Patients and the healthcare system have faced immense challenges as the COVID-19 pandemic has evolved. Rare and complex disease patients — whose underlying conditions compromise their immune, respiratory and cardiac systems — have been hit especially hard. In a recent survey by CORD, more than two-thirds of rare disease patients expressed concern about seeking healthcare due to fear of being exposed to the virus.
Complex patients often require frequent clinical visits in combination with specialized treatment. There is no doubt the COVID-19 pandemic has created an accessibility challenge for these patients, as many clinics and hospitals are restricting access for in-person visits. Limited access to health care professionals, whether real or perceived, can also mean that some patients with chronic, multi-systemic conditions will not get the care they normally need to monitor disease progression and their quality of life. It’s clear COVID-19 will continue to be a concern, so there will need to be better ways to ensure complex patients receive early guidance and prompt care in case of infection.
Who is at risk in your practice?
With thousands of patients on a physician’s roster, it can be challenging to know which patients could be at higher risk of complications or hospitalization from COVID-19. However, the ability to proactively screen for patients more susceptible to COVID-19 complications can give physicians the information they need to ensure those patients are receiving appropriate preventative and ongoing care and guidance through virtual care visits if appropriate. In fact, the CORD survey also noted some success with virtual care access, by both phone and email, along with telehealth services.
In a previous post, we talked about how technology can help accelerate rare disease diagnoses by identifying who may be at high-risk based on case input and incorporated medical knowledge. This technology could also be used to identify patients at risk for severe complications from COVID-19 infections based on risk criteria set out by the government and public health authorities. Further, rare diseases such as Kawasaki disease can exhibit similar symptomology to COVID-19 and it is important that physicians have the tools to discern the differences and provide the right care.
Khure Health: Screening for COVID-19
Incorporating risk criteria set out by the World Health Organization, the CDC, and the Government of Ontario, Khure Health enables primary care physicians to screen for patients at risk of COVID-19 complications, including elderly patients with exacerbated respiratory issues, patients with severe heart or kidney diseases, patients with diabetes, patients with cancer, and a number of additional risk factors.
As the development of COVID-19 therapies and vaccines advance, a common approach to who gets the vaccine first may be required. By screening rare disease and complex patients for those at the highest risk, physicians can prioritize vaccine access for our most vulnerable populations.
Until then, physicians can then plan for a higher level of safety including:
- Patients can be electronically notified that they are considered high-risk and advised to take extra precautions to ensure their own safety.
- Minimizing exposure posed by in-clinic visits by providing access to virtual care for high-risk patients.
- Flagging patients in the physician’s EMR so that upon referral to a specialist, the patient’s safety can continue to be maintained through their care pathway.
Khure Health’s clinical dashboard including our COVID-19 patient screener is available to family physicians across Canada.