The St. Louis County Department of Public Health promotes safety countywide through unprecedented times.
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“Government and public health entities are typically not at the forefront of digital transformation and, in most times, experience a hesitation with going digital,” said Nebu Kolenchery, Director of Communicable Disease Response at the St. Louis Department of Public Health. “But in fact, we have the most to gain from strategic shifts prompted by introducing a digital mindset to government and public health. Government has a lot to gain from a customer experience perspective as well as from a speed and scalability perspective. This makes me excited for what is possible in the public sector.”
The St. Louis County Department of Public Health (STLC DPH) is dedicated to protecting and improving the health of the community around them through a variety of services, programs, health centers, and divisions. Kolenchery and team have championed several COVID-19 initiatives to ensure coronavirus cases in the county are tracked, communicated, and mitigated according to CDC guidelines. Additionally, the DPH shares daily insight with the public on the risk of contracting COVID-19, symptoms, how it spreads, how to protect yourself, how to appropriately quarantine, where to seek resources, and more.
Modernization in public health.
"Public health case investigation and contact tracing has always been done on paper," Kolenchery said. "When COVID-19 hit, it overwhelmed the infrastructure that was in place and prompted an immediate need for change." For Kolenchery and his team, the pandemic acted as a catalyst to make a strategic investment in a digital tool that would redefine the way the STLC DPH monitors and manages the unprecedented times that were upon us.
Fundamentally, the biggest issue for the team prior to adoption was scale. “Our legacy system was not equipped for case investigation or contact tracing, and fundamentally we saw a major problem in scaling to meet an influx in cases,” said Kolenchery. “Prior to the pandemic, we were operating just fine with a system that was meant to act as a surveillance tool for small outbreaks, but COVID-19 introduced a need for greater searchable components, real-time adaptations, and flexibility to scale to meet new levels of demand.” Searchable components were minimal, edits were not possible in real time, and speed was limited across operations.
Streamline service delivery to deliver the ultimate user experience.
The STLC DPH launched a public health data management system to monitor and manage COVID-19 cases countywide. The team utilized an omni-channel strategy to reach constituents anytime, anywhere, to ensure they were meeting CDC guidelines, providing correct public health guidance, and preventing and protecting the spread of the virus through contact tracing.
“We have sped up our processes of case investigation while ensuring the information we are collecting is accurate and that the opportunities available for testing and treatment are presented to each resident that we come in contact with,” said Kolenchery. “Our office has been able to prioritize cases and our investigators time, without sacrificing the health of our people or their customer service experience.”
A look into the system in STLC …
- Health comes first
The team is enabling case investigations and contract tracing, while broadening the platform for greater public health capabilities. Building on Health Cloud, Salesforce’s industry-specific solution to meet the unique needs of healthcare professionals, Kolenchery and team are ingesting HL7 data from the state public health systems and from local healthcare providers. With built-in reporting and dashboard capabilities, the STLC DPH can educate the public on their risk of contracting COVID-19. Additionally, the team is electronically managing CDC forms and expanding its COVID-19 tools to tackle other diseases like STIs.
- Embracing an omni-channel strategy
When a county resident tests positive for COVID-19, there are several options available to complete the case interview based on personal preference. Using an omni-channel approach, people can choose to complete it over the phone or be emailed the survey to complete on their own time. If they choose the latter, they are then prompted through an automated set of questions through Experience Cloud. Additionally, residents can submit their health symptoms through a self-service portal for the chief medical officers to then determine their individual, official release status on a case-by-case basis. Those individuals have the option to track their symptoms with the office before receiving that official notice to return to school or work once a CDC-regulated quarantine has been completed.
These components have enabled Kolenchery and his team to serve more residents and investigate further cases with automation and integration capabilities that are essentially extending staffing hours without the need for additional human capital. The resident’s test result is then logged as a case in Salesforce and submitted internally to the system.
- Integration for the ultimate user experience
“Our office works heavily with the state of Missouri to ensure we are keeping people safe,” said Kolenchery. “With the platform, we have data flowing in via MuleSoft that populates prioritized lists for our DPH case investigators to start reaching out to the appropriate parties and citizens to provide resolution. These list views enable our investigation team to prioritize efforts, adjust, and target, based on things like household, geographic location, age group, and more.
“Omni-channel capabilities on the platform have allowed us the ability to send primer text messages via the system so that citizens can expect our phone call,” Kolenchery said. “If the resident answers the call, the investigator assigns the case to themselves, requests consent to interview them, and conducts a case interview from there.” This series of steps, alongside others, are walked through with a foundational flow that was built into the system, in efforts to capture specific information and identify contacts who are then generated as cases for further contact tracing. This is all in part of a goal to keep the residents of St. Louis County healthy and safe through these unprecedented times.
- Compliant with rules and regulations
Shield was layered on to help this department of public health stay compliant with applicable privacy and requirement laws.
- Countywide innovation
Kolenchery and his team are also monitoring and managing immunization data throughout St. Louis and ensuring the status history is tracked accurately and in real time. With Lightning, the team is inputting critical data and generating insight both efficiently and effectively, ensuring a layer of additional protection across the state. The timely reports are allowing the STLC DPH team to match people between datasets and further classify cases and residents.
Sandbox was layered on to boost collaboration efforts and ease the effect of working between multiple environments.
“With data insight that is near instantaneous, our office has been able to prioritize cases and our investigators’ time, without sacrificing the health of our people or the customer service experience. This also allows a jumping-off point for diseases beyond COVID-19, like STIs.”
This is only the beginning for St. Louis County.
In light of COVID-19, the team has seen case investigations skyrocket from 40 a month to over 100 a day. The team is received north of 3,000 cases daily at the peak of the Omicron surge, but they are not investigating all of them in their entirety to better scale efforts and human capital where it is most needed. “Furthermore, our case volume has quadrupled since go-live, and we have been able to meet the demand to the best of our ability. Our staff is happy, and our customers are being served better and faster,” said Kolenchery.
“We are experiencing a once in a generation pandemic and that has been the catalyst for a once in a generation opportunity to invest in a long-term, strategic infrastructure that can grow with our agency and people,” Kolenchery added. “We as government need to allow these unprecedented times to prompt a big change towards a more digital first way of thinking and of providing service to those who count on us most.”
Kolenchery and his team learned to take advantage of data insights and hired accordingly to digest the information found before narrating it into something that was usable and operational. The team suggests that other agencies work with the entire office ecosystem, hire talent to support the platform deployment, and support the back end with a thorough implementation partner. “We are beyond excited about our adoption of a digital product and its possibilities beyond COVID-19,” said Kolenchery. “Our office will also be expanding into efforts including other community health issues to help keep the people of St. Louis as healthy and happy as possible.”
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