Physician-in-Chief's Message April 20, 2020

Dear Colleagues, I hope each of you had some time to relax this weekend.  Thank you! Thank you to all of you!  As noted below, we have moved to 70% of our total outpatient encounters now being conducted through video visits!

UNC COVID Updates

Inpatient Care Please remember that the rapid COVID test is live now and can be ordered on symptomatic inpatients. Turnaround time is approximately 1 hour

Virtual Care Thank you to the schedulers in the clinics who have done an amazing job of dealing with all the changes and constant COVID updates! We have gone from almost no video visits, to last week almost half of scheduled visits were video, and today almost 70% are video visits!

For those of you closely following billing and coding for virtual visits ----BCBS and State Health Plan will reimburse us for regular E&M codes for phone visits. There will be 100% coder review of all virtual charges so they should catch and change this---but if you want to start using regular E/M codes for those two common private insurers you can! Click Here-see page 5. Don’t forget to keep using .pedvirtual template for notes and Click HERE for phone visit codes for other payers.

Your COVID-19 Questions & Answers Response from Tom Belhorn Q: Do we have to arrange follow-up virus testing for COVID-positive patients upon discharge from the hospital? I have heard only some patients have to be retested to come off isolation. Why?   A: Updated criteria for discontinuation of isolation and discharge of COVID-19 patients is available HERE and in a link on today’s “Vital Signs”. These recommendations, which are based on CDC guidance and review of the current literature, do vary dependent upon the patient. Individuals who are immunocompromised may carry the virus for a longer period of time compared to previously healthy individuals. Also some patients may be returning to settings considered to be “high risk” (e.g., assisted living facilities, prisons, etc.). These are both examples of situations where repeat tests for the virus (two separate NP + OP tests more than 24 hours apart) are recommended to make sure the individuals are confirmed virus negative prior to discontinuation of isolation. Patients who were previously healthy and returning to home to continue isolation often do not need a confirmed negative virus test but can go by time-based algorithms for decisions on the timing of isolation discontinuation.

Bilingual Patient Navigation - Now Virtual During normal times, Spanish-speaking parents of hospitalized children receive visits from volunteer bilingual navigators who check on their social and emotional well-being and help them navigate their hospital stay. Due to COVID-19 restrictions, families no longer receive these visits and many of our Spanish-speaking caretakers are finding they feel more isolated and have access to even fewer resources. Carolina Conexiones navigator Alexandra Cariboni offered to give her time and support during this time of great uncertainty. Alexandra serves in the Peer Amputee Mentorship program and as a bilingual pediatric navigator in the Children’s Specialty Clinics through Carolina Conexiones. She is a vibrant and compassionate volunteer, a mother, and no stranger to the health care system. She checks in on families weekly to let them know there is support in their language and connects them back to the healthcare team for any questions and concerns. Kristina Morris oversees Carolina Conexiones and is piloting innovative virtual methods for volunteers to continue to serve Spanish-speaking patients. In the midst of so many disruptions, volunteers such as Alexandra can provide needed support to those in greatest need.

Alexandra Cariboni Kristina Morris

The flow charts and plans for COVID have really been implemented very well across UNC Children’s. Thank you to all providers who have worked hard to make this happen. Given this, we will now plan to send this newsletter on a Monday, Wednesday, Friday basis. Please continue to send any questions regarding COVID-19. Thank you for all that you do!

sddavis@med.unc.edu 919-417-3130 (cell)