J Am Board Fam Med
-
Comparative Study
Quantifying Worsened Glycemic Control During the COVID-19 Pandemic.
We hypothesized that glycemic control in outpatients, measured by HbA1c, was worse during the early months of the COVID-19 pandemic than in 2019. We sought to quantify how much worse and to determine if social determinants of health were associated with these differences. ⋯ During the early months of the COVID-19 pandemic, glycemic control in our patient population was significantly worse than during the same period in 2019 (mean HbA1c difference = 0.57). Contrary to our expectations, we did not find associations between patient demographic variables and glycemic control, including race.
-
COVID-19 is primarily a respiratory illness. Historically, upper and lower respiratory illness has been cared for at home or in the ambulatory primary care setting. It is likely that patients experiencing COVID-19-like symptoms may first contact their primary care provider. ⋯ Primary care clinicians reported serious shortages of personal protective equipment (PPE) and testing capacity. Inadequate reimbursement for telehealth visits coupled with decreased in-person visits put primary care practices at risk of layoffs and closure. Policies related to primary care payment, federal relief efforts, PPE access, testing and follow-up capacity, and telehealth technical support are essential so primary care can provide first contact and continuity for their patients and communities throughout the COVID-19 pandemic response and recovery.
-
With the emergence of COVID-19, many primary care offices closed their physical space to limit exposure. Despite decades of telemedicine in clinical practice, it is rare to find it used in small-metro and academic settings. Following the decision to limit face-to-face care, we tracked our practice's transition to telemedicine. ⋯ Early use of the PDSA cycle allows for informed quality improvement at the local level. Our findings highlight factors to consider when implementing telemedicine such as need for physical examination and type or length of encounter. In addition, physician satisfaction can encourage use of telemedicine, and tools for learning and practicing telemedicine should be available.
-
The 2019 novel coronavirus (COVID-19) caused a global pandemic that forced medical providers to rapidly alter methods of health care delivery. One month into this pandemic, we surveyed providers and patients to assess satisfaction or concerns with the change from in-person visits. ⋯ Patients are open to the expanded use of telemedicine, and providers and hospital systems should be prepared to embrace it for the benefit of patient care.
-
The threat to the public health of the United States from the COVID-19 pandemic is causing rapid, unprecedented shifts in the health care landscape. Community health centers serve the patient populations most vulnerable to the disease yet often have inadequate resources to combat it. Academic medical centers do not always have the community connections needed for the most effective population health approaches. ⋯ Second, we developed and distributed evidence-based resources to these same communities via a large community health navigator team. Third, as telemedicine became the norm for medical consultation, the 2 institutions began to research how reducing the digital divide could help improve access to care. We continue to think about how best to create enduring partnerships forged through ongoing deeper relationships beyond the pandemic.