‘COVID-19 has pretty much taken over my life’: A practice administrator’s perspective

Editor’s note: This episode of the MGMA Insights podcast continues a series focused on COVID-19 and its effects on healthcare professionals and their patients. Keep up with the latest updates by visiting the MGMA COVID-19 Federal Assistance and Advocacy Center.

The “warning antenna” for Kelly Ladd, CMPE, chief executive officer and practice administrator, Piedmont Internal Medicine, went up regarding the threat of coronavirus and COVID-19 after seeing news reports of international travelers being screened for fever and other symptoms at her local airport.

Ladd oversees 11 physicians and five nonphysician providers in two locations in the Atlanta area.

“My first thought was, ‘the genie’s already out of the bottle,” Ladd said. Knowing that the situation would worsen, Ladd worked in early February to begin communication to patients via the practice’s website, develop an internal protocol for screening patients and regularly following updates from the World Health Organization (WHO) and Centers for Disease Control & Prevention (CDC).

Making changes and contingency plans

Ladd’s past work as director of physician operations at a Georgia hospital system during the Ebola crisis provided her some insights into how best to respond through updating protocols and procedures for the office. That includes contacting vendors to ensure the practice has sufficient personal protective equipment (PPE), reaching out to laboratories for information on testing kits and doing so regularly in the event of changes.

“It’s very time-consuming — a lot of reading, a lot of phone calls, emails,” Ladd noted. “Other day-to-day operational things that I perform in a normal day have really had to be put on the backburner, because I have 74 lives in my office, and I have a panel of 40,000 patients that we treat, and I need to be their advocate. I need to do whatever I can as the administrator to make sure that my physicians, my midlevels, my frontline employees and all of my patients are safe. … That’s really become my priority.”

The importance of good communication

Part of that work is keeping patients calm and educated as best as the practice can, Ladd said, so that anyone who should not be coming into the clinics can be advised to stay at home and self-quarantine, if warranted, and then call the practice to arrange for care if symptoms worsen. The practice also has a secure email communication in place with patients to reach them digitally.

“I think communication and getting out the word to your patients that, ‘we’re on this, we want you to be safe, we want to be here for you, we’re here as your advocate and trying to keep you healthy,’” Ladd said. “Having two-way dialogues with the patient, I think that’s so critical.”

One factor working in Ladd’s favor was that, at the time of this interview, the practice was still fully staffed and still seeing patients with illnesses other than COVID-19. As a response to COVID-19, Ladd said the practice was developing a contingency plan for a staggered schedule of well patients in the mornings, sick patients without respiratory issues later in the day and then separating patients with respiratory issues toward the end of the day to limit potential exposure.

That contingency plan also had a focus on offering telework arrangements for nonclinical personnel to still have access to the practice’s EHR and patient appointments system. Ladd also noted that cross-training across the office over the past several years will allow rotation of some clinical staff in and out of the office, as needed, to decrease their exposure as much as possible.

“Worst-case scenario, just do the best that we can with what we have until this crisis comes to an end,” Ladd said. “A lot of doctor’s offices, we’re used to thinking out of the box and finding resources in order to get the job done.”

Despite not previously looking into home health monitoring and telehealth services, Ladd said that was the next step for her practice, especially as federal regulations are loosened to allow for greater adoption and usage. “Everything is on the table,” she added.

But despite that entrepreneurial approach to solving the unique and evolving challenge of COVID-19, Ladd noted that she has looked to MGMA and her state chapter to advocate at the federal level for clear guidance and aid to properly respond.

“To me, it seems that if people are going to put the doctors and the doctor’s offices on the frontline in testing the virus, that people need to make sure we have the resources to do so,” Ladd said.

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CREDITS

MGMA Insights is presented by Decklan McGee, Rob Ketcham and Daniel Williams.