March 14, 2020
Dear CMG Providers,
Essential updates for today:
- This is my first try at creating the update and inserting all the links myself, so forgive any technical errors. Put mass communication during a viral pandemic on the list of things I never learned in medical school.
- Confirmed cases continue to increase. Unfortunately as expected, we are starting to see confirmed cases among our healthcare community. Our thoughts and prayers go out to our colleagues, as we try and take care of each other while we care for our patients.
- Our telemedicine vendor is trying to enroll practice as quickly as possible, however their capacity is strained. I have researched alternative options and will put forward another option- doxy.me This is a low cost service that was recommended by a couple of members. It is HIPAA compliant and will allow you to bill telemedicine services. Please note, we were not able to do anywhere near our normal vetting process. We reviewed their Business Associate Agreement and it is acceptable given the circumstances. I was able to register and enable visits in about 1/2 hour myself today. We expect further updates from Chiron on Monday.
- We are anticipating that we will soon remove travel screening from the triage process for patients under suspicion for Covid 19. This is because at this point it is clear the we almost certainly have community spread in CT. We are awaiting testing data to confirm this, but I would consider placing less relevance on travel history and assuming all patients are at risk at this time. The mainstay of triage still remains remote assessment of patients via phone or telemedicine. Every effort should be made to pre-screen patients before they arrive in the office. A sample flier you can place on your office doors can be found here. We are also recommending you change your triage process and phone tree to implement this change. Our adult triage protocol can be found here. We are close to finalizing a pediatric protocol and expect to publish it on Monday.
- Testing sites remain limited. There are limited number of sites available. At this point referrals should be prioritized due to limited capacity. Please reach out to me if you have any questions about testing sites.
- The CDC released updated travel precautions (3/14/20) for older adults and those with chronic conditions, essentially recommending suspension of all non-essential travel.
- The CDC updated their recommendations on sample collection (3/13/20) recommending a single nasopharyngeal swab. Collection of oropharyngeal swabs are of lower priority and should be placed in the same tube.
- Please see the important update (3/14/20) about ACE/ARBS and their impact on Covid-19 severity.
Please forward me any useful information you have, any corrections or
to the above.
Joseph L. Quaranta, MD
Joseph L. Quaranta, MD
President, Community Medical Group