EPtalk by Dr. Jayne 4/16/20

HIMSS could learn a lesson from the American Academy of Family Physicians, which is offering a “worry-free registration” guarantee for its annual conference that is scheduled for October 2020 in Chicago. Attendees can cancel their registrations at any time, for any reason, up to the day before the meeting and will receive a full refund. Bookings prior to April 30 can also receive an additional $100 discount in honor of National Doctors Day. AAFP’s hotel policy is deposit-free and rooms can be canceled within 72 hours of the meeting without penalty. Cancelations within the 72-hour window will incur a one-night charge. It’s unclear if the world will be ready for major conferences by that point, but at least they’ve come up with a good solution to try to make a go of it.

There has been a lot of chatter in the virtual physician lounge around plans for testing and contact tracing in preparation for the end of stay-at-home orders. Excitement about the point-of-care ID Now COVID-19 test from Abbott Labs has been building, as many practices already own the machines that are needed to run them. The company has shipped 560,000 test cartridges across the US, but I haven’t heard of anyone in my area receiving them despite having placed orders as soon as the company started taking them. An article says that the majority have been sent to “outbreak hotspots,” with a request for customers to prioritize testing for frontline healthcare workers and first responders. They are manufacturing 50,000 tests per day and plan to increase the capacity to two million tests per month by June.

Rapid testing is key to strategies for reopening the US economy, along with robust contact tracing. Even though San Francisco is located in a tech hotbed, they are going somewhat back to basics with their approach to contact tracing. They’re putting together a task force to interview patients and trace their interactions, building their team from 40 people to as many as 150. They are engaging researchers, medical students, and staff from the University of California, San Francisco.

Even though major parts of the process will be manual, the group will use online and phone-based tracking tools to follow up with exposed persons and assess them for symptoms. The team will also seek permission to review phone location data for additional tracking.

Where other countries are mandating use of state-developed apps to track movements and trace contacts, many people in the US would fight any mandatory sharing of data, despite the fact that they willingly give it up every day to random apps that sell their data and aren’t trying to keep people from dying.

Testing and contact tracing efforts are going to be expensive and will further stress an already burdened healthcare system. Nearly every facility has a story of salary cuts and hiring freezes along with layoffs and furloughs. Hospitals are still struggling, even those who are not yet in the midst of the surge. They’re paying inordinate amounts for personal protective equipment and still can’t get enough of what they need to function under anything but crisis standards of care.

Next time you read an article about COVID response, look at the pictures. Are the clinicians wearing consistent PPE, or is it a hodgepodge of gear, some brought from home? Do people have head coverings, masks, gowns, and face shields? Do they have masks that fit? Are all clinicians protected, or just those performing the highest risk procedures?

It saddens me to know that I had better PPE when I played the Quipstar game show in Medicomp’s HIMSS booth than some of my colleagues now have. Once we reach the point where healthcare workers have enough PPE that they can use in the way it was designed, not in a way that is modified for scarcity, then we’ll know that we are moving in the right direction.

Greenway health did a great job with their recent blog helping practices understand how the CARES Act may impact them. I’m on a number of vendor email lists and Greenway consistently sharesg relevant information without being too salesy. This particular piece included brief descriptions of the different types of loans and funds available to practices. It may help a practice who don’t know their options for weathering this storm.

If you’re on the team maintains your facility’s charge master or load contracts, make sure you’re keeping up with all the changes CMS is throwing your way. Today’s update was an increase in the payment Medicare is making for certain high-volume coronavirus lab tests. This payment of $100 covers “COVID-19 clinical diagnostic lab tests making use of high-throughput technologies developed by the private sector that allow for increased testing capacity, faster results, and more efficient means of combating the spread of the virus.” High-throughput systems are defined as those that can process more than 200 specimens in a day. Medicare will also be paying new specimen collection fees for homebound patients and those who can’t travel, like nursing home patients.

Road warriors of the US, rejoice. DoubleTree by Hilton has released the official bake-at-home recipe for their signature chocolate chip cookies. As a consultant who has opted to drive an extra hour each day from my hotel to the client site so that (a) I didn’t have to stay somewhere sketchy, and (b) I could have these cookies waiting for me, I am thrilled. I haven’t made them yet, but I am intrigued by the inclusion of lemon juice in the recipe. Apparently more than 30 million cookies are baked every year, and the cookie was the first food to be baked in orbit on the International Space Station a few months ago. It took two full hours for the cookie to bake in microgravity, although the experiment log documented the smell of cookies at 75 minutes. The official DoubleTree statement says, “A warm chocolate chip cookie can’t solve everything, but it can bring a moment of comfort and happiness.”

I bake an inordinate amount of cookies every year with my dad, so I couldn’t agree more. (The picture above is just a fraction of our 2019 effort). My local market is finally back in stock with flour, so these are on the schedule for the weekend.

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