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Weitzman ECHO COVID-19: Develop & Define Your Telehealth Strategy

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3/25/2020

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Weitzman ECHO COVID-19: Develop & Define Your Telehealth Strategy

  1. 1. Weitzman ECHO on COVID-19: Develop and Define Your Telehealth Strategy March 25, 2020
  2. 2. CME Credit • Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State Medical Society to sponsor continuing medical education for physicians. The Bridgeport Hospital Yale New Haven Health designates this live activity for a maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only credits commensurate with the extent of their participation in the various activities. • This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State Medical Society to provide continuing medical education for physicians. • The content of this activity is not related to products or services of an ACCME- defined commercial interest; therefore, no one in control of content has a relevant financial relationship to disclose and there is no potential for conflicts of interest.
  3. 3. Weitzman ECHO on COVID-19 A Primary Care Perspective cont’d Stephen J Scholand, MD Infectious Disease Consultant 25 March, 2020
  4. 4. Objectives - Review latest updates on novel coronavirus (2019- nCoV, SARS-CoV-2) epidemiology - Quick overview of potential drugs - Promise of Telemedicine - Manage resources effectively - Coordinate health care delivery in partnership with local health department and health care leadership - Remind people to follow the rules: This is war!
  5. 5. 46450 cases 3/24/20 – up from 6496 cases last week (3/18/20) - https://coronavirus.jhu.edu/map.html
  6. 6. Avoiding the surge
  7. 7. Italy, il mio cuore
  8. 8. Other options? • Hydroxychloroquin: early, positive evidence • Kaletra failed (lopinavir/ritonavir) • Remdesivir – no more compassionate use • IL-6 inhibitor - Tocilizumab • Other anti-virals… • Antibodies – Harvested serum, monoclonal antibodies • Vaccines
  9. 9. Patient groups at highest risk • Hypertension – ACE-2 receptors (?) – ACE inhibitors, ARBs – NSAIDs to be avoided • Other Cardiovascular disease • Chronic lung disease; moderate-severe asthma • Diabetes • Obesity (BMI > 40) • Immunocompromised (Cancer patients) • Renal failure; Liver disease • Nursing home residents/LTACs • Extremes of age (<1, over 65)
  10. 10. Use of Limited PPE Supplies • If your mask becomes wet or soiled, remove it, as it may cause a greater risk of infection if left on. • If you plan to reuse your mask, follow these steps between uses: – Wash your hands before removing your mask. – Remove your mask and place it in a bag (paper is better to allow the mask to dry out thoroughly). – If the mask is visibly soiled or ripped and damaged, throw it away. – When reusing, practice good hand hygiene as described above. – If you have more than one mask, consider alternating use to give maximum time between uses for drying. • If you are using a cloth mask, remove, place in a bag for transport and launder between uses. https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
  11. 11. Any good news? • Stopped transmission in China – Draconian measures: 3 days without any cases • Stopped transmission in S. Korea – Tested 20,000/day, implemented targeted quarantine • Italy: first decline in cases noted 3-24-20 • Which model will the USA follow?
  12. 12. Summary • Exploding epidemic – Your area could be next • Be a local health resource – Advise, educate, advocate • Telemedicine • Review PPE inventory • Continue with Communication – Colleagues, other health care facilities – State and local health departments Dr. Li Wenliang
  13. 13. Staying up to date – Trusted sources • https://www.cdc.gov/coronavirus/2019-ncov/index.html https://emergency.cdc.gov/coca/calls/2020/callinfo_030520.asp • https://www.who.int/emergencies/diseases/novel- coronavirus-2019
  14. 14. health phone work Putting it all “Remotely” together Veena Channamsetty, MD, FAAFP Mary Blankson, DNP, APRN, FNP-C Timothy Kearney, PhD
  15. 15. Telehealth: IT Infrastructure • Internet bandwidth • Increased home VPN/Remote connections to corporate network • Capacity to handle the increased incoming/outgoing calls • Assess current accounts capacity • Assess staffing needs to support telework environment • Trainings and train the trainer • Help Desk and live support
  16. 16. Tele-Work • Have a clear well thought out remote worker policy with clear requirements and expectations. • Ensure remote workers are comfortable with the technology they’ll be using at home to connect with others in the workplace – Zoom, Outlook calendar invites, Lync, etc. • Be sure that IT has developed a system with enough bandwidth to support remote workers. • Remote employees should be sure they are scheduling meetings in a regular basis to connect with key stakeholders. • As an organization be sure you create a way to track all of the employees who are working remote.
  17. 17. Telephone/Telehealth Visits • Preparation • Patient Consent • Documentation • Coding • Etiquette • Patient Considerations
  18. 18. Behavioral Health • Realities in Tension: – Patient/client need – Infrastructure capacity – Staff needs – Financial – Constant communication
  19. 19. Behavioral Health Emerging program • Patients moved to Telehealth services. • Schedules reflect 20 minute telehealth visits only. • Workflow • Changing regulatory and billing picture • Documentation • Staff training
  20. 20. Nursing • First line clinical responders to patient(s) calling in with a medical, dental or behavioral health complaint for triage. It is vital for nurses to have the training and guidance to correctly assess any patient presenting on the phone to determine what course of action is needed to best address the complaint they present with. • Telephone triage could range from recommending the patient proceed to the nearest emergency department, to accommodating the patient with a same-day appointment, or offering recommended self- management advice with appropriate follow-up guidance.
  21. 21. 22 Free COVID-19 eConsults • For all Safety-Net Primary Care Practices – FQHC, FQHC-look alike, Migrant Clinicians, Healthcare for the Homeless, Free Clinics • For clinicians and clinical staff with questions specific to Covid-19 • Consults addressed by ConferMED’s expert specialists • Submit consults and questions via the ConferMED website: www.ConferMED.com • Receive a rapid response by email * This initiative is supported by
  22. 22. 23 * This initiative is supported by
  23. 23. Thank You! For questions or to join our mailing list: Contact us at WeitzmanLearning@chc1.com www.weitzmaninstitute.org/coronavirus

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