The country can add “contact tracing” to the list of medical and public health terms that, thanks to COVID-19, are now part of our everyday lexicon. And no wonder. The CDC says it’s a key strategy for preventing further spread of COVID-19, and will ultimately enable the safe reopening and operation of municipalities, states, and workplaces.
The CDC also says, “Case investigation, contact tracing, and contact follow-up and monitoring will need to be linked with timely testing, clinical services, and agile data management systems to facilitate real-time electronic transmission of laboratory and case data for public health action.” As a regional vice president for state and local government at Salesforce, this is something I have seen more and more of these past several months as I assist departments and agencies with their digital transformation priorities.
CRM translates beautifully to contact tracing, largely because its digital tools and automated workflows minimize the time it takes public health officials to contact those who might have been exposed to a patient who just received a positive test result.
We have seen several states adopt this approach, including the State of Rhode Island, which transitioned its contact tracing system from an on-premise solution to Salesforce’s Customer 360 for Government. It gives the Rhode Island Department of Health a comprehensive record of each and every COVID-19 case across the state, and allows for a more integrated and adaptable solution to the pandemic. The state illustrates many contact tracing best practices (more on that later) and is also an example of the kind of a public-private sector partnership McKinsey says differentiates this crisis’s contact tracing efforts from those in the past.
But first, what exactly is contact tracing and how does it work?
The World Health Organization defines contact tracing as “the process of identifying, assessing, and managing people who have been exposed to a disease to prevent onward transmission. When systematically applied, contact tracing will break the chains of transmission of an infectious disease and is thus an essential public health tool for controlling infectious disease outbreaks.”
Contact tracing has been the centerpiece of communicative disease control in public health for decades. It was used to help control Ebola, SARS, and tuberculosis. Until recently, however, it was a manual, time-consuming process that relied on pen, paper, and telephone to track and record infections. When coronavirus hit, technology companies from Apple and Google to small startups identified the need for better contact tracing tools, spinning up enhanced manual and mobile technologies to make contact tracing faster and more scalable.
With the onset of COVID-19, Salesforce also deployed a number of digital contact tracing solutions across the country, including Rhode Island’s early deployment, which moved its pen and paper-based process into the cloud using Salesforce Health Cloud, Community Cloud, and Lightning Scheduler.
The experience and examples from our early adopters in government provides a number of best practices that serve as a roadmap for organizations in other industries — such as schools and companies managing multiple office buildings — which may still be considering whether contact tracing is necessary, as well as how to implement it.
Best practices in contact tracing using CRM
Any organization can adopt the following best practices as they put recovery and regrowth plans into motion.
1. Prioritize speed
As organizations of all sizes and stripes look “to operate in the new normal” as quickly as possible, speed has never been more crucial.
Cloud-based delivery platforms are inherently much faster and more efficient than the paper-based processes of yesteryear. The latter can lead to lag time in reporting, and raise the potential for data-entry errors. At the same time, standing up a new on-premise system can take weeks, if not months — a timeline that doesn’t align itself to a crisis where hours and days could literally mean the difference between life and death.
“The virus doesn’t take a break,” said Bijay Kumar, CIO for the State of Rhode Island, “which means this process has to be faster and more flexible in order for us to gain ground on the spread and make reopening the state possible.”
Cloud-backed testing and contract tracing deployments can be built in as little as 48 hours, allowing operators to gain ground against COVID-19’s spread.
2. Prioritize flexibility
When COVID-19 was first detected in the U.S., in late February, known symptoms were cough, fever, and shortness of breath. Since then, the Centers for Disease Control and Prevention (CDC) has expanded this list to include loss of taste and/or smell, headache, nausea, and more. As we become more knowledgeable about the virus, testing, and tracing systems need to be regularly updated to reflect the latest information.
Cloud-backed testing and contact tracing systems are inherently flexible allowing administrators to update their fields and forms with real-time data at frequent regularity. When tracers ask the right questions, everyone is working with the most updated data.
3. Configure, don’t customize
Because COVID-19 is still a moving target, custom-built contact tracing systems, especially on-premise or legacy systems, may create problems as the entry fields needed will likely change over time due to advances in our knowledge of the virus, resulting shifts in protocol, and more. For example, if an administrator wants to track a new symptom due to recent learnings from the medical community, they would need to manually copy and paste that new field across any custom-built areas of the platform.
On the other hand, if an admin with a configured platform makes an update, that change will automatically cascade throughout the system, reducing the time and energy spent on maintenance.
4. Start with what’s critical
Minimum viable products (MVPs) allow you to get to market faster because by definition you are only focused on building out critical components, instead of all the “nice-to-haves” that might be included with “ordinary” projects during ordinary times. MVPs also give organizations the ability to learn from and adjust to what’s working, instead of wasting time developing features that never get used or may not have the intended impact. This has proved to be an especially important strategy in contact tracing deployments because it helps departments roll out critical capabilities fast — Rhode Island, for example, launched its system in just four weeks — and layer on additional features like self-service test scheduling, email communications, SMS messaging, and more from there.
5. Ensure executive buy-in
In a municipal, statewide or enterprise setting, any foundational project requires full buy-in and continuous support of the senior most leaders at an organization because such an endeavor almost always requires the coordination and collaboration of several, independent teams all at once. And cross-functional projects are more successful when they are championed by a unified leadership team: “The work we do is important only in how much it helps,” said Chirag Patel, Chief of IT Enterprise Applications for the State of Rhode Island. “It’s easy for technologists to look at this kind of project as 1’s and 0’s, but the resulting impact has meant so much more.” Read more.
How Salesforce supports contact tracing
Here’s a deeper look at how Salesforce’s product portfolio can support the range of contact tracing functions:
- If someone comes down with COVID-19 symptoms and contacts their healthcare provider (public or private), they will likely be directed to a website to create a profile, schedule a test, and confirm sharing permissions — a classic function of Community Cloud.
- Many organizations then issue a survey, which can be done via Salesforce Marketing Cloud or Salesforce Surveys, prompting the patient to fill out symptoms, level of severity, any pre-existing health conditions, and so on. The survey response is then scored, and those that tip the scale are recommended for testing.
- Salesforce Maps serves up the testing locations nearest to the address the person entered into their profile. When they click on a given testing site, Lightning Scheduler serves up appointment availability, guides them through booking a time slot, and sends a confirmation email (complete with QR code for a touchless check-in, day-of). They show up, get tested, and are on their way.
- Test results are automatically integrated into a Health Cloud or Service Cloud instance, which (A) triggers an email to be sent to the patient, prompting them to log to see their results, and (B) completes the same profile-like view the patient sees on the front end, but in a way that is tailored to help tracers assess the results and take action. Caregivers can review test results, profile data, symptom history, and more. They can also request additional services (like food delivery or child care services if the patient is COVID-positive and, say, a single parent), and track progress just like any other case.
- The care team can also send the patient a daily email or text message survey to record changes in symptoms and schedule follow up phone appointments as needed via Marketing Cloud and/or Service Cloud, depending on the volume that will be required.
- Tracers can log into the Service Cloud instance, see if the patient volunteered contact information for those they might have come in contact with during the incubation period, and follow up with the exposed individuals accordingly.
- Integrated reports and dashboards use anonymized data to create heat maps of case clusters, compare hospital beds or available supplies to the number of patients, and more. Einstein and/or Tableau can extend data analysis further, making it easier for teams to spot trends, identify hot spots, and track community progress overtime.
Reopening businesses and states safely in this pandemic is a major challenge. There’s no precedent or playbook. That’s why we developed Work.com, a suite of tools including contact tracing, emergency management response, workforce reskilling, workplace command center technology, and more. Salesforce is proud to play a part in helping the public sector reduce the spread of COVID-19, and to help organizations reopen as safely and efficiently as possible.