A Homegrown Digital Solution for Ebola Healthcare Worker Monitoring: Development and Drill Implementation in an NYC Health System

As global Ebola virus disease (EVD) outbreaks continue to emerge, protecting healthcare workers (HCWs) remains a cornerstone of health security. Lessons from the 2014–2016 West Africa epidemic, during which two U.S. nurses were infected and 10 patients were repatriated to the United States for care, highlighted gaps in post-exposure monitoring. More recently, the 2024 case of travel-associated Lassa fever in Iowa reaffirmed the occupational risks faced by frontline clinicians: Among 180 disease contacts, 172 (96%) were healthcare-associated, and risk classification correlated with personal protective equipment lapses. These events underscore a practical reality in healthcare operations: Even a single uncertainty about an exposure can generate days to weeks of follow-up work across occupational health, infection prevention, and supervisory teams. To strengthen preparedness, NYC Health + Hospitals developed a homegrown digital solution to monitor HCWs exposed to suspected or confirmed Ebola and other viral hemorrhagic fevers. Built in 2022, the solution automates twice-daily symptom reporting, alerting, and escalation workflows for occupational health services (OHS). A 33-day systemwide drill in 2023 evaluated usability, timeliness, and coordination. The solution achieved >95% compliance, transmitted alerts within one minute, and enabled OHS follow-up within 15 minutes. Users rated the interface intuitive and efficient. In drill use, the system also captured operationally important near miss moments, such as a missed check-in during routine monitoring, that are easy to overlook in manual tracking but often consume disproportionate staff time when discovered late. The NYC Health + Hospitals Ebola HCW monitoring solution proved operationally feasible, user-friendly, and adaptable, demonstrating a scalable, sustainable approach to biopreparedness for health systems worldwide.