MascarenhasIn March 2020, when COVID-19 was classified as a pandemic by the World Health Organization (WHO) and became more widespread in the U.S., health care communication became more critical — and more challenging — than ever. The Division of Rheumatology and Immunology at the Ohio State University Wexner Medical Center began exchanging updates and messages, and email quickly became cumbersome as circumstances and guidelines changed rapidly.

“I realized pretty quickly that email was not going to meet our needs during this crisis,” says Sheryl Mascarenhas, MD, clinic director of the medical center’s CarePoint East Rheumatology and Nephrology Clinics. “On the day the WHO declared it a pandemic, I sent out an email with the subject line ‘Coronavirus Resources.’ It had updates to hospital screening policies, links to the Centers for Disease Control & Prevention (CDC) website and even a patient handout. But I didn’t realize at the time how quickly things would change. Before long, of course, our inboxes were overflowing with more updates, policies and news than we could possibly keep up with.”

With so many similar subject lines related to COVID-19 and information changing rapidly, it became difficult to find the answers to questions. Also, while the rapid-fire nature of email works well for many situations, one email message may spawn threads, often without including all team members on the original email. Just when team members needed to be working seamlessly together, Dr. Mascarenhas says, email seemed to be contributing to divisiveness.

Dr. Mascarenhas also knew that as the virus spread, she and her colleagues might be affected and unable to do their jobs. So she needed a solution — a hub for information and communication that everyone could easily access — with virtually no learning curve. There just wasn’t time.

It turns out the solution was readily available. All she had to do was click “Collaborate” on the medical center’s intranet site, where she learned about SharePoint.

Familiar tool takes on new life

SharePoint is one of many collaborative web-based platforms, such as Google Docs and Dropbox, but with one distinct advantage: SharePoint is a secure tool approved for health systems. The Ohio State Wexner Medical Center Department of Information Technology (IT) security has found SharePoint acceptable to use for both nonprotected and protected health information (PHI), with different levels of clearance for different kinds of information.

The first step was a request to the IT department to create a secure, invitation-only SharePoint site specifically for the division to share and store COVID-19 information and updates. Permission was quickly granted, and Dr. Mascarenhas set about creating the site.

The site originally contained six categories of information: Contingency plans for inpatient consults; clinical screening guidelines for suspected COVID-19 patients; a patient information handout; information on how to send out blast messages to patient panels over the patient portal; clinic-building entry policies for employees; and information on telehealth visits, including processes and billing information. The site has grown as needs have changed. Every time a document is added, metadata is embedded that tells who created the document and when, as well as when it was last modified and by whom. If a previous version of the document is needed, document history can be turned on.

As the site administrator, Dr. Mascarenhas invited rheumatology physicians, fellows, nurse practitioners and administrators to be full members of the site, so they can create documents and edit existing ones. Clinical nephrology collaborators, nursing staff and office staff are classified as visitors, so they can view information and documents but cannot make changes. This feature is important, as any changes to procedures or policies need to be approved by physicians and administrators.

Dr. Mascarenhas reports that the site has dramatically improved communication during the pandemic and has become an invaluable resource for storing and sharing constantly changing information that needs to be accessed quickly. While it doesn’t replace email, it has greatly reduced the number of emails piling up in inboxes — a huge help in a stressful and challenging time.

“It’s helpful to be able to direct our team and staff to one fully updated, comprehensive resource for information related to COVID-19,” Dr. Mascarenhas says. “It’s a solution other health care systems and medical professionals might want to consider as the pandemic continues or for other situations in which information is critical and constantly evolving.”

See Dr. Mascarenhas’ related article in The Rheumatologist.

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