COVID-19

QUICKLINKS:  TESTING | PERSONAL PROTECTIVE EQUIPMENT | TELEHEALTH | ADDITIONAL NEWS & RESOURCES

SCREENING, TESTING, LABORATORY GUIDANCE

NCDHHS Guidance 

UPDATED: Latest guidance from the NC Department of Public Health. (7/7/2020)

The update includes:

Temporary Order on COVID-19 diagnostic tests (July 7, 2020): North Carolina State Health Director Elizabeth Tilson, MD, MPH issued a temporary order requiring physicians, laboratories and others ordering or conducting COVID-19 diagnostic tests to report negative test results in addition to the requirement to report postive results.

The reason for the order is to track diagnostic test results necessary “for surveillance of a communicable disease that presents a danger to public health.”

The order is effective immediately and expires in 90 days.

Updated resources for you and your patients (7/15/20)

‘Pop-Up’ testing sites listed by county.
Ongoing Outbreaks in Congregate Living Facilities by county and facility.
Risk Factors for Severe Illness
Demographics of Contact Tracers hired by state (updated every Wednesday by 4 p.m.)
‘Why Should I Be Tested’ fact sheet for your non-English speaking patients in four new languages in addition to Spanish.(Burmese, Haitian-Creole, Karen, Swahili)
The Health Care Guidance for Providers page includes information for pregnant women, standing orders for testing and reporting and other information.

New tools offered by NCDHHS (6/5/2020):

    • “Check My Symptoms” web page that allows people to enter their symptoms and determine if they should get tested for COVID-19.
    • “Find My Testing Place”website, where the public can enter their county or ZIP code and find a list of nearby testing sites.
    • COVID-19 Community Team. This effort was recently launched and the team is made up of trained contact tracers. Team members reach out to people who have tested positive for COVID-19, or anyone who has been near someone with COVID-19, and get them the information and support they need. This support can include helping someone understand what it means to have been exposed to COVID-19, how to monitor their symptoms, when to get tested, if needed, and how to protect their loved ones.When the COVID-19 Community Team reaches out, it is important that people answer the call. Individuals being contacted would get an initial text from the number 45394 or email from NC-ARIAS-NoReply@dhhs.nc.gov with follow-up phone calls from NC OUTREACH (844-628-7223) or the Local Health Department. The Community Team represents North Carolinians across the state and will be available to provide support and information in multiple languages.NCDHHS has created a toolkit to help you disseminate this information to your patients via printed materials and social media posts. Access the toolkit here.

Safer At Home “Phase 2” of Easing of Covid-19 Restrictions (5/20/2020) – Phase 2 begins at 5:00pm on Friday, May 22, 2020 and remains in place until June 26, 2020

Interim Guidance for Outpatient Triage and Assessment  (3/23/2020)

Guidance for patients  (3/23/2020)

Clinicians should use their judgment to determine which patients are most in need of testing. NCDHHS does not recommend testing of asymptomatic patients for COVID-19.

Read the memo from NCDHHS on testing through LabCorp. (3/11/2020)

NC COVID-19 text information and updates are available. To sign up, text COVIDNC to 898211

LabCorp Guidance

To facilitate greater access to testing for the virus that causes Covid-19, NCDHHS is encouraging providers to submit specimens to LabCorp when ALL of the following conditions are met:

    • Fever
    • Signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath)
    • Negative influenza test (rapid or PCR).

Guidance for testing at LabCorp is available here.

Additional Resources

Our friends at The Pediatric Center in Wilmington have shared their testing flowchart.

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PERSONAL PROTECTIVE EQUIPMENT GUIDANCE

NCDHHS Guidance

The state is working to secure adequate supplies of personal protective equipment (PPE). Nationwide, there are shortages.

NCDHHS and the state Office of Emergency Management is instructing health care providers to  work through existing vendors and contracts to secure PPE. If you encounter a shortage, they advised that you contact your local health department or county emergency management department to request supplies. If you have questions or concerns, please contact Hattie Gawande (Hattie.Gawande@dhhs.nc.gov or call 919-906-1899)

CDC Guidance and Resources

CDC Latest Personal Protective Equipment recommendations

Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Health Care Settings (CDC, March 19, 2020)

Strategies for Optimizing Supply of N95 Respirators (CDC, March 27, 2020)

Alternative Care Sites and Isolation Sites (CDC, March 25, 2020)

Personal Protective Equipment (PPE) Burn Rate Calculator (CDC, March 25, 2020)

Disinfecting Your Facility if Someone is Sick (CDC, March 19, 2020)

Frequently Asked Questions about Hand Hygiene for Health Care Personnel Responding to COVID-2019 (CDC, March 18, 2020)

Strategies for Optimizing the Supply of PPE (CDC, March 17, 2020)

Health Care Supply of Personal Protective Equipment (CDC, March 13, 2020)

Health Care Infection Prevention and Control FAQs for COVID-19 (CDC, March 10, 2020)

Interim U.S. Guidance for Risk Assessment and Public Health Management of Health Care Personnel with Potential Exposure in a Health Care Setting to Patients with COVID-19 (CDC, March 7, 2020)

Health Care Supply of Personal Protective Equipment (CDC, March 1, 2020)

How to properly put on, use, and remove PPE (CDC)

Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings (CDC)

Additional PPE Guidance

Addressing COVID-19 Face Mask Shortages (Stanford Medicine, March 25, 2020)

N95 Filtering Facepiece Respirator Ultraviolet Germicidal Irradiation (UVGI) Process for Decontamination and Reuse (University of Nebraska)

Guidance for Use of Certain Industrial Respirators by Health Care Personnel (CMS, March 10, 2020)

Novel Coronavirus (COVID-19) – Fighting Products (Center for Biocide Chemistries) (via DSHS)

Guidance for use of Certain Industrial Respirators by Health Care Personnel (CMS, March 10, 2020)

EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2, the Cause of COVID-19 (EPA, March 3, 2020)

Surgical N95 vs Standard N95 Which to Consider (3M, January 2020)

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TELEHEALTH

To help protect patients and staff from spread of Covid-19 many practices are looking to telehealth technology. Below is guidance and policies from public and private insurers and additional resources.

NCMS Offers Telemedicine Help Through New Platform “Presence”

Commercial insurers

UPDATED: NCMS Compilation of Payers’ Telehealth Policies (8/6/2020)

List of telehealth policies and guidance from Aetna, Blue Cross and Blue Shield of NC, Cigna, Humana and United Healthcare. (Updated 3/18/20)

NC Medicaid 

NC Medicaid will allow practices to bill for defined telehealth services. Review the updated policies in this special NC Medicaid Bulletin.

FAQs for telehealth in Federally Qualified Health Centers (FQHC) and Rural Health Centers      are in this chart.

Medicare

On March 17, CMS announced expanded Medicare telehealth coverage. Beginning on March 6, 2020, Medicare will temporarily pay clinicians to provide telehealth services.

NEW! Video Available on Medicare Coverage and Payment of Virtual Services

CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. View the Video

Read the Fact Sheet on this announcement

Frequently Asked Questions about Medicare telehealth (3/17/2020)

           General Medicine Toolkit (3/20/20)

End Stage Renal Disease Provider Toolkit (3/20/20)

Workers’ Comp/NC Industrial Commission

The Industrial Commission has received several inquiries from health care providers regarding telehealth visits in lieu of in-person office visits, in light of health and safety concerns about COVID-19 transmission raised by nurse case managers, injured employees, and the health care providers. Please click here for answers to the most frequently asked questions about the telehealth visits.

HIPAA Compliance

The US Department of Health and Human Services Office for Civil Rights will not impose penalties on physicians using telehealth in the event of noncompliance with the regulatory requirements under the Health Insurance Portability and Accountability Act (HIPAA). Learn more here.

Telehealth Vendors

Company  Website Fee Structure
Presence https://therecoveryplatform.com/presence/ Free
Doxy https://doxy.me Free
Trimed http://www.trimedtech.com Free
Updox https://www.updox.com Free
DocsInk https://docsInk.com Fee Based
Dr. First https://drfirst.com Fee Based
CGM https://www.cgm.com/us/index.en.jsp Fee Based

Telehealth Resources

  • If you are interested in learning more about how to implement telehealth into your practice, Curi, a Medical Mutual Company, offers this quick one-page summary offering guidance on the structure/execution of clinical telehealth services, as well as a number of links to resources and regulatory bodies. Curi Telehealth Overview.
  • Telehealth Tipsheet provided by NC AHEC
  • National Consortium of Telehealth Resources is offering this free toolkit

NC Medical Board Position on Telehealth

Review the North Carolina Medical Board’s position on telehealth as of March 17, 2020. 

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ADDITIONAL NEWS & RESOURCES

Resources as You Reopen

Volunteering

NC Department of Health and Human Services Secretary Mandy Cohen, MD, MPH, has called on medical professionals to volunteer to help in the state’s response to COVID-19. Read her letter to the medical community.

For more information or to volunteer, please visit the state’s online platform to sign-up.

NC 2-1-1 to Provide Assistance for COVID-19

Wake County Health Department Offers COVID-19 Help

NC Medical Board Adopts Emergency Rules in Response to COVID-19

Other Resources

NCMS Compilation of Federal and State Regulatory Changes in Response to COVID-19

AMA Articles and Resources

5 ways medical students can assist during the COVID-19 pandemic

What to do when COVID-19 enters your physician practice

National Specialty Society Resources

View this compilation of national specialty societies and their COVID-19 resources (Excel)

General Practice Management Guidance for COVID-19

NCMS Business Alliance member Poyner Spruill has compiled numerous resources for employers:

NCMS Business Alliance member Curi has compiled a helpful page of resources, including additional information on telemedicine, practice workflows, disaster planning, helpful webinars and more. Access Curi’s COVID-19 Resource page.

Toolkit for Independent Physicians

Thanks to our friends at Avance Care, who have shared this toolkit (updated 7/24/2020) for independent practices grappling with their response to Covid-19. The kit includes practical advice and resources to protect staff; recommendations for room decontamination; sample scripts for patients who may demand testing even if it’s not warranted by clinical guidelines and links to other resources.

Access the toolkit. (updated 7/24/2020)

Rural Health Resources

Covid-19 & Pets 

Animals and Coronavirus: Frequently Asked Questions  (NC State School of Veterinary Medicine)

Hand hygiene videos

This New England Journal of Medicine video on hand hygiene is excellent and pretty technical. It’s 14 minutes long.

For patients, this National Health Service hand hygiene video has no words, just a great demo and lasts just 44 seconds.

COVID-19 Symptoms

COVID-19 Symptoms one sheet (NC Drug Card)

CDC Hand Hygiene Fact Sheets and Posters

Patient fact sheet

Provider fact sheet

Provider Poster: Clean-Hands-Count

Poster Clean Hands Count For My Patients

White House Coronavirus Guidance

Poster for Patients

Articles of interest

Coronavirus (Covid-19): New Telehealth Rules and Procedure Codes for Testing (FPM Journal, 3-10-20)

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