- - PowerPoint PPT Presentation

http://www.masoniccanceralliance.org/cancer-survivorship-echo-series.html

• K. Allen Greiner ,MD

Wyandotte County Health Officer, KPPEPR Medical Director Christian Sinclair, MD, FAAHPM Palliative Care Shawna Wright, PhD, LP Associate Director of KU's Center for Telemedicine & Telehealth Jennifer R. Klemp, PhD, MPH Director, Cancer Survivorship

AGENDA

Responding to COVID-19: Protect Patients and Healthcare Providers

Continuing Education Statement

• Physicians: The University of Kansas Medical Center Office of Continuing Medical Education is accredited by the

Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of Kansas Medical Center Office of Continuing Medical Education designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

• APRN/Nurses: The University of Kansas Medical Center Area Health Education Center East is approved as a provider
• f CNE by the Kansas State Board of Nursing. This course offering is approved for 1.0 contact hours applicable for

APRN, RN, or LPN relicensure. Kansas State Board of Nursing provider number: LT0056-0749. Mary Beth Warren, MS, RN, Coordinator.

• Social Workers: The University of Kansas Medical Center Area Health Education Center East, as an approved provider
• f continuing education by the Kansas Behavioral Sciences Regulatory Board presents this offering for a maximum of 1

hour credit applicable for relicensure of LASWs, LBSWs, LMSWs and LSCSWs. Kansas Provider Number 12-002. Mary Beth Warren, MS, RN, coordinator.

• Attendance requirement for nurses and social workers: Participants missing more than 10% of this offering will

not receive continuing education credit

• Certificates of attendance are available to other participants upon completion of documentation of attendance and

evaluation

Conflict of Interest Disclosure

• The following presenters do not have any relevant financial relationships with any proprietary entities

producing, marketing, re-selling, or distributing healthcare goods or services consumed by, or used on patients related to the content of their presentation: Shawna Wright, PhD; Allen Greiner, MD; Christian Sinclair, MD

• The following planning committee members do not have any relevant financial relationships with any

proprietary entities producing, marketing, re-selling, or distributing healthcare goods or services consumed by, or used on patients related to the content of their presentation: Hope Krebill, RN, BSN, MSW, Executive Director, Traci McCarty, Education Program Manager and Trish Long, PA, Navigation Program Director with the Masonic Cancer Center, KU Cancer Center and Mary Beth Warren, MS, RN, Executive Director, KUMC AHECs and Office of CE/PD

• The following presenter and planning committee member has disclosed potentially relevant financial

relationships with proprietary entities producing, marketing, re-selling or distributing healthcare goods or services consumed by, or used on, patients related to the content of their presentation: Jennifer Klemp, PhD, MPH, Associate Professor, KU Cancer Center Medical Oncology, received honoraria from Novartis, Pfizer Oncology and Astra Zeneca.

Continuing Education Credit & Certification of Attendance

ACTIVITY IDENTIFICATION CODE: 51nigh DEADLINE TO ENTER CODE AND COMPLETE EVALUATION: April 14, 2020 at 5:00 PM Using your mobile phone, you can text the activity identification code to (828) 216-8114. OR Accessing www.eeds.com from a mobile device or PC and entering the activity identification code; OR Downloading the eeds mobile app (iOS, Android) and using the activity identification code to sign-in to events.

Funding Source

This project was developed by Cooperative Agreement number DP17-1701, funded by the Centers for Disease Control and Prevention. Additional support from the KU Cancer Center and the Masonic Cancer Alliance.

Check-In

Organizations

 Advent Health Cancer Center Shawnee Mission  American Cancer Society  Ascension Via Christi, Pittsburg  Ascension Via Christi, Wichita  Blue Cross Blue Shield of Kansas City  Bryan Health- Crete Area Medical Center  Cancer Wellness for Life  Central Care Cancer Center  Coffeyville Regional Medical Center  LMH Health  Mosaic Lifecare  Newton Medical Center  North Kansas City Hospital  Olathe Health  Prisma Health Cancer Institute  ECHO Institute  Rehabilitation Hospital of Overland Park  Salina Regional Health Center  Sarah Cannon  Susan G. Komen Kansas + Western Missouri  Stanford  The Breast Center at St. Catherine Hospital  The University of Kansas Health System

 The University of Kansas Cancer Center  St. Francis Campus  Hays Med

 Truman Medical Centers  Wesley Medical Center/KU Wichita

Recording

We will be recording this Cancer Survivorship ECHO for educational and quality improvement purposes. By participating in this ECHO clinic you are consenting to be recorded.

https://echo.unm.edu/

Some Helpful Hints

• Test both audio & video​
• Mute microphone when not speaking
• Bottom left of your screen
• Remember to unmute before speaking
• Your participation is important!
• Speak clearly​
• Short and to the point comments are best
• Use chat function
• Position webcam effectively​
• Show your face
• Have a good light source from the front
• Avoid being backlit

Polling Questions

Poll Question Share Group Response

Lets Try Out a Poll

Question: Answer by Poll or in Chat Box Do you feel adequately informed about COVID-19 and the impact on cancer care delivery in your organization?

https://public.tableau.com/profile/kdhe.epidemiology#!/vizhome/COVID-19Data_15851817634470/KSCOVID-19CaseData

Kansas Department of Health & Environment

https://govstatus.egov.com/coronavirus

Example: Wyandotte County, Kansas

• 129 test positive cases, 6 deaths
• 2 Church Clusters, 1 Rehabilitation

Center (15 positives, 5 hospitalized)

• University of Kansas Health System –
• On 4/4/20: 33 positive inpatients, 19 inpatients

awaiting test results*, about half in ICU and on Vents

• Limited testing capacity – working

HARD to expand

*changes daily

Wyandotte County Health Department COVID-19 Testing Protocol

Patient self-reports symptoms online at: https://alpha.wycokck.org/Coronavirus- COVID-19-Information Other symptoms Called by healthcare professional with instructions: Check temp daily; isolate if fever and re-report symptoms

• nline

Probable COVID-19 case: Fever >100F sometime in last 48hrs Called by healthcare professional: do you want COVID-19 testing? Provider fills out on behalf of patient: https://us.openforms.com/Form/23 de1a07-7522-47ef-b02e- 5c6649b35a43 Referral for testing from area healthcare provider: https://us.openforms.com/Form/23 de1a07-7522-47ef-b02e- 5c6649b35a43 Patient seeks care from local Healthcare provider Form received via auto-email To WyCo HD Copy of patient information to HD lab and scheduler/EMR Patient called within 24 hours with appointment time (scheduled q15minuts); asked to bring cell phone. Patient arrives for testing at HD parking lot NP sample collected Sample labeled w/ requisition and placed on ice in cooler immediately 2 call-back numbers

• btained from

patient

Case Question?

If a patient is positive, what types of symptoms result in an admission to the hospital and is there a problem with ICU beds at this time?

https://covid19.healthdata.org/united-states-of-america/kansas IHME Measuring What Matters

COVID-19 projections assuming full social distancing through May 2020 Last updated April 7, 2020 (Pacific Time).

Cancer and COVID-19

Patients with cancer had a higher risk of COVID-19 and with a poorer prognosis than those without cancer.

• Men >65y/o more likely (in this study)
• Patients with lung cancer
• Evidence indicates that overwhelming inflammation and cytokine-associated lung injury could be

important in instigating these severe events in patients with COVID-19.

• History of smoking is an independent risk factor in severe COVID-19 cases.

Liang, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020; (published online Feb 14.)

Encourage Everyone to Stay Home!

Precautions

Should Cancer Patients Stay Isolated or Practice Social Distancing within their Home? Hand Washing/Hand Sanitizer Who should wear a mask??

• According to the CDC this week, a

face covering is a good idea

 less likely to emit if you have the virus and asymptomatic or pre-symptomatic

Case Example: Palliative Care Workflow

• Get the tech right
• then let the tech fall away
• Teamwork even more important
• Enlist family
• For tech support
• For camera work
• For exam
• For psychological support
• Use a script if you need it
• Non-verbal even more important

Cancer and COVID-19

• Check in with patients
• Lots of anxiety and fear
• What questions do you have?
• For high risk patients
• risk of hospitalization
• being sick enough to die
• Make plans for household
• Ensure secure food, housing, meds
• Reassure about clinical availability
• Encourage reaching out if sicker
• Resources
• VitalTalk COVID-19 Resource Guide
• https://www.vitaltalk.org/guides/c
• vid-19-communication-skills/

Poll Question

Question: Answer by Poll or in Chat Box Are you currently using Telehealth services in your practice?

Telehealth Updates

Local, state, and national policies are changing rapidly

Federal/National resources include US Department of Health and Human Services, Centers for Medicare and Medicaid, Drug Enforcement Agencies, Professional

• rganizations/associations

State resources include the Kansas Department of Health & Environment, the Kansas Department for Aging and Disability Services, Kansas Medical Assistance Program, Private payers, licensing boards

https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes

Fundamentals of Telehealth Programming

Administrative Clinical Technology

KUMC Telehealth Resources

KU Center for Telemedicine & Telehealth: http://www.kumc.edu/community- engagement/ku-center-for-telemedicine- and-telehealth.html Telehealth Bytes KUMC Project ECHO: http://www.kumc.edu/community- engagement/project-echo.html Telehealth ECHO will launch Thursday, April 9 (noon – 1:00 PM) and meet weekly for 4 weeks

Telehealth Billing & Coding - Cancer

https://www.accc-cancer.org/home/news-media/coronavirus-response

Summary

• Know and access accurate and reliable sources of up-to-date information. COVID-19

guidelines and resources are fluid and it is vital to stay up-to-date.

• Patient and HCP safety are paramount. Encouraging ‘Stay at Home’ and other best

practices will help (and are helping) flatten the curve.

• Updated pathways will provide structure for the care team to maintain the highest

level care during the COVID-19 crisis.

• Telehealth is part of our ”new normal”, building comfort, practice (practice, practice),

patient/family engagement, billing and policy, etc.…. are all part of the process.

• Self care for HCPs needs to be addressed on an on-going basis, identification and use
• f tools is vital to support our care team members.

WRAP UP

• Thank you for your participation!
• Make sure to sign in your name in the chat box.
• ACTIVITY IDENTIFICATION CODE: 51nigh

Text the activity identification code to (828) 216-8114 or

• www.eeds.com
• Next Session: COVID-19 and Cancer Mini-Series
• Wednesday, April 15 from 4:30-5:30PM
• http://www.masoniccanceralliance.org/cancer-survivorship-echo-series.html
• Review materials in the Toolbox