …”