TERRI HYDUKECEO

CPN/CHILDREN’S PHYSICIAN NETWORK

The Minnesota Flu Line

Pandemic Concerns

April 2009 – Children’s Hospitals Emergency Rooms

Overwhelmed

Concern of exposure to the worried well and exposed, but asymptomatic

Getting antivirals to appropriate patients rapidly

Reducing transmission, decreasing exposure Children’s Physician Network 3/12

Discussion with MN Dept of Health – September 2009

Triage as an approach to improve speed of care and reduce waiting room panic

Initial cost estimates staggering

Department of Health designed collaborative model

CPN “front-ended” service

Children’s Physician Network 3/12

MN Flu LineInitial Setup & Operations

Added telehealth workstations o Temporary until build-out Straightforward

Added telephone capacity Underestimated

Hired additional staff – ASAP Training time to operational

Automated multi-lingual instructions To maximize front-end system design

Children’s Physician Network 3/12

Successes/Lessons Learned

SuccessSpeed of call center expansion

Less than half the time normally requiredMajor partner (Department of Health)

Was nimble and highly effectiveExperience of handling large volumes

Experience with Influxes importantOngoing Quality Assurance program

… and training pays off!!

Children’s Physician Network 3/12

Successes/Lessons Learned

Lessons Learned

Could have helped more individuals with earlier start

Clinical training can’t be limited to the single algorithm - people present with other conditions

Build more telephone capacity than you think you need

Clearly define all participating partners’ capacityThis is a ramp up/ramp down initiativeSpeed and accuracy of “the build”

Children’s Physician Network 3/12

Ongoing Concerns

Ongoing ConcernsInfrequency = lost lessons

Expansion speed requires time (anticipate project earlier)

Need ongoing core of experienced telemedicine professionals (nurses) who do this daily = implies an ongoing public health line or a medical component to 9-1-1?

Children’s Physician Network 3/12

CPN Nurse Triage

Established: 1997 Governance: Part of Children’s Physician Network

A network of primary care, subspecialty and pediatric hospitals MN metro area

Tax Status: Non-profit, Taxable Corporation Services: - Medical Telephone Answering

- Nurse Telephone Care (adults/children)- Hospital Concierge Services- Health Plan Quality Program & Disease Mgmt. Pilots

Subscribers: Clinics from MN, WI, CA, WVA Volume: Average 200,000 calls/year

33% = nurse calls (patients)51% = medical answering service16% = hospital concierge (provider calls)