As COVID-19 stay-at-home restrictions lift, primary care practices should be strategic about when and how to open. The AMA provides a step-by-step guide.
The American Medical Association believes that the 4 signposts above must exist before state and local governments relax stay-at-home orders.
Chart a course to expected reopening day; include a "soft reopening" period for incremental change. Assess personal protective equipment (PPE) needs, alternatives - what's in stock, what you'll need. Order now.
Consider reopening in a stepped fashion to allow time to identify & address any practical challenges encountered.
Consider bringing employees back in phases, or having them work on alternate days or different parts of the day to help reduce contact.
Create a modified schedule to avoid high volume, spearate "well" and "sick" patients, and consider a flexible schedule with more time between visits.
Communicate personal health requirements clearly to clinicians and staff and keep records of employee screening results in a confidential employment file.
Consider rearranging open work areas to increase distance between employees and assigning work stations & exam rooms to minimize equipment sharing.
Use a teletraige program to ensure in-person appointment is needed and contact patients 24h before a visit to review logistics of office protocol and screen for COVID-19 symptoms.
Identify COVID-19 testing sites in your catchment area and provide patients with clear, current information on where they can be tested and how the process works.
Clearly post office policy for individuals who are not patients or employees to enter the practice and use phone, teleconference to engage with them. When necessary, designate a time outside office hours to minimize interactions with patients, clinicians, staff.
Congress has put in place protection, in certain instances, from liability for front line clinicians treating COVID-19 patients—however new risks may arise upon reopening that do not fall under those protections.
(AMA is also advocating to governors that physicians be shielded from liability for both COVID treatment and delayed medical services due to the pandemic.)
Institute or update confidentiality, privacy and data security protocols. Keep results of any employee screenings in employment records, separate from personnel file.
(While certain HIPAA requirements related to telemedicine are not being enforced during the COVID-19 public health emergency, generally, HIPAA privacy, security and breach notification requirements must continue to be followed.)
Consider employment obligations that may not have been required of your practice (eg, paid sick leave) because of furlough, etc. You may need to make decisions about opting out of these or putting in place and communicating to employees about procedures for requesting same.