Last Monday meant all hands on deck for Country Doctor Community Health Centers (CDCHC).
Gov. Jay Inslee had just taken his most drastic measures yet to stem the flow of the novel coronavirus in Washington, ordering the closure of all restaurants and bars. It was yet another step for the state in effectively shutting down personal interaction.
CDCHC, which has two main locations at 19th and Republican as well as 21st and Yesler Way on top of other partnerships, serves about 20,000 people, according to executive director Raleigh Watts. But they had to figure out how to continue to serve their patients while keeping with tight social distancing guidelines.
“Our main goal is that our patients are safe and one of the things that would put patients at great risk is if they came to the clinic while they were sick and they came to the clinic and somebody else was sick,” Watts told CHS Thursday. “So we’re really working hard to keep our patients home.
The solution? Telemedicine.
More than 80% of CDCHC’s visits are now being conducted over the phone, with the remaining space in the clinics reserved for patients that need care that must be done in-person. While they shifted a bit to phone visits about two weeks ago, Inslee’s order pushed them all in.
Part of this was made possible just this week as the federal Centers for Medicare & Medicaid Services lifted some rules on telehealth services so that places like Country Doctor can get reimbursed for telephone contacts. About 40% of the clinic’s patients are on Medicaid, according to Watts, while the rest are either on private insurance or uninsured.
Watts thinks other health care organizations could learn to use their telemedicine approach they’re utilizing to avoid mixing people with symptoms for COVID-19 and people without symptoms.
“Health care facilities can be a horrible mixing ground where people can actually get sick by going to the doctor,” Watts said. “We have been talking about telemedicine for 20 years and now we’ve implemented it overnight.”
For this reason, CDCHC is not doing coronavirus testing in its clinics because its facilities are simply not conducive to having people safely come in to be tested, despite getting lots of calls of people asking if they can get tested with them. They have no large parking lots, for example, to set up tents for drive-through testing like UW Medicine and Swedish Hospital, which recently opened up testing on its Issaquah and First Hill campuses.
The First Hill clinic for Swedish, which tests caregivers at the hospital and patients referred by their health care providers because they are symptomatic of COVID-19, the disease caused by the novel coronavirus, is open Monday through Friday from 8 AM to 5 PM.
Country Doctor can refer patients to get tested for COVID-19 if needed. There were 1,040 confirmed cases of the virus and 75 deaths in King County through Saturday night.
Meanwhile, the lack of personal protective equipment, such as gloves and respirators, which has been playing out across the country as the cases have skyrocketed is no different for CDCHC also. Switching to phone visits has alleviated much of the problem, however, as they can go through less each day.
Help has also come in from afar. Watts says Country Doctor received a box of donated medical supplies last week from Direct Relief, “a fantastic organization that sends health supplies to parts of the world experiencing medical emergencies.” Country Doctor received over $600 worth of masks and other equipment, Watts said.
Following Gov. Inslee’s call to suspend elective surgeries to save protective gear for medical workers, CDCHC has moved to only emergency care in its dental clinic to save some of its supply. Because of this, since the clinics don’t want to lay people off during this crisis, dental employees stand outside locations greeting patients and doing preliminary screenings.
One dentist has even moved into a human resources role, Watts said.
Watts, who worked in the UW’s global health department managing a project during the Haiti earthquake a decade ago, is no stranger to massive medical emergencies in places that might lack health supplies. He has used the lessons he learned during that time to build an entirely new leadership structure which allowed CDCHC to transform into telemedicine “overnight.”
Through all of this, about a quarter of its workforce is out either because they are in a high-risk group for the virus or have child care needs with schools closed across the state. Another quarter is telecommuting and the rest is still working in the clinics.
Much of the attention in recent weeks surrounding the virus has been on the major local hospitals as they have the most capacity for dealing with such a large-scale crisis, but Watts wants people to remember that Country Doctor is still there for them.
“We’ve been here for 50 years and now more than ever we just need to send the message out to people that we’re here,” he said. “We’re just here as we always have been and we’re a community institution that people can rely on.”
Country Doctor’s Capitol Hill Community Clinic is located at 500 19th Ave E. You can learn more at countrydoctor.org.
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