As a service to members and to the general public we will be posting weekly updates of our conversations and resource sharing efforts here. Because these are taken from email conversations, examples provided may refer to single clinics or situations. We hope this inspires, encourages and educates everyone as to the work that integrated care team members are doing in near real-time to the evolving pandemic. To Join CFHA and support integrated care, use this link: click to join.

Note that a compilation of key COVID-19 resources can be found on CFHA’s Technical Assistance website.

Questions CFHA Members Asked

• Members are looking for an ethical framework or tool to help guide COVID task-forces.
• Members are interested in how clinics are handling pharmacy curbside pickup.
• Members are looking for health care professional burnout assessment resources and tools to manage stress levels. 
• Members are interested in resources to help families during their time in self quarantine. 

Member-Provided Information

Supporting Healthcare Professionals

• CFHA members are creating resources designed to combat the cumulative stress carried by healthcare professionals; an example is the relaxation, distraction, refocus, and inspiration page at https://www.integratedprimarycare.com/care-for-covid-19-warriors. 
• In an effort to reduce anxiety of healthcare professionals, many behavioral health teams are using technology to connect with them. 
• Caring for Clinicians is offering a free, interactive webinar series about the pressures, fears, and demands of COVID-19 places on health care professionals as well as coping strategies with a focus on sustainability and resilience. 

Distance Learning and Training

• The UMass Center for Integrated Primary Care (CIPC) is offering free online training for students and primary care teams. The courses are Primary Care Behavioral Health (https://umassmed.ungerboeck.com/prod/emc00/PublicSignIn.aspx?&SessionID=fanfemfg8fapfamfc9&Lang=*) and Patient-Centered Healthcare (https://umassmed.ungerboeck.com/prod/emc00/PublicSignIn.aspx?&SessionID=fa7fe6fg3fa9fb6fa3&Lang=*) and are open to one hundred registered individuals each by March 31st. Continuing education credits are not provided and technical support may be limited.
  • Primary Care Behavioral Health: Sections include Creating and Managing an Integrated Primary Care Practice, Bio-psycho-social Treatment, and Dealing with Substances and Pain in Primary Care.
  • Patient-Centered Healthcare: Care management topics involving Core Issues, Special Populations, Bio-Medical Issues, and Psycho-Social Concerns are implemented in this course for medical assistants, nurses, social workers, and others part of an interprofessional healthcare team. 

Telehealth

• Some institutions are insisting that healthcare professionals go through the EHR for telehealth encounters for audit tracking despite flexibility provided by federal and state authorities. This has resulted in delayed care.
• Many CFHA members are using phone visits given spotty patient access to video telehealth and/or institutional limitations. 
• Requirements for telehealth visits include the patient name, patient consent for a telephonic visit, an assessment, a plan, a medical decision making, and the total time spent in a meeting. Review of Systems (ROS) and Physical Exam (PE) are not requirements. 
• Boulder Care is offering telemedicine MAT services to people with opioid use disorder in Oregon and Alaska. Same-day services are open to everyone, regardless of insurance status. 

Patient Care

• With schools closing and the risk of accidental trauma increasing, some clinics are providing families with schedules, coloring books, and problem-solving skills to develop self-compassionate parents. 
• Some clinics recommend sharing educational resources with parents: examples include Khan Academy, library-developed online educational services, Reading Rockets, and other home learning activities.
• A discussion about supporting family and children during COVID-19 took place; the conversation was documented at (https://drive.google.com/file/d/1ZHOauaHFs9eDffbd3VU4CWZNq45Bf5zM/view) and a list of generated resources is available at (https://docs.google.com/document/d/14CZ0NY3JvhizxGfgzLwzT80zXPzE-lnoZ_gtf6QI24I/edit).  
• The general consensus is that public health officials should tell patients to stay home but emphasize the fact that patients should and must call if they have any healthcare needs.  

Ethics in a Healthcare Crisis

• Healthcare professionals across the country are making difficult decisions and adjusting ethical frameworks in light of the current situation. Documents and trusted models shared by CFHA members are linked below.
• David D. Clarke, the assistant director at the Center for Ethics at OHSU, has shared a number of ethics and healthcare crisis resources which are linked. 

Links We Shared With Each Other

Supporting Healthcare Professionals Links

• https://www.integratedprimarycare.com/care-for-covid-19-warriors
• http://teamcareconnections.org/books/exou/#p=18
• https://www.cstsonline.org/assets/media/documents/CSTS_FS_Sustaining_Well_Being_Healthcare_Personnel_during.pdf.pdf
• https://nam.edu/valid-reliable-survey-instruments-measure-burnout-well-work-related-dimensions/
• https://www.crowdcast.io/e/cnlnhhkb/register
• https://public.3.basecamp.com/p/cFftczEXUB46uURmUPdzySPe

Distance Learning Links

• Primary Care Behavioral Health Short Courses: https://umassmed.ungerboeck.com/prod/emc00/PublicSignIn.aspx?&SessionID=fanfemfg8fapfamfc9&Lang=*
• Patient Centered Healthcare Courses: https://umassmed.ungerboeck.com/prod/emc00/PublicSignIn.aspx?&SessionID=fa7fe6fg3fa9fb6fa3&Lang=*

Telehealth Links

• https://public.3.basecamp.com/p/A6evtK8kXfHSz5iHMiirEpyt
• https://boulder.care/refer/

Patient Care Links

• https://www.washingtonpost.com/graphics/2020/world/corona-simulator/
• https://chcw.org/tips-for-helping-your-family-and-yourself-deal-with-the-isolation-of-staying-home-to-stay-safe/?fbclid=IwAR0Skp_MEOrIPKhuDBKzFpXIceev3DoPJq_hNCcdk4AwRu1dilqkiiSSaEA

• https://m.youtube.com/watch?v=QedhXVRyMcY
• https://www.khanacademy.org
• https://www.readingrockets.org
• https://www.racialequitytools.org/fundamentals/resource-lists/resources-addressing-covid-19-with-racial-equity-lens
• https://public.3.basecamp.com/p/eHJUrAiwTVMj3oFTkiqiQsk3

Ethics in a Health Crisis Links

• http://depts.washington.edu/lend/pdfs/4_box_model.revised_Fitzpatrick_2017.pdf
• https://emailer.emfluence.com/viewaswebpage/4133116C-242F-465A-A0A8-1B9671BC87DB
• http://bioethics.pitt.edu/covid-19-ethics-resources
• http://nciom.org/what-the-2007-nciom-pandemic-flu-task-force-recommendations-can-tell-us-about-the-ethics-of-handling-covid-19/
• http://nciom.org/wp-content/uploads/2017/07/guidelinesforflu_fullreport.pdf
• https://vimeo.com/399959309
• https://www.ohsu.edu/center-for-ethics
• http://www.siaarti.it/SiteAssets/News/COVID19%20-%20documenti%20SIAARTI/SIAARTI%20-%20Covid-19%20-%20Clinical%20Ethics%20Reccomendations.pdf

Thanks to CFHA intern Emma Serrano for her work in compiling the above information.