Project Summary/Abstract
The COVID-19 pandemic has exposed vulnerabilities across the United States healthcare system and provided
a serious test of hospitals’ resilience. The system has faced formidable challenges associated with all facets of
disaster medicine, including prevention, such as containment strategies to prevent spread; preparation, such as
ensuring sufficient supplies for testing and personal protective equipment; and response, such as anticipating
surge events and ensuring sufficient staffing, space, and supplies. A robust disaster medicine response requires
hospitals to engage in rapid, evidence-based decision-making where decisions need to be made on resource
allocation, patient care, and other factors. Unfortunately, just-in-time data may not be readily accessible, and
decision-making is further complicated by rapidly changing circumstances and uncertainty. Health information
technology (HIT) has the potential to enhance the emergency pandemic response but has shortcomings in terms
of usability and effective presentation of data, which are widely documented. The proposed project will examine
local COVID-19 response through the lens of hospital resilience, decision-making, and human factors
engineering at University Hospital of Brooklyn (UHB), a lower-resource, but highly impacted COVID-19 safety-
net hospital located in Brooklyn, New York, which will serve as the primary site. Columbia University Irving
Medical Center (CUIMC) will serve as a secondary site for Aim 1 to provide a point of comparison. The proposed
research will address a critical barrier to effective pandemic response by (1) identifying information and data
needs of local hospital decision-makers and (2) characterizing workflow around decision-making tasks. The
results of this initial evaluation will be used to inform the design and prototyping of novel HIT solutions leveraging
existing systems and technologies that have potential to support decision-making and hospital resilience to
pandemics. Phase 1 of the research, consisting of Aims 1 and 2, will be a discovery process in which the study
team interviews and observes members of the UHB and CUIMC emergency response teams central to pandemic
response. The team will also interview key informants who provide necessary inputs into the decision-making
process and who receive the outputs, such as directors of clinical departments. Phase 2 (Aim 3) will investigate
how methods and tools support the UHB emergency management response team’s information and workflow
needs. A set of prototypes will be developed that include dashboards, visualizations, and data integration tools.
The study team will also investigate whether an established composable (drag and drop) interface platform,
MedWISER, can be used to fashion solutions to address information needs and enhance decision-making. The
ultimate objective is to facilitate the development of a more robust platform to meet information needs and
enhance decision-making capabilities and resilience in response to the formidable strain imposed by a pandemic.
