Technology: Solving Problems, Uniting a Community
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Technology: Solving Problems, Uniting a Community

Sara Mulligan-Mauermann, and Brianna Kulp, Public Health Nurse – Communicable Disease, Waukesha County Department of Health and Human Services

Sara Mulligan-Mauermann, and Brianna Kulp, Public Health Nurse – Communicable Disease, Waukesha County Department of Health and Human Services

The COVID-19 pandemic thrust Waukesha County Public Health, Wisconsin, into navigating the same challenging paths as public health departments across the nation: shift focus from typical daily activities to keep individuals and groups healthy to problem-solving solutions to keep an entire county safe from an unknown disease. Population density is a critical factor in disease spread. As the third-largest county in Wisconsin, with more than 406,785 residents, 12,620 businesses, and 15,000 students, COVID-19 cases mounted rapidly and challenged the capacity of Waukesha County Public Health, which was not staffed to manage a pandemic. Recognizing the trajectory of disease burden, an early decision in the pandemic response was to onboard additional staff. The nature of the disease spread created the need to alter typical training methods as mitigation and social distancing requirements needed to be maintained to protect staff. Innovation was essential to be able to train new staff with an emphasis on remote learning.

Waukesha County Public Health was committed to maintaining its standard of initiating contact with an individual within 24 hours of receiving their test result knowing that timely notification and investigation are critical to slowing the spread of the virus. The need to hire a significant number of limited-term employees (LTEs) was integral to maintain protocols. To build and train a team of over 200 investigators in a matter of weeks, Waukesha County leveraged an existing partnership with a local university to create an online Contact Tracing training program. The university utilized its expertise in online learning and curriculum development, and worked with content experts from Waukesha County Public Health, to create an effective training program. This online platform afforded the opportunity to train any size group of newly-hired contact tracers in a short amount of time from the safety of their own homes. The platform also monitored each contact tracer’s progress and tested their understanding of the complex materials throughout the course. Fluidity was built into the training model allowing for staff members who excelled as contact investigators to access additional training to elevate to a disease investigator. The format was also scalable to allow flexibility to accommodate changing staffing needs as the pandemic progressed. By removing the task of contact tracing training from Waukesha County Public Health, staff members were able to maintain focus on policy, new technology training, and utilization of the state’s electronic disease surveillance system.

As the number of COVID-positive cases skyrocketed, Waukesha County Public Health staff reached a point where it was unsustainable to keep up with traditional contact tracing efforts, despite the addition of 200+ LTE contact tracers and disease investigators. Waukesha County recognized that introducing additional technology to contact tracing efforts would help with staff workloads and allow for an innovative way to reach COVID-19 cases. The new technology solution used a text-based approach to reach cases to deliver critical health information, provide resources to the cases and their families, and gather critical disease surveillance information. The technology allowed the positive case to get information on their test results, connect to county-provided resources, and gather information on their symptoms, exposures, and travel while infectious.

After the technology provider gave Waukesha County Public Health the data gathered from the positive case, the investigator followed up with the individual as needed. The speed at which the information was received allowed for timely communication with affected businesses and schools, which was critical for them to make data-driven decisions and operational changes as necessary. This localized, real-time data allowed Waukesha County to guide the community and quick pivots as warranted by that data. Ultimately, Waukesha County successfully used this data to restart the economy and allow schools to continue to offer in-person learning.

The text-based process was well-received overall by a population familiar with and accepting of text communications. Case completion rate averaged 45 percent or more during the peak of surge activity. This technology allowed Waukesha County Public Health to keep up with the demand of cases, and preserved funds received under the Coronavirus Aid, Relief, and Economic Security Act to allow for a more sustainable, long-term solution to the pandemic response relative to contact tracing efforts.

These two technology solutions helped Waukesha County Public Health connect people and processes while maintaining focus on keeping the community safe in the most efficient, effective, and timely manner possible. Technology was critical to the success of the pandemic response to manage over 49,000 cases of COVID-19 in 2020 and into 2021. Waukesha County is proud to lead the way in applying technology solutions to inform data-driven decisions that helped to meet the needs of Waukesha County Public Health staff, businesses, schools, and the community.

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