COVID-19 (March 17 Update)

PHG COVID-19 Mitigation in Ambulatory Practice Locations

As cases of novel coronavirus (COVID-19) emerge and spread in Southwest Ohio, it’s important for our providers and staff to understand overall actions which are consistent with recommendations, per national, state, and local authorities. These recommendations were approved by Premier Physician Network physician leadership group today (PPN board co- chairs, charter chairs and primary care medical directors), and apply to both specialty and primary care practices. Premier Health Group is sharing with you as community partners. These recommendations will evolve over time, based on changes, which are likely to occur.

At the same time, Ohio and the nation are facing a direct shortage of personal protective equipment (PPE), including that maintained in the national cache.

Patients should be encouraged to receive a phone-based triage, which in most cases will be done by their primary care provider. Based on these phone consultations, providers will decide whether patients require an in-person assessment. If call volume becomes unmanageable, you can direct patients to Premier Virtual Care. This is available 24 hours a day, 7 days a week to video chat with a health care provider. However, there is a fee to the patient associated with this screening.

CURRENT KEY RECOMMENDATIONS:

1. Initiate daily practice huddle and telephone calls, to patients with scheduled appointments:
   1. Screen for Upper Respiratory Symptoms and/or exposure to COVID-19 lab confirmed persons
      1. Offer pathway to care if symptomatic or known exposure
   2. Reschedule non-essential appointments for patients that are high risk for COVID-19 complications 6-8 weeks out (goal is to limit exposure for these patients)
      1. Non-Essential Appointments include but are not limited to:
         1. Routine follow up appointments
         2. Refill appointments
         3. Annual physicals/annual wellness visits/ MAAP
      2. Definition of Patients at high risk of COVID-19 complications (CDC guidelines):
         1. Patients > 65 years of age
         2. Any patient with (regardless of age): diabetes mellitus, heart disease (CHF, cardiomyopathy), chronic lung disease, chronic kidney disease, transplant recipient, oncology patients (undergoing active treatment), autoimmune disorders (e.g. RA, SLE, Sjogren’s etc.), patients on immunosuppressants (including long term prednisone),
   3. Provide refills to patients who are rescheduling until they can be seen in office
   4. Implement office specific process for patients that must be seen and exhibit any upper respiratory infection symptoms. ***Example for illusory purposes:
      1. Nurse will contact the patient to determine if they have low risk or increased risk symptoms or history.
      2. Low risk patients can be seen in the office with a mask placed on them when they arrive
      3. Increased risk patients will be referred to the provider who will perform a telephone encounter evaluation to determine what treatment or evaluation is appropriate
      4. Increased risk would include the following criteria:
         1. Travel on airliner or cruise ship in last 14 days
         2. Exposure to known COVID-19 patient
         3. Fever
         4. Cough
         5. Shortness of breath
         6. Body or muscle aches
2. Implement visitor restrictions aligned with local Health System policies. View the policy.

Premier Health is collaborating with Compunet and the University of Dayton to set up a collection site in the UD Arena parking lot, 1801 Edwin C. Moses Blvd., beginning on Tuesday, March 17. This site will offer a process to collect specimens from patients who have a physician order with them for a COVID-19 test to be performed. A logistical team from the University of Dayton will be on hand to direct traffic. Security also will be present. If patients do not have a physician’s order, they will not be screened.

The hours of operation will be 10 a.m. to 6 p.m. each day.

• View the instructions on completing the patient order.
• View sample workflow for screening patients in office and placing orders for testing.

Resource from the week of March 16

• GDAHA Entrance Signage
  • Horizontal
  • Vertical
• State of Ohio Coronavirus FAQs
• Ohio Department of Health’s Facebook page
• State of Ohio's website
• Department of Health hotline: (833) 4-ASK-ODH(833) 4-ASK-ODH

Have additional questions?

Join Roberto Colón, MD as he answers FAQs about COVID-19.

Friday, March 20, 2020
12 p.m. to 1 p.m.

Microsoft Teams Meeting

• (937) 401-2803(937) 401-2803 - United States, Dayton (Toll)
• (877) 287-6804(877) 287-6804 United States (Toll-free)

Conference ID: 814 519 177#

RSVP by March 19 and submit your questions in advance to PHG@PremierHealth.com. Please note the first 250 people who join the call will be connected into the meeting. A recording of the call will be placed on the Premier Health Group website at PremierHealthGroup.com.

 We will continue to communicate with updates as they become available.

Back to the March 2020 Issue>>

Roberto Colón, MD

System Chief Medical Officer and Vice President of Quality and Safety for Premier Health