BCMS Medical Record Fall 2020 - 41

In contrast, reasons for SUD patients not receiving treatment
included lack of health coverage paired with inability to afford
treatment and/or patients requiring a higher level of medical,
surgical, or psychiatric care.4 Many cases involved intoxicated
patients or patients under the influence of controlled substances
coming to the ED after motor vehicle collisions, episodes of mental
health illness, and substance overdoses. Additionally, there were
several instances of patients accepting a WHO, but zero beds being
available at many inpatient treatment facilities. Other facilities
only accepted certain insurance programs, so some patients were
discharged home, only to come back to the ED later.
For the future, a criterion for a WHO Consult should be outlined
for healthcare providers to reference in the Epic Medical Record
System. If a patient fulfills certain requirements involving substance
abuse, a WHO or an Addiction Medicine Consult should
automatically be placed. This allows patients to be informed of all
possible treatment options. Furthermore, a medication-assisted
treatment (MAT) program in the ED could provide even faster
treatment options to patients suffering from SUD.

Creation of Patient Database
to Study COVID-19 Infection
Outcomes-A Quality
Improvement Project
Molly Gallagher, MS1, Summer Intern, and Olubunmi
Oladunjoye, MD
Department of Internal Medicine
Tower Health Reading Hospital, Reading, Pennsylvania
INTRODUCTION: The novel SARS-CoV-19 was identified as
the pathogen responsible for the rapidly spreading COVID-19
infection. COVID-19 has been shown to cause severe respiratory
symptoms in some patients that acquire the infection while it
remains asymptomatic in others. At the start of the pandemic, much
remained to be understood about the disease and its treatment,
posing a clinical challenge. Through a clinical database, we can
analyze characteristics of the disease. We sought to create a clinical
database of patients with COVID-19 infections cared for in the
Tower Health System inpatient services to contribute to such a
database.
METHODS: All patients with a Tower Health hospital admission
beginning March 2020 with positive SARS-CoV-19 testing
were enrolled in the study. The project was deemed to be quality
improvement by the IRB. Information contained within the index
hospital admission related to COVID infection was extracted
through review of the patient's Epic electronic health records. The
information was entered into a REDCap database constructed by
other team members. Select patient demographics including work
in healthcare, past medical history including organ-system specific
comorbid conditions, medications used prior to admission, date
of symptom onset, all symptoms leading up to hospital admission,
number of medical encounters for COVID infection, influenza
PCR, RSV PCR, and hospital-based treatments were recorded.

https://www.samhsa.gov/find-help/disorders
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077851/
3
https://www.ddap.pa.gov/Pages/Warm-Hand-Off.aspx
4
https://europepmc.org/article/nbk/nbk447253?client=bot&client=bot
&client=bot&client=bot&client=bot
1
2

Joaquim Diego Santos is scheduled to graduate from The
Eberly College of Science, Penn State University, University
Park, PA in 2021 with a B.S. in Biochemistry and Molecular
Biology. Joaquim is active in the UPUA (Penn State's
student government), holding positions that have included
Academic Affairs Committee Chairman. His volunteer work
has included serving on the Photography Committee for
THON.
Alexis Schoener is scheduled to graduate from The
Pennsylvania State University - Berks in 2021 with a B.S.
in Science.
McKenna Brower is scheduled to graduate from Syracuse
University, Syracuse, NY in 2021 with a major in Biology
and Forensic Science.
The vitals, Columbia suicide risk score, John Hopkins fall risk
score, NT pro BNP, and hemoglobin A1C levels on admission day
were also recorded. Any test results including blood cultures with
findings, interleukin-6 levels, highest triglyceride levels, lowest
fibrinogen levels, sputum cultures with findings, chest x-rays with
lung findings, and chest CTs with lung findings were also noted. A
patient's influenza vaccination history was also recorded. In patients
admitted to the intensive care unit, ventilator and vasopressor use
was also documented. Patient outcomes including date of discharge,
readmission status, discharge disposition, organ-system specific
complications, statin medication use, anticoagulation use with dosing
and indication during admission were also recorded. Daily COVID
vitals and treatments were collected.
RESULTS: Currently, a total of 1276 patients have qualified for
the study. The study remains ongoing with approximately 200
charts yet to be extracted and expected to be completed within
the calendar year. Each chart contains over 75 data points. Author
MG was responsible for the entry of 510 charts and approximately
38250 data points, with each extraction taking around 15 minutes.
Other authors and volunteers were responsible for the remaining
data extractions. All data points pertaining to daily vitals and daily
treatments were recorded by other authors.
CONCLUSION: The construction of a database allows for the
statistical analysis of extensive clinical data that can be utilized for
future research. Utilizing this database, researchers will be able to
study COVID-19 infections. The authors intend to study factors
which predict patient and treatment outcomes.
Molly Gallagher is a graduate of the University of Pittsburgh
who is currently a second-year medical student at the
Drexel University College of Medicine, Philadelphia, PA.
Her preceptor in the Reading Hospital - Tower Health
Department of Internal Medicine was Ryan Zimmerman, DO.
Molly volunteers at a homeless shelter for women, teaching
mindfulness, conducting guided patient interviews, and
helping children with crafts.
FALL 2020

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