Dear Faculty and Staff,

It’s been a little while since my last update.  That’s good news for it means we’ve had no new crises.  Let me start with a big THANK YOU as we continue to work shoulder-to-shoulder on the challenges imposed by this ongoing COVID-19 pandemic.  It’s certainly not over, yet we are beginning to see glimmers of hope on the horizon.  This is all due to your continued dedication to the mission of caring for our patients during these most trying times.  So again, thank you.

As we prepare for this next phase of this pandemic, school/university re-openings and high-volume rapid turnaround COVID tests are taking center stage.  Here are a few important updates:

A Note on Predicting the Next COVID Surge

Sg2 was quite helpful in predicting the last surge.  However, there are two new variables which impact this model (or any model for that matter) – uncertainties related to seroprevalence and the impact of school openings.

Nevertheless, Sg2 predicts if current mitigation levels of masking, distancing, and testing are maintained we can anticipate a steady rate of COVID hospitalizations during and after schools reopen this Fall.  However, during this time frame the citywide COVID census is not predicted to pose high stress levels on our health care system compared to the last surge.  This projection will be closely monitored and modified as more information becomes available.

What About the Flu?

The impact of influenza this winter is not clear, so we will be watching it closely.  We do anticipate some individuals will get co-infected with both COVID and influenza, in which case they will be at high risk for poor outcomes including death.  We strongly encourage everyone get a flu shot this Fall.  Information on vaccine administration at UTHP sites and Wellness 360 will be made available soon.  In the event you become ill, you should immediately contact your supervisor, stay home, call your PCP, and promptly obtain flu and COVID testing.  Again, we encourage everyone to maintain masking, distancing, and handwashing since these measures also reduce the likelihood of getting the flu (although they are not a substitute for getting the flu shot).

A Few Important Notes on COVID Testing

1. Reporting of Ambulatory Results

a. For tests ordered from UT Epic.  In order to improve turnaround times, COVID test results are now auto-released through MyChart at 24 hours (rather than manual release).  Likewise, UT lab personal are no longer calling positive results to ordering providers.  This will give the lab more time to focus on test throughput and turnaround times.

b. For tests ordered from UHS Epic or through the Standing Delegated Nursing Order at the Pavilion.  Results are routed to your UHS Epic in-basket.  Pre-procedure + COVID results will continue to be called to the ordering proceduralists.  If you are experiencing something different, please let me know.

2. If you work in the PCC, Geriatrics Clinic, or Mays Cancer Center (locations where frequent COVID testing is performed), COVID tests not only populate the ordering provider’s in-basket, but now also a clinic-specific COVID in-basket.  This gives on-call providers easy access to results afterhours.

3. Repeat COVID Testing is not indicated for Follow Up of Positive Pre-Procedure Tests.  Instead, we endorse a symptom-based strategy for moving forward with rescheduling the procedure (see first attachment for updated UT Health guidance).  This is consistent with the CDC guidelines and UHS Policy (see attachments two and three which have also recently been updated, OR click this link to access UHS COVID Clearinghouse).  Also, if a patient had a + COVID test done at an outside facility, it would be helpful for the patient to bring the official copy of the result so it can be uploaded into our EMR.  If we have such documentation, we will not require re-testing which the patient will appreciate.  One can only stand having a swab stuck up his or her nose so many times.

A Note on Clinic Costs and Scanning Notes 

Remember, clinics are charged a few cents for every page sent for scanning.  One way to keep clinic costs down is by minimizing scans.  Instead of sending the full hospitalization record for scanning (which may include blank pages, demographics, etc), consider just scanning the most relevant reports.  That’s not just good for business during these hard times, but it also prevents chart bloat which thereby allows important information to be found more readily.  Another option is for the clinic to do its own scanning.  Please speak to your Practice Manager for more details.  Sorry to end with something so mundane.

Please contact me for any questions.

Thank you for all you do.

B

Bob Leverence, MD, FACP

Chief Medical Officer