A Randomized Controlled Trial of the Effectiveness of Traditional and Mobile Public Health Communications With Health Care Providers

A COVID-19 call center for healthcare providers: dealing with rapidly evolving health policy guidelines

BACKGROUND

Communication between health authorities and healthcare providers is an essential element of the response to public health emergencies. Although call centers can facilitate such communication, no published reports describing their outcomes exist. In advance of the expected COVID-19 outbreak in Israel, the Israel Center for Disease Control established a call center dedicated to queries from healthcare professionals.

METHODS

The call center operated from February 5, 2020 (week 6) to May 14, 2020 (week 20). Data on calls received, including date and time, caller characteristics, questions and responses were recorded in a database designed for this purpose. The volume, sources and content of queries were analyzed.

RESULTS

In 15 weeks of operation, the call center responded to 6623 calls. The daily number of calls ranged from 1 to 371 (mean 79.8, median 40), peaking on week 12, 2 weeks prior to a peak in new COVID-19 cases. Callers were predominantly physicians (62.4%), nurses (18.7%) and administrators (4.4%). Most worked in primary care clinics (74.2%) or hospitals (8.7%). Among physicians, 42.3% were family physicians or internists, and 10.0% were pediatricians. The issues most commonly addressed were home quarantine (21.6%), criteria for suspected cases (20.6%), and SARS-CoV2 testing (14.1%). Twenty-five percent of questions involved requests for clarifications of MOH guidelines regarding travel restrictions, clinic management, triage of symptomatic patients, routine medical and dental care, recommended precautions for health care workers with preexisting medical conditions, and other matters. A total of 119 queries were not resolved on the basis of existing guidelines and were referred to MOH headquarters.

CONCLUSIONS

This is the first report of a call center established to serve the needs of healthcare providers seeking guidance on COVID-19 management, and to facilitate communication of providers' concerns to the central health authority. Our work indicates that a central call center for healthcare providers can facilitate the development, implementation and amendment of guidelines and should be an integral element of the early response to public health emergencies. Real-time analysis of the call data may reveal important trends requiring prompt attention.

Variations in Healthcare Provider Use of Public Health and Other Information Sources by Provider Type and Practice Setting During New York City's Response to the Emerging Threat of Zika Virus Disease, 2016

The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) used multiple methods to provide guidance to healthcare providers on the management and prevention of Zika virus disease during 2016. To better understand providers' use of information sources related to emerging disease threats, this article describes reported use of information sources by NYC providers to stay informed about Zika, and patterns observed by provider type and practice setting. We sent an electronic survey to all email addresses in the Provider Data Warehouse, a system used to maintain information from state and local health department sources on all prescribing healthcare providers in NYC. The survey asked providers about their use of information sources, including specific information products offered by the NYC DOHMH, to stay informed about Zika during 2016. Trends by provider type and practice setting were described using summary statistics. The survey was sent to 44,455 unique email addresses; nearly 20% (8,711) of the emails were undeliverable. Ultimately, 1,447 (5.8%) eligible providers completed the survey. Most respondents (79%) were physicians. Overall, the most frequently reported source of information from the NYC DOHMH was the NYC Health Alert Network (73%). Providers in private practice reported that they did not use any NYC DOHMH source of information about Zika more frequently than did those working in hospital settings (29% vs 23%); similarly, private practitioners reported that they did not use any other source of information about Zika more frequently than did those working in hospital settings (16% vs 8%). Maintaining timely and accurate databases of healthcare provider contact information is a challenge for local public health agencies. Effective strategies are needed to identify and engage independently practicing healthcare providers to improve communications with all healthcare providers during public health emergencies.

Attitudes, Motivators, and Barriers to Emergency Preparedness Using the 2016 Styles Survey

This study assessed adults' perceptions toward preparedness to better inform emergency planning efforts for households and communities. The 2016 Styles, an Internet panel survey, was used to assess emergency preparedness competencies. Descriptive analyses were performed to describe the sociodemographic factors by preparedness status. Multivariable logistic regressions were used to examine the association between perceived preparedness and characteristics associated with preparedness attitudes, motivators, and barriers. Approximately 40% of adults surveyed reported that they were prepared for emergencies. The main motivator for those prepared was awareness of local disasters (38.9%), and a leading barrier was confusion about how to plan for the unknown (23.7%). Those prepared were more likely to have the right supplies (adjusted odds ratio [AOR] = 1.25, 95% confidence interval [CI] = [1.05, 1.50]), discuss emergency plans (AOR = 1.21, 95% CI = [1.02-1.42]), and act before an emergency occurred (AOR = 1.35, 95% CI = [1.15, 1.59]), compared with adults who did not report being prepared. Results from this research indicate that identifying motivation to prepare for emergencies can contribute to public health disaster planning. Preparation is a critical step that allows the community and its citizens to be more equipped to function during and after a disaster.