Even before the specter of coronavirus settled over Chicago and its disruption of life crystallized into inevitability, the medical community had surmised a simple, harrowing reality: this could overwhelm the healthcare system.
It’s the standard story: PPE shortages, insufficient ventilators, patients lining the hallways of overcrowded hospitals. This is what happened in Spain and in Italy and quite nearly all over New York, but when it came to Chicago, this nightmare never materialized.
Chicago is unique among many major metropolitan areas in that its healthcare sector rests at the intersection of leading research institutions (like the University of Chicago and Rush University), business collaboration, and technological innovation. The final piece has been crucial in mitigating the health crisis, not only in Chicago, but across the United States. To put it plainly, some of the software innovations developed here in recent years have proven indispensable in fighting the worst effects of the coronavirus.
One of the greatest challenges posed by COVID-19 is how novel it is.
When it first emerged, there was no clear understanding of how the virus worked, what treatments were necessary at which points, or what protocol should be in place for diagnosis. As a consequence, providers on the front lines were making assessments on unsteady ground. Clinicians needed an easy, simple way to internalize constantly fluctuating information as they assessed a great number of patients quickly.
“We have never had to consume data with a changing workforce and a changing population and changing resource availability at this speed and this scale before,” Dana Edelson, a clinician at the University of Chicago and the co-founder & president of the healthcare software developer AgileMD, said.
That’s where AgileMD comes in. AgileMD creates innovative software that is embedded directly into electronic health records (EHR), the very files clinicians use while treating patients. One of their solutions, which is proving crucial to COVID-19 reponses, pulls up to the minute recommendations from the CDC in order to inform providers about the best course (known as a clinical pathway) of action based on the latest feedback from how clinicians are treating the disease in the field. Usually, these updates are distributed through email, which in a crisis can be cumbersome.
“The last place you are is in your email,” Edelson said. “These people all dressed up in personal protective equipment, gowned up and covered, patients lined up in the hallways—they are not in their email looking to see which is the latest version of the treatment algorithm that we’re supposed to be following right now.”
Building into the EHR system quickly and seamlessly has been a crucial part of making this tool available, particularly given the pressures of the moment. The University of Chicago medical center, where Edelson works, had more than 100 patients that she was helping to treat, and this is the norm in major urban hospitals around the country right now. There is simply too much work to try integrating complicated new systems, which AgileMD has mitigated by bringing their software directly to where providers already are—in patients’ EHR.
“The idea of doing something new and different right now when our hair is on fire just seems scary,” Edelson said. “A lot of people aren’t even able to look two weeks in advance because they’re just drowning with the patients that are coming in front of them.”
The most notorious threat posed by the coronavirus was a shortage in PPE, particularly masks. One major contributor to this problem was a general lack of supply, a problem easy to identify but somewhat challenging to solve immediately (production takes time). But beneath this barrier lies a somewhat more insidious challenge: not all the PPE in Illinois is where it needs to be.
All kinds of organizations stock PPE that can be used by medical professionals on the front lines. Research labs, veterinary clinics, residence halls at universities, dentists’ offices—the list goes on. But there is no simple system for keeping track of these stockpiles and distributing them widely. That’s the problem Rheaply, a Chicago-based startup solves.
They use an exchange platform that serves as a virtual marketplace where supply managers in hospitals (and other relevant organizations) can make requests and report excess stock. For Tom Fecarotta, VP of External Affairs, this is a nimble solution to a behemoth blocker around the state.
“The procurement decisions within large organizations are very antiquated and underwhelming in the sense that there’s not a lot of user friendliness to those platforms,” Fecarotta said. “There’s just a lot of inefficiency in the system. There needs to be resource efficiency and a digital effort alongside this so that we can make those efforts more impactful.”
Beyond just fixing inefficiencies—which has been crucial for arming healthcare workers during the crisis—Rheaply aims at accomplishing a part ecological, part democratic vision of zero-waste resource procurement and exchange. While their solutions are particularly relevant to the current crisis, they see this as the long-term disruption of an exceedingly outdated system.
“We are the technology to scale the circular economy—waste is non-existent,” Fecarotta said. “We connect all the players in a reuse network. We’re trying to democratize reuse within large organizations. And in the case of COVID-19, we’re trying to democratize PPE exchange and make sure that everyone within Illinois can connect with each other.”
While a mix of different innovations and partnerships have been crucial to Chicago’s response to the pandemic, technological innovations like these have completely changed the outlook. Despite being the third largest metropolitan area in the country, Chicago has not hit hospital capacity, ventilator capacity, or ICU capacity. And because clinicians and leaders making life and death decisions are being armed with data and tools (like those provided by AgileMD and Rheaply, among many others), the prognosis, while not a ray of sunshine, isn’t as bleak as it has been for other parts of the country.
“We are not going to look like New York,” Edelson said. “And we owe that in part to our front leading clinicians and administrators who work together to make their own institutions safe, but also our government that’s really been in front of this.”