Increasing Access to Care during Pandemic

OurHealth quickly adapted to meet the realities of the COVID-19 pandemic without disrupting the level of care our patients expect by implementing a national virtual care program.

 

 

In less than 10 days, we went from 90% in-person appointments to 90% virtual and our care team made personal calls to more than 60,000 patients to check in and offer help.

 

Today, patients can see providers, behavioral specialists, or health coaches nationwide either in person, by video or telephone, eliminating the need to delay or defer their care.

 

By delivering care according to patient preference, we’re able to serve our patients and communities when and where they need it most. Keeping patients comfortable and safe are critically important to us.

 

Amidst the pandemic, patients continue to face the same health issues and concerns that they always have and as a result of the pandemic we’re seeing a rise in mental health cases. Unfortunately, many patients are putting off health visits due to COVID-19 – national trends suggest a decline in patient demand around 30%. They’re doing so out of a concern for their safety as well as making tradeoffs due to financial or time constraints.

 

Healthcare systems as a whole have had to shift the ways providers are able to provide essential and necessary care in order to minimize the potential risk of patients and healthcare workers contracting COVID-19.

 

Continuity of care is critical in order to avoid the consequences related to delaying preventive, routine, or chronic conditions. With care delivery options, such as virtual care, appointments are more readily accessible, especially for those who might be medically or socially vulnerable.

 

Many aspects of our lives were put on pause when the pandemic hit earlier this year. Patient health, however, does not need to be put on pause with the accessibility of virtual care and a connection to providers they know and trust.

 

Here’s what we’re doing in our health centers to ensure the safety of our patients and care teams:

 

  • Every member of our care team is required to complete a COVID-19 symptom screening and self-attestation form every day.
  • Masks are required for everyone in our health center.
  • No visitors are allowed with patients, unless in the case of a minor being seen.
  • To reduce patient overlap and improve physical distancing, we’ve added more time between appointments
  • We separate ill visits from well visits by time of day.
  • Health center staff disinfect all surfaces between visits to avoid any contaminated surfaces.

 

 

A Roadmap to Reopening Part 2: Industry-Specific Considerations

by Terry Layman, MD, SVP Corporate Medical Director

When returning to the workplace, each company’s plan will be unique. Among many considerations, factors such as company size, industry, and location come into play. For companies to respond to this pandemic and return employees into their workplace in a safe and responsible way, it is important to consider guidelines that are tailored for each industry – one size does not always fit all. In last week’s blog, we took a look at some safety and procedural recommendations for all businesses and industries to consider. This week, we’ll be diving into some of those industry-specific suggestions.To note – within each industry, it is highly suggested that workers wear masks to cover their nose and mouth to prevent the spread of the virus.

 

Within the manufacturing industry, social distancing can sometimes be a challenge – for work activities where this is the case, consider limiting the duration of these activities and/or implementing a safe approach to keep employees at a distance from each other. This might mean temporarily moving or repositioning workstations to create more distance or installing barriers (e.g. plexiglass shields) between workstations. Discourage employees from sharing tools when possible and equipment and educate employees on how to clean equipment before and after use. This should be done whether or not employees are sharing equipment. Promote personal hygiene – if workers do not have access to soap and water for handwashing, provide alcohol-based hand rubs containing at least 60 percent alcohol.

 

The construction industry offers its own set of challenges and specific considerations. To the extent that tools or equipment must be shared, as with the manufacturing industry, discourage employees from sharing tools when possible and provide/instruct workers to use alcohol-based wipes to clean tools before and after use. When cleaning tools and equipment, workers should consult manufacturer recommendations for proper cleaning techniques and restrictions. Keep in-person meetings (including toolbox talks and safety meetings) as short as possible, limit the number of workers in attendance, and use social distancing practices. Clean and disinfect frequently touched items (e.g. door pulls and jobsite toilets) frequently. Hand sanitizer dispensers should also be filled regularly and proper hygiene practices encouraged.

 

For the package delivery workforce, it is important to minimize interaction between drivers and customers by leaving deliveries at loading docks, doorsteps, or other locations that do not require person-to-person exposures. Along with this, discouraging workers from using other workers’ vehicles, tablets, and other equipment or educating workers on how to clean equipment, is something that should be considered as well.

 

For retail workers, a major part of the job is interacting with store patrons and customers. For this reason, special considerations should be taken to account for this. Whenever possible, limit customer volume and practice sensible social distancing, maintaining six feet between co-workers and customers. Demarcate six-foot distances with floor tape in checkout lines. Workplaces where social distancing is a challenge should consider innovative approaches, such as opening only every other cash register, temporarily moving workstations to create more distance, and installing plexiglass partitions. Use a drive-through window or curbside pick-up where necessary and be sure to provide workers and customers with tissues and trash receptacles.

 

The current state of things is variable and dynamic across the country. There is variation by region, state, county, and local jurisdiction, and also within these specific industries. We appreciate how everyone is adapting during this time. From manufacturers changing products to schools making huge adjustments to scheduling, everyone has done such a remarkable job staying connected and shifting their operational approach. This same flexibility and adaptability will be crucial in the months to come as businesses across the country reopen their doors to their workforce. Utilizing a framework when returning to work is crucial for maintaining a safe and responsible workplace.

For more considerations, as well as sample tools and guidelines, take a look at our Return to Business eBook.

A Roadmap to Reopening: What All Industries Should Keep in Mind

By Terry Layman, MD, SVP Corporate Medical Director

Over the past few months, we have been creating a strategic Return to Business framework to help our customers address the impact of COVID-19 and resume operations while protecting the ongoing health and safety of employees. As more businesses open up, utilizing a framework is crucial to return to the workplace in a safe and responsible way.

 

We have organized this framework into four pillars:

Workforce Planning: Evaluation and feasibility of response components tailored to the specific workforce; for example, public sector, manufacturing, hospitality, and food service, among others.

Physical Environment: Evaluation of the physical workspace and identification of risks and opportunities to reduce the spread of infectious diseases.

Active Monitoring: Biomarker monitoring (temperature and other symptoms), including digital symptom monitoring, contact tracing, and virtual visits for those with elevated risk factors.

Prevention and Sustainability: Measures to maintain a safe work environment, ongoing monitoring and follow-up and, as available, vaccines, effective treatments, and ongoing best practice learnings.

During this process, it is important to be thoughtful about communications with your employees. Being up front and communicating the measures being taken to provide a safe work environment is crucial.

Below are five suggestions for all businesses to keep in mind when returning employees to the workplace:

  • Perform a worksite survey to determine where and how employees might be exposed to COVID-19 at work, in accordance with OSHA guidelines. This would include evaluating employee movement in, out, and throughout the workplace, and identifying potential controls to prevent the spread of infection, such as:
  • Engineering controls – Installing high-efficiency air filters, increasing the ventilation rates in the work environment, installing physical barriers such as clear plastic sneeze guards where social distancing is not possible, or installing a drive-through window for customer service.
  • Administrative controls – Using virtual meetings whenever possible, establishing alternating days or extra shifts to reduce the total number of employees in a facility at a given time, discontinuing non-essential travel, providing workers with up-to-date education and training on COVID-19, and training workers on the proper donning and use of protective clothing and equipment.
  • Discourage workers from using other workers’ phones, desks, or other work tools and equipment. If work tools and equipment must be shared, determine cleaning methods necessary in between uses.
  • Practice sensible social distancing and maintain six feet between co-workers, where possible, and encourage respiratory etiquette, including covering coughs and sneezes.
  • Provide resources and a work environment that promotes personal hygiene. For example, provide tissues, no-touch trash cans, hand soap, alcohol-based sanitizer, disinfectants, and disposable towels for workers to clean their work surfaces.
  • Maintain regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the work environment. The Environmental Protection Agency (EPA) has approved products that are effective against COVID-19. Follow the manufacturer’s instructions for use of all cleaning and disinfection products (e.g., concentration, application method and contact time, PPE).

When it comes to prevention and sustainability long-term, we stand ready to be a resource as new information comes to light and future vaccines and/or treatments are developed. We remain a consultative partner for our customers when navigating this transitional time.

Check out our Pandemic Response eBook and Return to Business Playbook to learn how we responded as a company and our recommendations for keeping employees safe when returning to the workplace.

Stay tuned for more industry-specific suggestions for returning to business in next week’s blog!

Supply Meets Demand: A Call for Creativity and Resourcefulness

Natalie Koriath, director of operations, OurHealth

When an Amazon box arrived at my house in mid-January, I was surprised to find three boxes of N95 respirator masks, as this was very different from my typical Amazon order. I soon realized that the package was actually addressed to my husband who was preparing for a business trip to Dubai in early February. In response to the emergence of COVID-19 and the lack of N95s in Dubai, he had ordered some for a business partner there.

Remember those days – when we heard reports about COVID-19 but were blissfully unaware of what it would come to mean for us in only a few short weeks?

Fast forward into mid-March when the United States went into a tailspin of consumers purchasing every mask in sight – a very different outlook from only a couple of months prior, when that Amazon package arrived at my doorstep.

The combined organization of OurHealth and Marathon Health began securing personal protective equipment (PPE) and quickly discovered all our normal sources were completely dry. We began to start sourcing PPE to protect our own clinicians through every imaginable supplier – dental and veterinary suppliers, hardware stores, random web sites, local health collaborations, personal connections, you name it.

Interestingly, it didn’t take long for unexpected PPE suppliers to come out of the woodwork – companies who were able, quickly pivoted to begin importing medical supplies, with seemingly little past knowledge or understanding of the supplies themselves. It truly became a community effort.

When securing PPE through these unusual avenues, three major themes always played into our decisions:

Quality

When it comes to the wellbeing of our employees and patients, we simply cannot sacrifice purchasing quality products. We’re mitigating this risk by only purchasing from FDA approved facilities – though there are many variations on levels of PPE, we are evaluating each product to ensure it meets CDC guidelines.

Speed

Many PPE products are manufactured in Chinese factories, which have been impacted by COVID-19 and may not have the normal throughput capabilities. While this was a potential constraint early on, more recently, the major speed constraint has been the physical movement of materials. Many companies stopped new shipments out of the country in order to work through backlogs.

Cost

Supply and demand is in full effect and many products are easily 3-4x normal pricing. While this is a cost of doing business now that we have to accept, there is a balance between stocking up, in preparation, and waiting and hoping that the stresses on the marketplace lessen to allow normal pricing and availability.

In summary, I am excited that we’ve landed on a few suppliers that balance the quality/speed/cost triangle and are positioned to deliver a robust supply of the necessary PPE to protect our clinicians and patients in the coming weeks, as OurHealth and Marathon Health look forward to opening our doors more broadly!

Marathon Health and OurHealth announce “Return to Work” framework for employers

Comprehensive health strategy navigates complex issues to responsibly resume operations  

 

FOR IMMEDIATE RELEASE

April 23, 2020

 

WINOOSKI, Vt. – Marathon Health and OurHealth, leading national providers of employer population health solutions have created a strategic Return to Work framework to help employers address the impact of COVID-19 and resume operations while protecting the ongoing health and safety of their employees. The two companies announced their strategic combination in January.

 

Employers are under significant pressure to manage both the economic and health implications of the COVID-19 pandemic, including the development of a clear plan for re-emergence.  Inconsistent regulation across geographies and jurisdictions, uncertain testing and social distancing protocols, and potentially dramatic fluctuations in employee headcount and staffing are several of the dynamics driving immediate challenges for the leadership of U.S. employers.  Marathon Health and OurHealth, trusted partners to more than 150 employers and approximately 600,000 patients nationwide, have begun rolling out a comprehensive solution to meet the need for certainty, clarity, and effective protocols, allowing employers to lay the groundwork to safely resume operations.

 

“We have a strong sense of urgency to help our employer partners create a strategy for both acute COVID-related dynamics as well as ongoing employee health and wellness, and our Return to Work approach is an important prong of our broader offering,” said Marathon Health CEO Jerry Ford.  “I am extremely proud of our collective team for responding to this crisis and delivering much needed patient care on the front lines, as we simultaneously look ahead to return to work scenarios,” he added.

 

Dr. Jeff Wells, President of the combined organization, said, “Helping employers plan and execute on strategies to safely, responsibly, and expeditiously bring their employees back into the workplace will be a critical element of effective COVID recovery.  Our Return to Work framework is based on four pillars that span workforce planning, physical space considerations, actively monitoring the population with screening and testing, and future-looking sustainability measures. Near term, we are focused on partnering with employers to resume operations with a critical emphasis on physical distancing approaches, and over time, facilitating contact tracing, vaccines, and treatment strategies to maintain and improve holistic employee health going forward.”

 

The Return to Work framework will help employers answer complex operational questions, including: where employees should go if they experience COVID symptoms, how and when to implement consistent policies across different geographic locations, and how and when to bring employees back to the workplace. The solution encompasses the following pillars:

 

  1. Workforce Planning: Evaluation and feasibility of response components tailored to the specific workforce; for example, public sector, manufacturing, hospitality, and food service, among others.
  2. Physical Environment: Evaluation of the physical workspace and identification of risks and opportunities to reduce the spread of infectious diseases.
  3. Active Monitoring: Biomarker monitoring (temperature and other symptoms), including digital symptom monitoring, contact tracing, and virtual visits for those with elevated risk factors.
  4. Prevention and Sustainability: Measures to maintain a safe work environment, ongoing monitoring and follow-up and, as available, vaccines, effective treatments, and ongoing best practice learnings.

 

Employer response to the COVID-19 pandemic varies by industry, essential or non-essential personnel, physical work environment, and local infection rates. However, the elements of preparation, monitoring, operational response, and creation of policies to keep workers safe and productive transcend all employer types.

 

Marathon Health and OurHealth have conducted successful outreach and clinical intervention to over 100,000 of their covered patients over the past three weeks alone, leveraging a combination of virtual care solutions. By driving high levels of employee engagement with its clinicians, Marathon Health and OurHealth have demonstrated a track record of enhancing patient health outcomes, while delivering quantifiable, hard dollar savings to employer partners, all while maintaining industry-leading patient and provider satisfaction scores.

 

Learn more

 

* * *

 

About Marathon Health and OurHealth

Marathon Health and OurHealth offer a proven solution to help employers both improve the health of their populations and reduce the total cost of healthcare. The Marathon Health and OurHealth approach integrates the best practices of advanced primary care, health assessment with risk identification, coaching and advocacy, behavioral health and therapy, occupational health, physical therapy, and disease management for high cost, chronic conditions. For more information, please visit www.marathon-health.com and www.ourhealth.org.

 

Media Contacts

Tracey Moran

Vice President of Customer Community and Media Relations

tmoran@marathon-health.com

10 Tips for Providers to Deliver a Great Virtual Visit

Virtual visits officially launched this week across the OurHealth network! We asked our providers to share tips for how to make these visits as valuable as possible for the patient and the provider.

  1. First, relax. Virtual visits are new for you and your patients. Have fun with it. “I’ve loved learning this new way to interact with our patients and have met lots of spouses, pets and kids on camera along the way!” says Kelly McDonald, MD, an OurHealth physician in Charlotte, NC.
  2. Before you begin the visit, make sure you’re in a private space with good lighting and no background noise. Sitting near a window can be a huge help if you have low lighting.
  3. It’s vital to find a chair that provides the support you need. “Seriously, this is a big one and after almost two months of delivering virtual visits I finally have a chair I love and my neck and back are grateful!” says McDonald.
  4. Ask the patient if they can see and hear you clearly. Do this early on so you can work out any technical issues at the beginning of the appointment and avoid frustrations.
  5. Once connected with the patient, first ask for identifying information. Have the patient confirm their full name, DOB, home address (for HomeMed purposes) and a phone number (to call back if connection is lost).
  6. If a patient is driving – ask them to pull over! (Don’t virtual and drive!) Offer to restart the visit after they pull over safely within a reasonable period of time (<5 minutes).
  7. Own everything on that patient chart. Don’t assume that the information in the chart is up to date or correct. If it is a new patient, fill in those blanks on that chart! Reconcile the medication list, confirm drug allergies, reconcile the problem list.
  8. Update any relevant history especially if the visit is short/simple.
  9. Don’t be afraid to attempt a physical exam via the virtual platform!
  10. Before you hang up, review next steps, offer to schedule a follow up appointment and finalize any directions for prescriptions.

5 Tips for a successful Virtual visit with your Provider

Video visits are a great way to maintain your health and wellness – all from the comfort of your home or office. OurHealth asked its providers for some tips on how to prepare for a video visit so you and the provider have a great experience! 

  1. Before your scheduled appointment, find a quiet location with good internet connection and lighting. Make sure you’ve got the technology in place – download and launch the app in advance, bookmark the web page, etc. It’s also a good idea to fill out any forms so that doesn’t eat into your actual visit. 
  2. Tell your provider if you’re struggling to see or hear them. Resolve any technical issues early on to make the most of your appointment time. If a disconnection occurs, your provider will attempt to reconnect or call your phone.
  3. Be prepared to answer questions. Depending on the reason for your visit, you may want some privacy. It may be hard to see certain things through video, so we’lask extra questions to ensure we’re as thorough as possible,” says OurHealth provider Kelly McDonald, MD.
  4. Enjoy yourself and be patient with the process –  there may be some trial and error as you both work together to get the right angle, lighting and clarity. And don’t worry about dressing up or sitting at a desk, do what’s most comfortable for you. “I’ve had virtual appointments with patients in their homes, cars (not driving!), in bed with pajamas on, in the store, at work and a Chik-fil-A drive-thru,” says McDonald, MD. 
  5. As your visit comes to an end, ask your provider anything you would normally ask at the check-out desk. For example, ask for a summary of next steps, review prescription(s) or schedule a follow-up appointment 

5 Tips for a smooth Telephonic Visit

Face it – visiting with your doctor via video or over the phone is just one more example of our “new normal” – at least for a while. The good news is, these telehealth visits can be every bit as productive as in person visits if you plan accordingly. OurHealth asked its providers for some tips to make the transition as smooth as possible.

    1. When scheduling the call, be sure to give the provider the best phone number to reach you at. And at the time of the scheduled call, make sure you’re available. Don’t ignore it because you don’t recognize the phone number – that can take away from the valuable time you have with them.
    2. Before your scheduled call, find a quiet, comfortable location with good cell service. A windy street or noisy kitchen makes for terrible communications. And they’re going to ask you to confirm your identity so you may also want some privacy. “Don’t be shocked if we ask for DOB or some other identifying info,” says OurHealth Chief Medical Officer Terry Layman, MD.
    3. Be descriptive. If it’s a telephonic visit, the provider won’t be able to see you in person. Instead of using vague descriptors like “big, small or over there” – say things like “quarter-size” or “two inches” or “the top of my head.”
    4. Also, because we’re not face to face, expect the provider to interrupt while you’re talking to ask clarifying questions. “Be patient and understanding,” says Dr. Layman. “More than anything we want to be thorough.”
    5. As the visit wraps up, restate the decisions that you made and ask for any necessary follow up to be emailed to you.

10 Tips to Find a Healthy Balance

Now, more than ever, taking care of the mental and physical wellbeing of yourself and your loved ones is critical. We rounded up some tips from our health coaches to help you find a healthy balance.

 

  1. The information you consume and who you spend your time with will dominate your perspective. Be mindful of how much time you’re spending on social media and watching the news. Pick up a book, get lost in a great show, capture your thoughts in a journal or send a letter to a friend you haven’t seen in a while.
  1. Working from home? Schedule a walking meeting or exchange your commute time for a home workout tape or treadmill session. Go outside and take in the fresh air. Even a short, 30-minute walk can do wonders for your headspace. Relocate your workspace to a different room of the house each day.
  1. Schedule virtual lunches or “happy hours” with co-workers. All those great remote working tools aren’t just great for actual meetings – use them to catch up with co-workers and friends throughout the day!
  1. Feeling sad or stressed? Reach out to a friend or family member and ask to talk. You’ll be amazed what a relief you feel just by saying your fears out loud.
  1. Offer to help elderly family members, friends or neighbors.
  1. Cook healthy meals for those who are unable to and drop them off at their doorstep.
  1. Organize a room or area in your living space each day – the lack of clutter or new layout will be a nice adjustment.
  1. Use the calm or headspace app to meditate.
  1. Plant some flower seeds indoors to water and care for the next few weeks and look forward to planting them outside in warmer, brighter days ahead.
  1. Try creating big and small activities in your day that are consistent such as: making your bed every morning, walking your dog daily at the same time and going to bed at the same time each night.

We love those tips, but we’d also love to hear your ideas for how we can be helpful. Tell us here: OHHealthCoach@ourhealth.org

 

An HR Leader Perspective on Coronavirus

By: Debby Routt, VP of People and Culture at OurHealth

You can’t turn on the TV, listen on the radio, or log into any social media site right now without encountering a story, a predication, or a warning about the coronavirus.  This is concerning to many including those who work in our organizations. So how can HR leaders address the concerns of their staff (and other family members) while meeting the needs of the organization, as well. In other words, how can we lead in an unfamiliar world.

Having spent more than 30 years in an HR leadership position for several companies and now in that role for a national health care organization that is treating patients who may have the coronavirus, six things come to mind:

  1. Be visible, be calm, be present. You are the people leader of the company. While there are undoubtedly many personal and professional demands on your time, make your presence known to your employees through multiple channels.
  2. Be as transparent as possible. We all know the HIPAA regs and the need to protect PHI. But communicate what you can about the situation at your organization.
  3. Don’t forget the people at home. Address the concerns of the spouses who may wonder about their loved one at work and what he/she may bring home…
  4. Don’t be afraid to ask for clinical help. From your health plan, the local health system, the state health department – let the experts provide expert advice.
  5. This is an opportunity to show the company cares. We all say that our employees are the most important asset. Let’s show it.
  6. Be flexible and trusting. Consider suspending rules related to work from home, travel, etc. Each business is different, but tailor short term policies that makes sense for your team.

Most importantly, we need to do what we as HR professionals do best:  Listen, provide counsel based on data, maintain confidentiality for our employees, support for our leaders who are uncertain, be empathetic, and ensure colleagues know that their health matters.