Best practices for resuming patient care as states loosen COVID-19 restrictions
CHICAGO - In response to states across the nation revising COVID-19 executive orders to allow elective or non-urgent medical procedures, the American Medical Association (AMA) is announcing a new resource that provides a step-by-step guide for physicians planning to reopen medical practices. This new guide builds on the AMA's ongoing efforts to ensure physicians and health care professionals have the most up-to-date information and resources necessary to navigate the rapidly changing landscape of the COVID-19 pandemic.
Specifically, the resource offers support and guidance for managing the safe reopening of a medical practice as more routine in-person care resumes, protecting the health of patients, clinicians, staff and the public. It serves as a one-stop-shop outlining how best to approach the unique challenges that the COVID-19 pandemic brings to the practice reopening process, providing physicians with checklists, supplemental information and helpful links to COVID-19 resources from the AMA, Centers for Disease Control and Prevention (CDC) and other federal agencies.
"The AMA believes decisions about public health and the provision of health care -- including decisions to allow non-urgent or elective medical procedures amid the COVID-19 pandemic -- should be made based on science, evidence and data," said AMA President Patrice A. Harris, M.D., M.A. "With some physicians beginning the process of reopening their practices, this essential resource supplies them with guidance to do so while keeping patients, staff and the general public as safe as possible from a COVID-19 resurgence. The AMA remains focused on ensuring the viability of physicians' practices that have been seriously impacted by this public health crisis and will continue providing support while aggressively advocating on physicians' and patients' behalf."
A summary of practice reopening tools available to physicians includes:
- Ensuring state and federal government compliance
As states and municipalities modify COVID-19 executive orders detailing the types of medical services permitted, the AMA provides recommendations for closely reviewing and following these individual guidelines while remaining in compliance with federal mandates. This section includes an AMA-developed chart and fact sheet overviewing state-specific resumption of elective or non-urgent procedures.
- Creating a plan for opening medical practices
This portion of the guideline includes a step-by-step approach to safely and incrementally opening a medical practice. It includes details needed to plan for supplying the office with personal protective equipment (PPE), suggestions for routine disinfecting regimens and staff scheduling protocols. As health experts continue to urge physical distancing as the most effective way to reduce the spread of COVID-19 until a vaccine or effective treatment is available, the resource suggests continuing to gauge whether a telemedicine or in-person appointment would be more appropriate.
- Instituting new safety measures for patients, clinicians and staff
Because COVID-19 screening processes designed to reduce community spread of the virus are new territory for physician practices, the guide offers recommendations on how to establish staff, patient and visitor safety protocols to ensure safe physical distancing, minimize interactions and limit the volume of individuals in the practice. Provided is a pre-appointment patient screening script template, designed for staff to inquire via phone about patients' potential COVID-19 symptoms or exposure ahead of entry to the facility. Consistent with CDC guidance, practices should require all individuals who visit the office to wear a cloth face covering to reduce the risk of virus transmission. In addition, information about monitoring and restricting non-patient visitors, staggering appointment scheduling, designating waiting areas and creating dedicated workstations is included here.
- Reviewing medical liability, privacy and confidentiality policies related to COVID-19
This page overviews the new legal territory and scenarios related to essential COVID-19 screening of patients, visitors and staff, including how to establish and maintain health-related privacy, confidentiality and data security to protect COVID-19 employee testing results while remaining in compliance with HIPAA rules. It also links to topics related to discussing current coverage with medical liability insurance carriers and the AMA's advocacy efforts for greater reliance on health care emergency response protections to support physicians amid the COVID-19 pandemic.
The AMA has been tracking states' plans for relaxing COVID-19 restrictions on non-urgent or elective medical procedures, and continues to urge that state governments meet four criteria before loosening these mandates in order to minimize the risk of another surge in COVID-19 infections and to ensure that health care systems have the capacity to care for newly-infected patients. Those criteria include: (1) minimal risk of community transmission based on sustained evidence of a downward trend in new cases and fatalities; (2) a robust, coordinated and well-supplied testing network; (3) a well-resourced public health system for surveillance and contact tracing; and (4) fully-resourced hospitals and health care workforce.
This new physician practice reopening guide joins a growing list of important tools and resources, as the AMA remains dedicated to supplying physicians with the comprehensive guidance needed for patient care amid the evolving COVID-19 pandemic. The AMA will also continue to release additional information in response to the urgent public health crisis to support physicians and the patients they care for, which can be found on the AMA's COVID-19 Resource Center.