COVID-19 Clinician Support

COVID-19 Clinician SupportMarch 16, 2021

1. EPI Report

2. Health Equity – Confluence Health

3. Vaccine Equity – Skagit Regional Health

4. Appointments for Patients Identified Through the EMR and Enforcement Concerns

5. Additional Q&A and Updates

We will have discussion and Q&A throughout the call. Use the “raise hand” function if you have a question or

comment.

Agenda

• COVID Epidemiology• March 16, 2021

• Scott Lindquist MD MPH

Washington State Department of Health is committed to providing customers with forms

and publications in appropriate alternate formats. Requests can be made by calling

800-525-0127 or by email at [email protected]. TTY users dial 711.

Addressing Vaccine

Equity

Why Equity Matters In North Central WA

COVID has disproportionately

impacted our Latinx Community

Respecting Existing Community and Equity Efforts

• Confluence Health:

Health Equity, Diversity and Inclusion Council (HEDI)

• Physician champions – Dr. Mabel Bodell and Dr. Bindu Nayak

• CAFÉ (Community for the Advancement of Family Education)

• Grassroots healthcare settings

• Spanish language media

• Parque Padrinos

• Wenatchee Valley College

• Community Service Coalition

• And many others!

Intentionality Matters

• Build trust

• Listen to the community impacted and make decisions

based on their feedback

• Community should be at the table

• Leverage respected community influencers

• Obtaining funding honors this work

• Track metrics, both subjective and objective

• Remove barriers

What Partnership Looks Like

Data from all CH Sites

All Doors are the Right Doors

• Vaccine work is community work

• If another setting works, patients are referred there

• Mass Vaccination sites and Public Health

Partnerships

• Local pharmacies

Thank you for the

opportunity to share

this work and learn

from you!

COVID Vaccine and EquityMarch 16th 2021 WSHA Clinical Support Call

Dr. Josh Griggs, MD, MHA – Chief Quality Officer

Recognizing Need for Equity

• Skagit Regional Health has been receiving and offering vaccines since December 2020.

• Realized that our vaccines were not reaching vulnerable and non-English speaking members of the Skagit and Snohomish communities.

• Established COVID & Equity workgroup to focus on initiatives to provide equitable distribution of our vaccine inventory.

Guiding Principles

• Serve our local communities in Skagit and Snohomish counties.

• Use a targeted universalism approach in outreach efforts to vulnerable populations

and BIPOC members of the community.

• Begin with equality, but strive for equity.

• Include both SRH patients as well as members of the community.

• Target a weekly goal of 30% of all vaccines SRH receives to be given to vulnerable

and/or BIPOC members of the community.

• Use and embody IHI and HRO principals in our outreach strategy approach.

• Target as many BIPOC and/or vulnerable patients as possible using a sustainable

outreach approach.

Outreach Strategy

Activity 1: Event at Sunrise

Partner with local church to host specific event for congregation.

Activity 2: SRH Patients

Outreach to SRH patients who are vaccine eligible, and a member of a vulnerable population and/or identify as BIPOC.

Activity 3: Waitlist

Outreach to people on the Vaccine Waitlist who meet "zip code criteria".

Activity 4: Community Education

Educational campaign to address vaccine hesitancy. Create ongoing support for non-English speaking patients within the existing vaccine clinics.

WSHA Dashboard Use

Slicing and Dicing our Data

• Patients on MyChart (patient portal)

• >65 years old

• > 30 BMI

• Zip Code 98273, 98233, 98241

• On a Chronic Disease Registry

Ongoing Efforts

• March 5th: Invites for vaccines sent to all patients 65 and older in the top three zip codes.

• March 10th: Invites for vaccines sent to all patients on MyChart who are non-white and 65 and older.

• This week: all patient 65 and older in top 8 zip codes and not enrolled in MyChart

• Translation of all vaccine documents into Spanish.

• Ensuring there is telephone scheduling option for patients.

Results

Questions?

Thank you for your time!

Appointments for Patients Identified Through the EMR and Enforcement Concerns

Scheduling: Patients identified in EMR v. Public Slots

Electronic Medical Records (EMR)

Reflect large segments of the state’s population as hospitals provide a

broad spectrum of care

EMRs reflect visits to the ED, specialty, and primary care clinics

EMRs are a powerful tool to identify high-risk eligible patients

Can help with promotion of equity

Hospitals are also sensitive to VIP access concerns

DOH Guidance regarding an acceptable scheduling approach:

EMR may be used to identify/schedule up to 80 percent of available slots

A minimum 20 percent of slots must be opened to the general public

Enforcement Concerns

Complaint Driven Enforcement Communication –With No Specific Information

DOH Guidance Re Minimum Access Standards• Providers instructed to assess accessibility for limited English proficiency and people with disabilities by April

2, 2021 and work on areas that need improvement.

• Complaint based enforcement? “We will reach out to proactively support overcoming access barriers if we

hear of them by community members.”

• Review the Language Access Planning Tool and implement strategies that are relevant to your vaccination

clinic or organization.

• Access for people with disabilities: Checklist to Ensure that Vaccine Sites are Accessible to People with

Disabilities and implement strategies that are relevant to your vaccination clinic or organization

• Collect patient race, ethnicity, and language data: o Self-report - patients do not have to provide this information

o Note: Language data has not previously been requested by DOH

“We ask you to confirm that [vaccine provider name] has not instituted any policies or procedures which granted access to COVID-19 vaccines to individuals who were not eligible for such vaccines pursuant to guidelines issued by the Centers for Disease Control and Prevention and the Washington State Department of Health. Please send your response . . . within fourteen (14) days of your receipt of this letter.”

Look for an email today or tomorrow with the link

Q&A

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