Research boosts hope USC’s COVID-19 self-triage tool can ease hospitals’ burden

In March, a team at USC’s Gehr Family Center for Health Systems Science and Innovation helped create a patient self-assessment tool to help people determine whether they might have the novel coronavirus.

The Gehr team kept at it, tracking usage of the tool to detect trends. What they’ve found is that only 20 percent of users reported severe symptoms that require immediate medical attention. The rest reported mild symptoms “that can likely be managed with simple home self-care,” said William Mehring, a first-year medical student at the Keck School of Medicine who helped work on the tool and who led the research.

The findings were published in the Journal of General Internal Medicine last month.

At the time the research was conducted, 275,000 people around the world have accessed the web-based tool. Now it’s been used by almost half a million unique users worldwide. From the start, the goal was to help people determine whether their symptoms merited further care, and if they could engage in home-based care to get better, that’s one fewer patient entering the increasingly strained clinics, urgent cares and hospitals.

“This is a way to de-stress the system, which was becoming quickly overburdened and still is,” Mehring said. “In the future it could be used as a way to collect data on outbreaks and determine where they are occurring.”

COVID-19 cases have been surging in the U.S. for weeks, and on Monday the country reached 130,000 deaths from the virus.

Customized recommendations

The Gehr Center, which is part of the Keck School, collaborated with Akido Labs, a Los Angeles-based health data technology company, to launch the assessment tool in late March. They used information from the Centers for Disease Control and Prevention as a guide. The tool asks users to provide answers to six simple questions about their current situation, including the nature of the user’s symptoms; risk factors for COVID-19 such as advanced age or presence of high-risk chronic medical conditions; and whether they work in a high-risk environment that requires close physical interaction with others. Based on these answers, the tool provides an assessment along with customized recommendations regarding evaluation and treatment, self-care and infection-prevention practices.

“Although the new study does not validate the appropriateness of the guidance provided by the tool, it highlights the eagerness of the public to engage with digital health tools and self-assessment in this time of public health crisis,” said Andrew Poksay, senior product manager at Akido Labs.

Mehring, who did his undergraduate work at UC Santa Barbara and earned a BS in Biopsychology, says it may seem rare for a first-year med student to lead research published in a leading publication like the Journal of General Internal Medicine. “But that’s just because I was supported, and in cooperation with such a widespread team, in such a multi-disciplinary approach,” he said. “We have people from the data side, from the clinician side, from people who are doing the user experience, all these kinds of things that are all being rolled together. And now this published study is about getting this information out to people, so it can be used to better fight this epidemic we’re up against.”

Removing barriers to health care

The tool, which is freely available in English and Spanish, was developed in partnership with AltaMed Health Services, the nation’s largest independent federally qualified community health center. AltaMed, which specializes in safety-net multi-ethnic populations, operates nine COVID-19 testing sites throughout Los Angeles County. AltaMed has been using the tool to help triage patients seeking care for symptoms that may be due to the infection.

Digital tools like the patient self-assessment tool, coupled with access to in-person consultations like our testing and evaluation sites, are critical for ensuring patients can receive the care they need now and after the pandemic,” said Dr. Ilan Shapiro, Medical Director of Health Education and Wellness at AltaMed.

About this study

In addition to Mehring, the study’s other authors are Michael Hochman, MD, MPH and Chris Hendel, MA from the Gehr Center for Health Systems Science and Innovation, The Keck School of Medicine of USC; Michael D. Wang, MD  from Keck Medicine of USC;  and Andrew Poksay, Jesse Kriege and Rithvik Prasannappa from Akido Labs, Inc.