Webinar Summaries

IEFMC Telehealth Webinar 3/25/2020 12:30 meeting with Dr Barry Bittman as understood and summarized by Dr. Tim Watson

Take Home Points:

1) Don’t Shut down practices

2) A surge is expected in next 10-12 days.  With peak in next 10-20 days.

3) We need to safeguard office staff while providing care, so the majority of staff to work from home

4) Keep all phone lines open to help patients, consider designated phone for symptomatic patients.

5) NEVER TEST PATIENTS IN YOUR CLINIC

6) Telehealth for all patient visits recommended

Goals:

1)  Optimize healthcare for those in need

2)  Prevent ER bottlenecks

3)  Treat non-virus healthcare

4)  Assume everyone is infected since 60% infected are asymptomatic.  

Triage Questions

1) You know your patients, so know if they have asthma, cancer or immune problems, EMR should be available when answering phones.

2) Find out if they have been in contact with anyone who tested positive

3) Fever

4) Age

5) Muscle aches

6) Stomach ache.

7) Respiratory Cough/chest pain difficulty breathing, shortness of breath

8) Severe headache

9) Weakness or confusion

10) Altered Level of Consciousness or Fainting

11) How long are symptoms

Early Symptoms

1) Diminished smell or taste

TESTING:

1) No symptoms, no testing recommended.

SEND TO TALK TO YOUR PROVIDER:

1) If febrile plus symptoms listed in TRIAGE QUESTIONS

SEND TO ER:

1) If symptomatic with preexisting conditions, diabetes, lung disease, kidney disease, immunocompromised.

2) Fever plus breathing problems must go to ER

3) Anyone with High Fever

4) If Provider deems sick enough to require a physical exam

DOCUMENTATION ESSENTIALS:

1) Must document at beginning of note that patient consents to telehealth method for delivery of care, “the patient was offered a telehealth consult for a visit and verbally agreed”

2) Sign on door not to enter offices.

3) 1135 waiver requires established relationship and HHS will not conduct audits, so don’t need established relationships

4) Telehealth includes three areas: True telehealth with audio and video.  Virtual checkins which are done by phone and E-visits which are with a portal (or email?)

5) Site of service with doctor in their home and patient in their home is acceptable

PPE FACTS:

1) Virus survives on surfaces for 3 days in some cases

2) 60% asymptomatic people are carriers

3) PPE not being used should be given to front lines.

PEDIATRIC

1) Consult the AAP for recommendations on vaccines.