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Outcomes

How A Central Clinic Helped Treat COVID-19 Cases in Southern Mississippi

“Aggressive, ongoing management” of COVID-19 cases using a cough and fever clinic and at-home observation helped keep patients out of the hospital

Hattiesburg Clinic in Hattiesburg, Mississippi implemented what CEO Bryan Batson, MD, calls “aggressive, ongoing management” of COVID-19 by isolating people with symptoms for testing as well as treating and monitoring them from home, when possible. A cornerstone of this strategy was the opening of a cough and fever clinic dedicated to COVID-19 testing and follow-up care.

Identifying and Managing New Cases

The first step in Hattiesburg’s management of COVID-19 was identifying positive cases and helping those with COVID-19 isolate to avoid spreading the coronavirus to others. Hattiesburg made their COVID-19 tests more accessible by allowing patients to use MyChart or a website to virtually sign up for curbside testing. To increase awareness, Hattiesburg invested in print and TV advertising to publicize their testing.

“We centralized testing and treatment of COVID-19 so we could identify cases early and prevent as many hospitalizations as possible,” said Dr. Batson, who led the COVID-19 response plan. “Almost every patient with symptoms of COVID-19 has been directed to our dedicated cough and fever clinic for testing, care, and thorough follow-up tracking in this joint project with Forrest General Hospital.”

The strategy proved effective; patients understood where they could go for testing and treatment, COVID-19 care was centralized for more efficient identification of new cases and follow-up, and clinicians were able to closely observe patients with COVID-19 and make treatment recommendations based on trends over time. Batson credits this approach with helping maintain hospital capacity and keep the average mortality rate for Hattiesburg’s patients with COVID-19 lower than the national average.

Monitoring Patients Who Are Recovering from COVID-19 at Home

To maintain enough hospital beds to treat patients with severe cases of COVID-19, Hattiesburg established a home monitoring program for those with mild symptoms. If a patient’s test is positive, Hattiesburg staff drop off a care package including a mask, thermometer, pulse oximeter, vitamins, and other necessities for the isolation period. The patient is also instructed to enroll in MyChart Care Companion, which provides tasks to complete each day such as taking one’s temperature, checking blood oxygen levels, and reporting any new symptoms. If the patient is using a smart device, information from the device can be recorded in MyChart automatically. Nurses at the cough and fever clinic monitor each patient’s progress through the care plan in Epic and follow up when needed. If patients have concerning symptoms or are not meeting goals of care, they have follow-up visits with the clinic—using video visits when possible to limit staff exposure.

“Had it not been for the cough and fever clinic we opened in partnership with Forrest General, we would have far outpaced emergency room and inpatient capacity in the early months of the pandemic,” Dr. Batson said.

Observing COVID-19 Trends and Responding with Clinical Recommendations

In addition to helping clinicians efficiently identify and triage new COVID-19 cases, the cough and fever clinic provided an opportunity for physicians to closely observe the new disease and learn more about how to treat it. The clinic’s staff and clinicians work exclusively with patients who have symptoms of COVID-19, so they’re able to closely observe the disease’s effects. For example, several of the clinic’s physicians noticed “long-haulers,” or patients who experienced persistent COVID-19 symptoms for months after their initial diagnosis. Using analytics in Epic, clinicians confirmed that these cases were reflective of a larger trend. They continue to monitor these patients closely throughout their recoveries. Similarly, as additional outpatient therapeutic options have become available, such as monoclonal antibody infusions, staff have been able to centrally coordinate distribution of these therapies to patients within days of FDA approval.

“Carefully monitoring our patients and focusing on prevention will continue to be a cornerstone of our pandemic response,” Dr. Batson said. “Keeping people out of the hospital and saving lives remain our most fundamental goals.” To learn more about Hattiesburg Clinic’s centralized approach to testing for and treating COVID-19, contact Bryan Batson at bryan.batson@hattiesburgclinic.com.

Photo: Dr. Bryan Batson, CEO of Hattiesburg Clinic, with colleagues at the opening of the cough and fever clinic.