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CORONAVIRUS (COVID-19) – RESOURCES FOR DERM PAs

Thursday, March 26, 2020   (0 Comments)
Posted by: Blair Beggan
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A Message from the SDPA...

We Care about Keeping You and Your Patients Safe, Healthy, & Informed

As patient-facing healthcare providers, Derm PAs are in a unique position to communicate current, evidence-based information not only related to the field of Dermatology, but also the general health and safety of communities in which they serve. The 2019 novel coronavirus (COVID-19), now a household name, is a very real and present threat.

Standing on the frontlines of healthcare, all providers have a responsibility to address COVID-19. Keeping up to date on the latest news and sharing good resources with colleagues and patients are ways in which you can act during this uncertain time.

SDPA cares about you, your families, and your patients. As we all continue to navigate this pandemic, we will be providing resources for our Derm PA community to access as needed.

We have also set up a special discussion thread on SDPA Connect for members to share their thoughts on the information presented here as well as their own ideas, suggestions, and any questions they have for their Derm PA colleagues.

What safety measures have you taken in your personal and professional daily lives? How is your practice adapting to these rapidly changing conditions? We encourage you to join the conversation today.

In health,
SDPA Board of Directors and Staff


 

FREQUENTLY ASKED QUESTIONS

What is COVID-19? 

How does COVID-19 spread?

Who is at risk for severe disease from COVID-19?

How should we treat patients with immunocompromising conditions like psoriasis and psoriatic arthritis during this time? Should they continue biologics?

How should we treat patients currently on or starting isotretinoin? Are they still subject to laboratory testing or imaging requirements?

What can I do to prevent transmission of the virus?

What should I know about infection prevention at home, in my community, and in my healthcare facility?

What should I do if I begin to exhibit COVID-19 symptoms?

Where can I find reliable, up-to-date information and resources on COVID-19 to share with colleagues and patients?

What is telehealth?

What are some benefits of using telehealth in Dermatology?

Are there limitations to implementing and providing telehealth services?

How do I get started implementing telehealth in my practice? 

Looking for financial guidance? We've compiled some resources that can help.

Can I participate in the COVID-19 response?  

 


COVID-19: THE BASICS & IMPACT ON PATIENT CARE

What is COVID-19?
COVID-19 is a respiratory illness that can spread from person to person, possibly through respiratory droplets during close contact. Most patients with confirmed COVID-19 develop fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Reported illnesses range from mild symptoms to severe illness and death for confirmed COVID-19 cases. In some cases, people who are infected have no symptoms.

 

How does COVID-19 spread?
The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.

 

Who is at risk for severe disease from COVID-19?
From the limited data that are available for COVID-19 infected patients, and for data from related coronaviruses such as SARS-CoV and MERS-CoV, it is possible that older adults, and persons who have underlying chronic medical conditions, such as immunocompromising conditions, may be at risk for more severe outcomes.

 

How should we treat patients with immunocompromising conditions like psoriasis and psoriatic arthritis during this time? Should they continue biologics?
Currently, the CDC and WHO have no guidelines on the use of biologics during the pandemic. Both the American Academy of Dermatology and International Psoriasis Council have issued guidance on the use of biologic agents during COVID-19 outbreak.

How should we treat patients currently on or starting isotretinoin? Are they still subject to laboratory testing or imaging requirements?
As part of the U.S. Food and Drug Administration’s ongoing efforts to address the coronavirus pandemic, the agency issued a new guidance to sponsors and healthcare providers regarding certain Risk Evaluation and Mitigation Strategy (REMS)-required testing during this time.

iPLEDGE PROGRAM CHANGES DUE TO COVID-19

Summary:

  • The iPLEDGE Program REMS requires pregnancy testing of Females of Reproductive Potential and other patient monitoring so that they may receive isotretinoin.
  • During the COVID-19 national emergency, FDA will not object to healthcare providers using their best medical judgement to ensure their patients continue to have access to drugs subject to these REMS.
  • The iPLEDGE contractor has indicated to American Academy of Dermatology Association (AADA) that at-home pregnancy tests and telemedicine visits are acceptable for complying with the iPLEDGE requirements during the COVID-19 outbreak.
  • Dermatologists will still have to enter pregnancy test information for prescriptions to be filled.

Changes to iPledge Requirements:

  • Requirement - Pregnancy Testing
  1.  Pregnancy test can be “at-home.”
  2. The tests can be obtained at drug store, grocery store, or online retailer.
  3. The test results and date performed must be communicated to prescriber.
  4. Prescriber or designee would enter the date performed (specimen collection date) and test results per usual iPLEDGE program process.
  • Requirement - Prescription Window
    This requirement will not change.
  • Requirement— Two forms of birth control or abstinence
    This requirement will not change.

 

What can I do to prevent transmission of the virus?

  1.  Stay at home. If you must go out, practice social distancing by maintaining a distance of at least 6 feet from others. Even those with no symptoms or mild illness could pass the infection to others.
  2. Personal hygiene – WASH YOUR HANDS multiple times per day, especially before preparing meals or after contact with family members. Try not to touch your face as the eyes, nose, and mouth are potential transmission points. Do not cough or sneeze into your hands. If you do,
  3. Clean and disinfect all “high-touch” surfaces every day. High-touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Remember to disinfect any surfaces that may have blood, stool, or body fluids on them.

 

What should I know about infection prevention at home, in my community, and in my healthcare facility?

MORE INFECTION PREVENTION GUIDANCE

For more ways in which you can protect yourself, loved ones, and patients, visit https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html

 Recommended Precautions

 Handwashing: Clean Hands Save Lives

 COVID-19 Interim Prevention & Control in Healthcare Facilities

 Key Concepts

  •  Limit how germs can enter the facility. Cancel elective procedures, use telemedicine when possible, limit points of entry and manage visitors, screen patients for respiratory symptoms, encourage patient respiratory hygiene using alternatives to facemasks (e.g., tissues to cover cough).
  • Isolate symptomatic patients as soon as possible. Set up separate, well-ventilated triage areas, place patients with suspected or confirmed COVID-19 in private rooms with door closed and private bathroom (as possible), prioritize AIIRs for patients undergoing aerosol-generating procedures.
  • Protect healthcare personnel. Emphasize hand hygiene, install barriers to limit contact with patients at triage, cohort COVID-19 patients, limit the numbers of staff providing their care, prioritize respirators and AIIRs for aerosol-generating procedures, implement PPE optimization strategies to extend supplies.

 

What should I do if I begin to exhibit COVID-19 symptoms?

  • Call your doctor: Before seeking care, call your healthcare provider and tell them that you have symptoms of COVID-19 and ask for next steps.
  • If you have a facemask, wear it—even at home to protect those in your household.
  • Ask your healthcare provider to call the local health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.
  • If you have a medical emergency and need to call 911, notify the dispatch personnel that you may have COVID-19. Put on your facemask before emergency medical services arrive.

 

Where can I find reliable, up-to-date information and resources on COVID-19 to share with colleagues and patients?

 The CDC has made available an excellent compilation of resources for your patients, including info on symptoms, high-risk patients, pregnant women & children, small business owners, travel policies and school policies.

News and resources from The White House, CDC, and FEMA, including Coronavirus Guidelines for America: 15 Days to Slow the Spread (available in English and Spanish)

WHO provides a detailed daily report on countries, territories, or areas with reported laboratory-confirmed COVID-19 cases and deaths.

Track confirmed cases across the globe in real time. You can also drill down to the United States to see confirmed cases by State.

 

The American Academy of Dermatology (AAD) has assembled resources on COVID-19, including guidance on how to adjust to the outbreak in your clinic (below), legislative and regulatory updates that may impact you and your practice, information about the business implications of the outbreak, and the latest information on how to use teledermatology to provide care during the outbreak.

The AAPA resource center offers news about how PAs are responding to the COVID-19 pandemic, public health resources and state & federal public policy resources.


See AAPA's map showing those states that have have taken action to suspend or waive certain practice requirements for PAs in response to the COVID-19 pandemic.

 

Visit the FSMB website for information on guidance for federal, state, and local governments and government agencies seeking emergency changes to licensure requirements and a list of states declaring emergency declarations and details on licensing waivers.

 

Are there any toolkits or handouts available that I can use to communicate important messages to staff members and patients?

Yes, in addition to general public safety announcement posters, the CDC and other organizations have developed signage specific to COVID-19 for your use.

RESOURCES FOR YOUR PRACTICE: TOOLKITS, POLICY TRACKERS, POSTERS & INFOGRAPHICS

  •  US Chamber of Commerce
  1.  Coronavirus Response Toolkit
  2.  Coronavirus State and Local Government Policy Tracker
  3.  COVID-19 Customizable Flyer
    Customize an alert flyer to reassure visitors that you are taking recommended action to keep people safe and secure a healthy practice environment. Insert your logo, save, print, and post.

 

  •  CDC Resources

Click here for Healthcare Print Resources - see samples below.

     

 

 

Click here for Social Media Infographics: A variety of graphics tailored for social media sharing. Available in English & Spanish.

 

TELEHEALTH: DELIVERING VIRTUAL HEALTHCARE TO YOUR PATIENTS AMID CRISIS

What is telehealth?
Telehealth, as defined by The Health Resources Services Administration, is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

What are some benefits of using telehealth in Dermatology?
Benefits of implementing telehealth services include improved access and cost efficiencies, both of which are top of mind during health emergencies. Dermatology is well-suited for telemedicine. “Teledermatology” is an effective way to evaluate and treat patients for routine symptom management and other nonurgent follow-up visits. It can potentially reduce your patient volume and thus limit COVID-19 exposure for high-risk patients and staff.

Are there limitations to implementing and providing telehealth services?
Prior to the COVID-19 pandemic, limitations on Medicare coverage and payment for telehealth services furnished to Medicare beneficiaries were in place. In consideration of the developing health crisis, Department of Health and Human Services (HHS) has been given the authority to temporarily lift certain restrictions on Medicare telehealth coverage to assist in the efforts to contain the virus.

As of March 6, 2020, providers can bill telehealth visits during the current public health emergency through the Coronavirus Preparedness and Response Supplemental Appropriations Act. 

SOURCE: Key Takeaways from Telehealth Provisions:

  1. Waiver of Originating Site Requirement. Medicare’s originating site requirement—requiring telehealth services be performed in a qualifying rural area at one of 11 qualifying originating sites—may be lifted, allowing for telehealth services to be provided to patients at any location within the emergency area and during the emergency period.
  2. Who Can Perform the Telehealth Services? The eligible telehealth services can only be performed by a “qualified provider” as defined by the Telehealth Services During Certain Emergency Periods Act of 2020 (TSDCEPA). Qualified provider is defined to include the same list of permitted physicians and practitioners authorized under existing telehealth statutes and regulations. 
  3. Telehealth Can Be Provided via a Smartphone. The TSDCEPA clarifies that telehealth services can be provided via phone, but only if the phone has audio and video capabilities that can be used for two-way, real-time interactive communication.
  4. When Will the Waiver Be Effective? The declaration of a public health emergency was made on January 31, 2020, when HHS declared that a national public health emergency relating to coronavirus existed as of January 27, 2020. As of now, HHS has not made a certification to Congress activating the waiver of the aforementioned telehealth requirements.  If the waiver is certified, HHS has the option of implementing the waiver retroactive to the commencement of the declaration of the emergency period.
  5. Uncertainty as to Duration and Narrow Scope. The duration of the waiver period is uncertain.  Providers will need to closely track any changes to the availability of the waiver and take this into consideration when deciding whether to offer telehealth services under the waiver.

How do I get started implementing telehealth in my practice?

Download this free Guide to Starting Telemedicine Video Visits.

Courtesy of 

 


 

FINANCIAL GUIDANCE RESOURCES

 

NerdWallet: Coronavirus Stimulus Checks, Debt Relief and Your Finances

  • How Expanded Coronavirus Unemployment Benefits Work
  • Mortgage Relief Programs
  • Laid Off Due to Coronavirus?  Take These 6 Steps
  • How to Get Student Loan Relief

HerMoney - WE GOT YOU: Coronavirus Resources and Financial Advice

H&R Block: Get the latest info on the coronavirus tax impact

Kiplinger: Coronavirus Coping Tips for Family and Finances

 


Please Note:  All content provided here is for informational purposes only. The SDPA is not responsible for your use of the information contained in or linked from our COVID-19 resource page.


 


Calendar

SDPA Digital 2020
October 29 – November 1, 2020
A virtual educational offering
Learn more >

 

SDPA Annual Summer Dermatology Conference
June 10 - June 13, 2021
Chicago, IL

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