Phreesia’s Coronavirus Disease 2019 (COVID-19) Screening Module and Workflow

Last updated: 10/4/2021

Screening Questions for Pediatric Patients (patients 17 years and younger) 

For Pediatric Patients

Major Updates

Patients receive the following COVID-19 screening questionnaire, prior to their visit or in the office.

If a patient is completing the COVID-19 screening questionnaire in-office, the final Visitor Policy question will be phrased differently to allow practices to assess whether the person accompanying the patient is exhibiting symptoms.

Patient-Facing Alerts – Dependent on Question Answers & Session Type

Educational messages are generated for patients and their families to inform them how to proceed given their responses to the screening questions.

Practices will have more flexibility when it comes to configuring the language and presentation of patient-facing alerts. For example, the patient-facing alerts can be suppressed for telemedicine visits or the language can be adjusted to reflect individual practice’s policies (e.g. mask policy).

Scenario 1

Patient’s parent/guardian completes questions pre-visit; patient is symptomatic and/or has an epidemiologic risk factor(s):

Scenario 2

Patient’s parent/guardian completes questions pre-visit; patient is asymptomatic, has no epidemiologic risk factor(s) and is not immunocompromised

Scenario 3

Patient’s parent/guardian completes questions pre-visit; patient is asymptomatic, has no epidemiologic risk factor(s), is immunocompromised but not due for an additional dose (<28 days). 

Since pre-visit may be done one or more days in advance of a visit, a patient’s eligibility may change by the time of their appointment; as such, in this scenario, a patient’s family is still encouraged to discuss whether an additional dose of COVID-19 vaccine is appropriate for their child. It also allows patients’ families and providers to discuss vaccine sentiment, timing and logistics of receiving the additional dose.

Scenario 4

Patient’s parent/guardian completes questions pre-visit; patient is asymptomatic, has no epidemiologic risk factor(s), is immunocompromised and due for an additional dose (>28 days).

Dashboard Alerts

If a parent or guardian’s responses to the COVID-19 screening questions puts the child in an at-risk status, Phreesia will display an alert to notify staff. The icon will be the same in all scenarios.

Staff-facing alerts display all of the parent or guardian’s answers—regardless of whether the screening questions are completed pre-visit or in-office. 

Alerts are triggered if a patient has a response that indicates positive symptoms, positive household symptoms, positive for recent close contact, outstanding or positive COVID-19 test results due to symptoms/contact, or positive household test. 

Parent/guardian’s responses to the vaccination questions do not factor into the alerting logic. That said, responses to the vaccination questions inform both the patient-facing education (see above) and the practice-facing alert (see below) to encourage further discussion between patients’ families and clinical care teams for children who may be eligible for an additional dose (if immunocompromised).

Pre-Visit Alerts 

For example, if a parent or guardian completes the screening questions pre-visit and answers “no” to fever, “no” to respiratory illness, “none of the below” in reference to other new symptoms, “no” to recent close contact with someone who has COVID-19, “no” to travel, “yes” to COVID-19 testing and that the test was positive, specifies that testing was done on 7/1/2020 and the reason for testing was “We wanted to know my child’s COVID-19 status”, and specifies that he/she “will not send a sick adult with the child”, the following staff alert will be generated. At the bottom of the staff alert there is a date stamp that specifies when the patient completed this COVID-19 Screening. The screening module will automatically calculate whether the difference of time between the patient’s self-reported COVID-19 diagnostic test date and this screening module’s completion is within the time frame that requires staff and patient notification.

In-Office Alerts 

For example, if a parent or guardian completes the screening questions pre-visit and answers “no” to fever, “no” to respiratory illness, “none of the below” in reference to other new symptoms, “no” to recent close contact with someone who has COVID-19, “no” to travel, “yes” to COVID-19 testing and that the test was positive, specifies that testing was done on 7/1/2020 and the reason for testing was “We wanted to know my child’s COVID-19 status”, and specifies that the visitor “do[es] not have a fever, cough, or shortness of breath”, the following staff alert will be generated. At the bottom of the staff alert there is a date stamp that specifies when the parent or guardian completed this COVID-19 Screening. The screening module will automatically calculate whether the difference of time between the patient’s self-reported COVID-19 diagnostic test date and this screening module’s completion is within the time frame that requires staff and patient notification

Appointments Hub

At-risk patients will appear in the Appointments Hub to be tracked by staff.

Any new COVID-19 alerts that appear in the Appointments Hub will now have detailed information related to when the patient’s scheduled appointment is. In order for Phreesia to properly pull the appointment date, time, location, and provider the reason for visit must include COVID or Coronavirus. 

Staff can filter their alerts to show patients who have been flagged for possible COVID-19 risk factors. This filter is conveniently located next to the filters icon and will apply a setting to only select COVID-19 reasons for visit (or Coronavirus reasons for visit) for any status other than closed. As needed, additional filters can be layered on top of this auto filter.

When a COVID-19 alert is triggered and displayed in the Appointments Hub, questions and answers for the screener will now be displayed on the View Appt Request overlay. Staff can access this detailed information by clicking on the magnifying glass to the right of each alert on the hub. All questions and answers can be located at the bottom of this overlay. 

Appointments Hub Reason for Visit 

  • Patient’s parent/guardian completes questions pre-visit; patient is symptomatic, someone in their household is symptomatic, has had a recent close contact with someone who has symptoms of COVID-19 or who tested positive for COVID-19, has an outstanding or positive COVID-19 test result due symptoms/contact, someone in their household has a positive COVID-19 test: “COVID19 – Previsit” 

  • Patient’s parent/guardian completes questions in-office; patient is symptomatic, someone in their household is symptomatic, has had a recent close contact with someone who has symptoms of COVID-19 or who tested positive for COVID-19, has an outstanding or positive COVID-19 test result due symptoms/contact, someone in their household has a positive COVID-19 test: “COVID19 – In-office”

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COVID-19 Screening Module Updated early October 2021

As always, our priority is to help your staff, as well as your patients and their families, stay safe. Our COVID-19 Screening Module was updated early October 2021 to reflect the latest guidance:

  • The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommend that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine

  • The age groups authorized to receive this additional dose are unchanged from those authorized to receive the primary vaccination series:
    • Pfizer-BioNTech: aged > 12 years
    • Moderna: aged > 18 years

To reflect these recommendations, our COVID-19 Screening Module has undergone the following updates:

  • If a child has received an mRNA COVID-19 vaccine, there is a new answer choice available for those who have received three doses.

  • If a child has already received two doses of an mRNA COVID-19 vaccine, there is a new question asking their parent or guardian to identify if the child has any condition(s) that results in their being moderately to severely immunocompromised and for which the CDC recommends an additional dose of a COVID-19 vaccine.

  • If a parent or guardian indicates that the child has any such immunocompromising condition(s), there is a new question asking about the timing of the child’s second dose of an mRNA COVID-19 vaccine. They will indicate whether the child’s second dose was “less than 28 days ago” or “28 or more days ago.

  • New patient-facing notices have been created to accommodate the responses to these new questions.

Additional information on COVID-19 Screening Module updates is included in our Product Release Notes as well as the Quarterly Release Summaries.

Alerting Logic:

A parent or guardian’s responses regarding COVID-19 viral risk factors and COVID-19 vaccination status are collected and presented to the practice. Their responses to the vaccination questions do not factor into the alerting logic. That said, responses to the vaccination questions inform both the patient-facing education and the practice-facing alert to encourage further discussion between patients’ families and clinical care teams for children who may be eligible for an additional dose (if immunocompromised).

As always, patient alerts will trigger for:

  • Positive response to symptoms
  • Positive household symptoms
  • Positive for recent close contact
  • Outstanding or positive COVID-19 test results due to symptoms/contact
  • Positive household test

Only appears if answer to previous question is “yes” 

Only appears if answer to previous question indicates patient was tested for COVID-19 (regardless of whether their test result is pending, positive, or negative)

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Only appears if the parent/guardian designates that the patient has ever received a dose of COVID-19 vaccine

Only appears if the parent/guardian indicates that the patient has already received two doses of an mRNA COVID-19 vaccine. The conditions shown reflect CDC guidance.

Only appears if the parent/guardian identifies the child as having a condition that results in their being moderately to severely immunocompromised. The timing reflects CDC guidance.

Scenario 5

Patient’s parent/guardian completes questions in office; patient is symptomatic and/or has an epidemiologic risk factor(s):

Scenario 6

Patient’s parent/guardian completes questions in office; patient is asymptomatic, has no epidemiologic risk factor(s) and is not immunocompromised.

Scenario 7

Patient’s parent/guardian completes questions in office; patient is asymptomatic, has no epidemiologic risk factor(s), is immunocompromised but not due for an additional dose (<28 days). 

In this scenario, a patient’s family is still encouraged to discuss whether an additional dose of COVID-19 vaccine is appropriate for their child. It allows patients’ families and providers to discuss vaccine sentiment, timing, and logistics of receiving the additional dose.

Scenario 8

Patient’s parent/guardian completes questions in office; patient is asymptomatic, has no epidemiologic risk factor(s), is immunocompromised and due for an additional dose (>28 days).