Rebecca S Brienza1, Juliette F Spelman1, Kelly Hager1, Christopher Ruser1. 1. and are Primary Care Physicians, is Chief of Primary Care, all at Veterans Affairs Connecticut Healthcare System in West Haven. Rebecca Brienza and Christopher Ruser are Associate Professors, Juliette Spelman is an Assistant Professor, and is an Internal Medicine Resident, all at Yale School of Medicine in Connecticut.
Abstract
BACKGROUND: The COVID-19 pandemic has forced a shift from in-person to virtual care to reduce exposure risks to patients and health care workers. This report aims to describe a large primary care system's implementation of virtual respiratory urgent care clinics (VRUCs). METHODS: The VA Connecticut Healthcare System (VACHS) delivers care to more than 58,000 veterans in at 8 primary care sites. VRUCs were established as part of the VACHS primary care rapid transition to virtual care model. Retrospective analysis and qualitative chart reviews were performed from February 2020 through May 2020 to describe characteristics of patients who received care through the VRUCs. RESULTS: VRUCs were used by > 445 patients, 51% received COVID-19 testing, 10% tested positive, 5% were admitted to the hospital, and 18% had ≥ 1 subsequent emergency department visits. Chart documentation rates of discussion of isolation precautions, high occupational risk, and goals of care were 71%, 25%, and 14%, respectively. CONCLUSIONS: Average wait time for health care provider evaluation was 104 minutes, suggesting VRUCs are an expedient means to provide assessment of COVID-19 symptoms. Use of templated notes may ensure routine counseling about isolation, occupation, and goals of care.
BACKGROUND: The COVID-19 pandemic has forced a shift from in-person to virtual care to reduce exposure risks to patients and health care workers. This report aims to describe a large primary care system's implementation of virtual respiratory urgent care clinics (VRUCs). METHODS: The VA Connecticut Healthcare System (VACHS) delivers care to more than 58,000 veterans in at 8 primary care sites. VRUCs were established as part of the VACHS primary care rapid transition to virtual care model. Retrospective analysis and qualitative chart reviews were performed from February 2020 through May 2020 to describe characteristics of patients who received care through the VRUCs. RESULTS: VRUCs were used by > 445 patients, 51% received COVID-19 testing, 10% tested positive, 5% were admitted to the hospital, and 18% had ≥ 1 subsequent emergency department visits. Chart documentation rates of discussion of isolation precautions, high occupational risk, and goals of care were 71%, 25%, and 14%, respectively. CONCLUSIONS: Average wait time for health care provider evaluation was 104 minutes, suggesting VRUCs are an expedient means to provide assessment of COVID-19 symptoms. Use of templated notes may ensure routine counseling about isolation, occupation, and goals of care.
Authors: Rashid L Bashshur; Joel D Howell; Elizabeth A Krupinski; Kathryn M Harms; Noura Bashshur; Charles R Doarn Journal: Telemed J E Health Date: 2016-05 Impact factor: 3.536
Authors: Juliette F Spelman; Rebecca Brienza; Robert F Walsh; Paul Drost; Amy R Schwartz; Jeffrey D Kravetz; Patricia Pitkin; Christopher Ruser Journal: J Gen Intern Med Date: 2020-07-23 Impact factor: 5.128
Authors: Jacqueline M Ferguson; Josephine Jacobs; Maria Yefimova; Liberty Greene; Leonie Heyworth; Donna M Zulman Journal: J Am Med Inform Assoc Date: 2021-03-01 Impact factor: 4.497