How clinicians treating COVID-19 are connecting to stay ahead of the disease

By Dr. Chris O’Connor, President & Founder of Think Research, and ICU Physician at Trillium Health Partners

I spent last week treating COVID patients in the ICU. This week, I’ve been in my basement, self-isolating from my family, and spending a lot of time alone thinking about how my two worlds of clinical medicine and technology are colliding in such a profound way right now.

At the bedside, we are so focused on what’s right in front of us. Someone who is very sick, with a disease we are only starting to understand. We collaborate as colleagues caring for the patient in the hospital, sure, but I’ve also been encouraged to see that collaboration is extending much, much further. 

I want to share some data showing clinicians and researchers sharing clinical protocols and order sets for treating Covid 19 during the pandemic.  

The graphic accompanying this blog shows the sharing of clinical protocols/order sets across Think Research’s Network during the first three weeks of the COVID pandemic. It’s a visual representation of a learning network.  Each separate dot represents a healthcare organization. A line between dots represents when an organization downloads another organization’s order sets. It consists of two parts.

1. Think Research COVID Reference Library (central yellow dot on left in the middle of the floret pattern):

  • Developed by Think’s Research and Development team using a rigorous evidence-based process in collaboration with leading clinical experts and health care organizations.
  • Contains order sets and clinical protocols (OS/CP) that can be used as a starting point for local order set development and implementation  (in future iterations there will be multiple reference libraries which will be adapted for different countries/jurisdictions).
  • As you can see, this order set is used heavily by most, but not quite all, organizations.

2. Network Library: This is all the COVID-related order sets and clinical protocols in use across all the health care organizations that belong to our network. 

  • All of the order sets/clinical protocols on our network are in production (e.g., actively being used to care for patients). There are no order sets that are not implemented. 
  • These order sets/protocols can be downloaded and used by other hospitals in the Think Network as a reference for their own order set development.  

Each organization customizes OS/CPs for their local use. They can include and share their innovative approaches to implementing best practices in each of these interventions. That creates variation across the network — new knowledge and new approaches in action!

What this image tells me is that organizations are taking advantage of this added knowledge – looking at each other’s orders sets as a potential source of new information about how to most effectively implement the evidence.  That they are doing this during a time when everyone in clinical medicine is extremely busy I think reflects the value of network effects as a resource for health care organizations.

On our end, the R&D team reviews this interaction and tries to incorporate new knowledge back into the core reference order sets creating a virtuous feedback loop of knowledge creation.