Clinically Integrated Network Briefing
Latest COVID-19 News
January 20,2022

A Message for the Wellforce Clinically Integrated Network, including primary and specialty care physicians, practice administrators, Network leaders (Presidents, Administrators, and Medical Directors) and Network staff
Now Available

  • COVID-19 Webpage for Ambulatory Practices

Treatment

Treatment Options
Tufts Medical Center’s Atrium 3 Outpatient Pharmacy now has supplies of two oral COVID-19 treatments – nirmatrelvir/ritonavir (PaxlovidTM) and molnupiravir. Click here for prescribing guidance.

For patients needing COVID-19 treatment of any kind, consider sending them to Tufts Medical Center’s Respiratory clinic (617-636-3164). Clinic staff will decide which therapy is best for each patient, based on patient-specific factors and availability of agents. The following criteria will be needed from the referring physician:
  • Confirmation of high-risk status
  • Accurate list of the patient’s medications, problems, allergies
  • Pregnancy test results (if applicable)
  • eGFR

Use the updated Gothams form for Monoclonal antibodies (mabs) or oral antiviral therapy:
  • Locations: Athol*, Everett, Holyoke, Fall River, Lowell*, Pittsfield* and Plymouth* (*indicates newer location).
  • Starting to acquire oral treatment (currently at Lowell site) in addition to the mabs.
  • Send the form in addition to a prescription for the drug of choice by fax or email.

Treatment Decision-Making
Check the Tufts Medical Center website for a link to its Therapeutics Decision Guide with details about the two oral antivirals, managing drug interactions for them, as well as a decision map from NIH for determining which oral treatment would be best for each patient.

Massachusetts DPH has released guidance on which patients to prioritize for treatment when supply is limited. See this document for the full information and their chart detailing how to prioritize patients for therapy.
 
Drug-Drug Interaction Guidance for COVID oral treatment options
  • Ensure the patient’s medication list is up-to-date and accurate
  • Wellforce Pharmacy contacts for questions regarding drug-drug interactions
  • Contact Tufts Atrium 3 Outpatient Pharmacy via phone: (617) 636-5381
  • Contact Wellforce CIN Answer Center via form or phone: (781) 664-5705
  • University of Liverpool drug interaction checker for COVID-19 treatments
  • New oral COVID-19 treatment options (ie Paxlovid and molnupiravir) may not have been added to the EMR drug database yet. In addition, since they are brand new medications, the EMR drug interaction checker may not be functional either, depending on EMR vendor. Please reach out to Wellforce Pharmacy contacts listed above for questions regarding drug-drug interactions.
PPE/Test Ordering



  • If your office needs supplies in the near future, consider ordering now, as the Chinese New Year celebration starts on February 1, production and shipping from mainland China is likely to halt for 2 weeks afterwards.

Telehealth
The Department of Public Health has announced that the Public Health Emergency (PHE) will be extended for at least another 90 days
  • Telehealth for Medicare and commercial insurers will continue to be reimbursed the same as an in-person visits.
  • We recommend use of a HIPAA compliant platform, although CMS continues to state that they will allow for non-HIPAA compliant platforms for the time being.
  • Telehealth across states is not allowed, unless licensure for the provider is present in both states.
  • For this information and other orders of the PHE, visit the DPH website.

Diagnostic Testing
Antigen Tests
  • Available for anyone, but specifically the best option for Medicare patients as Medicare will not be reimbursing for purchased tests.

Private insurers - such as Blue Cross Blue Shield, Harvard Pilgrim, and Tufts Health Plan - are advising their members to save receipts and follow a reimbursement plan as detailed on their websites until pharmacy networks and systems are in place.
COVID-19 Answer Center for Wellforce CIN Clinicians and Staff
Wellforce CIN Clinicians and practice personnel may use this form (OR call (781) 664-5705) to ask question(s). This is NOT a resource for patients to use directly. Our Pharmacy team will do its best to answer questions as soon as received.
  • Hours: Monday-Friday; 8:30 a.m. and 5 p.m.
  • Weekends/holidays will be answered the next business day
The Wellforce Clinically Integrated Network is a distinctively different population health enterprise and value-based care contracting entity. It comprises 2,300 primary care and specialist physicians and advanced practice clinicians, in private and employed practices, working in community and hospital settings. The Network’s purpose is to build healthier communities and to create healthy, rewarding experiences for our participating physicians and care teams. The Network was launched in July 2021 by building upon the legacies of two long-standing, high-performing organizations – Lowell General Physician Hospital Organization and New England Quality Care Alliance (NEQCA).