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OHSU RNs pivot to screening those with COVID-19 symptoms so they don't risk an ER visit

COURTESY PHOTO: OHSU - Dr. Eric Herman, a family care physician at OHSU, heads up the Connected Care Center and the COVID-19 hotline.Staffing the vital phone lines in the fight against COVD-19 at OHSU is a platoon of registered nurses and doctors whose regular medical duties have been put on hold for the time being.

They are the backbone of the Connected Care Center, answering phone calls from every part of Oregon and Southwest Washington to the COVID-19 Hotline (833-647-8222). Since its establishment on April 22, they've fielded a thousand calls per week.

The mission of these 40 medical professionals, who work out of their homes, is to listen to "anxious and understandably concerned patients," said platoon leader Dr. Eric Herman.

As of mid-May there are no plans to curtail the operation. "We're fully live and we're operational and we're fielding calls from patients and providers across the state. We are of course trying to respond to the supply and demand of how COVID is affecting the community and the prevalence and incidences of it.

"Our service right now is to be able to answer general questions. If a patient has symptoms or concerns, we can triage them, we can make sure that we direct them to video visits. We do all of that by first making sure that we preserve continuity of care between patients and their existing providers," he said.

The first question to callers is whether they have a primary care physician. If they do, they're told to call that doctor. If not, the nurse goes to work on the telephone, "answering questions and providing reassurance. We get them to the right next step, whether that's to call your primary care physician or a respiratory clinic, visit a mobile testing site or set up a virtual visit," Dr. Herman said.

Dr. Herman, a family practice physician at OHSU in less stressful times, said that by convincing only those with the most serious coronavirus symptoms to head to the emergency room, these front line/phone line professionals have prevented the spread of the disease.

"I think we really did our part to decrease the spread of this pandemic by keeping people safe and not going to medical facilities when it wasn't necessary. We had one dramatic data point: of the 3000 calls we had, we only needed to direct seven people to emergency departments," he said.

"We met the mission in terms of keeping people safe, those people that otherwise may have gone to primary care, emergency departments or urgent cares and potentially had a higher risk of infection stayed home," he said.

The hot line was created when nurses taking calls from worried patients at OHSU's clinics around Oregon were "inundated."

"My role is to be a kind of executive director and to really make sure we brought a multidisciplinary patient-centered team into the fold quickly. We did everything we could to make sure we had people who are experts in the patient experience," said Dr. Herman, citing the value of his training as an electrical engineer in bringing together his team, the technology and the collection of data.

He was headed for a career as an engineer when he served in the Peace Corps in Gambia at the beginning of this century. He so admired the work of the volunteers in public health who educated Gambians about the risks of malaria and dehydration that he decided to pursue a career in medicine.

Creating the Connected Care Center so quickly was possible due to a $1.6 million gift from the Andrew and Corey Morris-Springer Foundation. "The philanthropic fund gave us the creative freedom to do what we knew was best," Dr. Herman said.

Andrew Morris-Singer is an Assistant Professor in the OHSU Department of Family Medicine and a Lecturer at Harvard Medical School. Corey Morris-Singer, Ph.D., is a biological and biomedical scientist.

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