Title
Medical Director’s Report - Dr. Zun
Body
Physical Health
Provider Collaboration
• Provider communication concerning COVID-19 continues. Email briefings are sent weekly, or more frequently if needed, and there are monthly COVID-19 agency response updates to all providers through the Microsoft Teams platform.
• Remote telephonic patient visits continue to increase and audio/video visits through Zoom recently began.
Clinic Operations
• The capability to provide services to patients with COVID-19 or COVID-19-like symptoms has been increased. The Respiratory Illness Clinic (RIC) has been relocated from BMB and Midlakes Clinics to the North Chicago Clinic. The RIC is staffed by three providers daily, except for Saturdays. The COVID Telehealth service is centralized to Grand Avenue. Currently, there are four providers performing telehealth visits with our patients Monday through Friday.
• Providers are encouraged to schedule remote visits for all patients who had their visits delayed due to the COVID-19 pandemic.
External Relations
• Dr. Zun was selected to serve on the National Suicide Prevention Lifeline steering committee.
• We continue to reach out to Rosalind Franklin University to provide volunteers and students to work with Communicable Disease (CD) doing contact tracing, for which the students receive credit. Students are not allowed to work in the clinics at this time.
Regulatory
• Preparation for The Joint Commission site visit continues.
Behavioral Health
Provider Collaboration
• All hiring remains frozen; interest exists for various positions.
Clinic Operations
• Continuing remote care for all patients; has been primarily by phone, some by video interface using Zoom.
• Lab tests and medication injections continue in person.
• No-show rates have decreased by about 50% in the past month.
External Relations
• Dr. Nathan has made radio appearances on WRLR and WXLC to discuss mental health during COVID-19, and behavioral health services available at LCHD during the crisis.
Regulatory
• Temporary regulatory changes remain in effect:
o Governor’s Executive Order and various federal agencies have relaxed regulation on telehealth, so patients can be physically located at home, with provider being located at the office or elsewhere.
o DEA and SAMHSA have also implemented emergency temporary regulatory changes to allow remote visits for addictions and less frequent dosing of methadone.
Dental Health
Provider Collaboration
• We have redeployed much of the dental staff to work under our Communicable Disease Program or under our Safety Section. Dental assistants serve as safety screeners at the various site locations. There are two dental providers working as contact investigators on a project tracing COVID 19 exposures at Long Term Care Facilities here within Lake County. This is under the guidance of our Communicable Disease Program.
Clinic Operations
• Presently, clinical services are operating under the guidance of the CDC. We are providing emergency care only, Monday thru Friday at the Zion and BMB clinics, until further notice.
Latest CDC Guidance (revisions made 4/27/20)
• To address asymptomatic and pre-symptomatic transmission, implement source control (require facemasks or cloth face coverings) for everyone entering the dental setting (dental healthcare personnel [DHCP] and patients), regardless of whether they have COVID-19 symptoms.
• Actively screen everyone on the spot for fever and symptoms of COVID-19 before they enter the dental setting.
• Actively screen DHCP on the spot for fever and symptoms before every shift.
Regulatory
• We continue to monitor the CDC website for infection control updates as related to COVID-19 and dental operations. In addition, Dr. Cockey has instituted evidence-based clinical guidelines from the American Dental Association for the management of patients who present for emergency and urgent dental care. A more recent publication dated April 24, 2020, Return to Work Interim Guidance Toolkit, will serve as a reference tool to assist in slowly reopening our offices. We await guidance from the CDC as to when the dental service restriction will be lifted.
Suggested Motion
None, for information only.