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

Last updated: 7/14/2020

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 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 completes questions pre-visit; Is symptomatic and/or has an epidemiologic risk factor (contact): 

Scenario 2

Patient completes questions pre-visit; Is asymptomatic, and has no epidemiologic risk factors (contact): 

Scenario 3

Patient completes questions in-office; Is symptomatic, and/or has an epidemiologic risk factor (contact):

Scenario 4

Patient completes questions in-office; Is asymptomatic and has no epidemiologic risk factors (contact): 

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 generated if a patient answers “yes” to any question on the screening module. This includes instances in which a patient reports symptom of lower respiratory illness, even if his/her symptoms are not new or worse than normal.

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. 

A new button has been created to help staff better sort their alerts to patients with COVID-19 Alerts. This new button will be 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) in 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 complete questions pre-visit; Is symptomatic and/or has an epidemiologic risk factor (travel, contact): “COVID19 – Previsit”
  • Patient completes questions in-office; Is symptomatic, and/or has an epidemiologic risk factor (travel, contact): “COVID19 – In-office”

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We greatly appreciate your patience and partnership. We postponed last week’s COVID-19 Screening Module updates to incorporate practice feedback regarding new hotspots and travel concerns. Updates were released on 7/14/20 and included the following:
 
Symptom: We have added clarifying statements to our symptom questions to ensure that patients only report new symptoms, not associated with chronic health conditions. We have also updated question 3’s answer choices to reflect the CDC’s latest signs and symptoms to watch out for in adults. The pediatric screening module continues to reflect the CDC’s clinical presentation for children and does not require any updates at this time.
 
Travel: We reworded the travel question to ask patients if they have traveled outside of their local community in the past 2 weeks. Patients who answer “yes” receive a follow-up question asking where they traveled. Practices will be notified any time a patient reports travel even in the absence of any other risk factors. With this change, patients will not receive alerts when they have traveled but have no other risk factors. The decision not to alert patient who only have a travel risk is meant to reduce call volume and confusion during summer months when many patients are traveling outside their community, but are not necessarily at risk. Given the rapidly evolving nature of these hotspots, these changes provide crucial information regarding recent travel but leave it to the practices’ discretion which locations warrant additional intervention prior to a patient’s visit.
 
COVID-19 Testing: We will be simplifying the second half of the screening module. Patients will be able to report:  

  • Whether they have been tested for COVID-19 
  • The date and result of their test 
  • The reason why they were tested (regardless of the result) 

Alerting Logic:

If at least ONE of the following are true, an alert will trigger:

  • Fever = Yes
  • Respiratory Illness = Yes
  • Other New Symptoms = Anything except “None”
  • Travel = Yes (regardless of location) PRACTICE ALERT ONLY
  • Testing
    • “My child was diagnosed with COVID-19 but was never tested” AND the diagnosis date = <30 days from the date the Screening Module is being filled out
    • “Yes, my child was tested, and we are waiting for the results” AND the testing reason = “My child had symptoms of possible COVID-19” or “My child had close contact with a person who has COVID-19”
    • “Yes, my child tested positive” AND the diagnosis date = <30 days from the date the Screening Module is being filled out
  • Visitor = Sick