- PowerPoint PPT Presentation

http://www.masoniccanceralliance.org/cancer-survivorship-echo-series.html

K. Allen Greiner ,MD Wyandotte County Health Officer, KPPEPR Medical Director Christian Sinclair, MD, FAAHPM Palliative Care Shawna Wright, PhD, LP Associate Director of KU's Center for Telemedicine & Telehealth Jennifer R. Klemp, PhD, MPH Director, Cancer Survivorship

AGENDA Responding to COVID-19: Protect Patients and Healthcare Providers

Continuing Education Statement Physicians: The University of Kansas Medical Center Office of Continuing Medical Education is accredited by the • Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of Kansas Medical Center Office of Continuing Medical Education designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity. APRN/Nurses : The University of Kansas Medical Center Area Health Education Center East is approved as a provider • of CNE by the Kansas State Board of Nursing. This course offering is approved for 1.0 contact hours applicable for APRN, RN, or LPN relicensure. Kansas State Board of Nursing provider number: LT0056-0749. Mary Beth Warren, MS, RN, Coordinator. Social Workers: The University of Kansas Medical Center Area Health Education Center East, as an approved provider • of continuing education by the Kansas Behavioral Sciences Regulatory Board presents this offering for a maximum of 1 hour credit applicable for relicensure of LASWs, LBSWs, LMSWs and LSCSWs. Kansas Provider Number 12-002. Mary Beth Warren, MS, RN, coordinator. Attendance requirement for nurses and social workers : Participants missing more than 10% of this offering will • not receive continuing education credit Certificates of attendance are available to other participants upon completion of documentation of attendance and • evaluation

Conflict of Interest Disclosure The following presenters do not have any relevant financial relationships with any proprietary entities • producing, marketing, re-selling, or distributing healthcare goods or services consumed by, or used on patients related to the content of their presentation: Shawna Wright, PhD; Allen Greiner, MD; Christian Sinclair, MD The following planning committee members do not have any relevant financial relationships with any • proprietary entities producing, marketing, re-selling, or distributing healthcare goods or services consumed by, or used on patients related to the content of their presentation: Hope Krebill, RN, BSN, MSW, Executive Director, Traci McCarty, Education Program Manager and Trish Long, PA, Navigation Program Director with the Masonic Cancer Center, KU Cancer Center and Mary Beth Warren, MS, RN, Executive Director, KUMC AHECs and Office of CE/PD The following presenter and planning committee member has disclosed potentially relevant financial • relationships with proprietary entities producing, marketing, re-selling or distributing healthcare goods or services consumed by, or used on, patients related to the content of their presentation: Jennifer Klemp, PhD, MPH, Associate Professor, KU Cancer Center Medical Oncology, received honoraria from Novartis, Pfizer Oncology and Astra Zeneca.

Continuing Education Credit & Certification of Attendance ACTIVITY IDENTIFICATION CODE: 51nigh DEADLINE TO ENTER CODE AND COMPLETE EVALUATION: April 14, 2020 at 5:00 PM Using your mobile phone, you can text the activity identification code to (828) 216-8114. OR Accessing www.eeds.com from a mobile device or PC and entering the activity identification code; OR Downloading the eeds mobile app (iOS, Android) and using the activity identification code to sign-in to events.

Funding Source This project was developed by Cooperative Agreement number DP17-1701, funded by the Centers for Disease Control and Prevention. Additional support from the KU Cancer Center and the Masonic Cancer Alliance.

Check-In  Advent Health Cancer Center Shawnee Mission Organizations  American Cancer Society  Ascension Via Christi, Pittsburg  Ascension Via Christi, Wichita  Blue Cross Blue Shield of Kansas City  Bryan Health- Crete Area Medical Center  Cancer Wellness for Life  Susan G. Komen Kansas + Western  Coffeyville Regional Medical Center  Central Care Cancer Center Missouri  LMH Health  Stanford  Mosaic Lifecare  The Breast Center at St. Catherine  Newton Medical Center Hospital  North Kansas City Hospital  The University of Kansas Health System  Olathe Health  The University of Kansas Cancer  Prisma Health Cancer Institute Center  ECHO Institute  St. Francis Campus  Rehabilitation Hospital of Overland Park  Hays Med  Salina Regional Health Center  Truman Medical Centers  Sarah Cannon  Wesley Medical Center/KU Wichita

Recording We will be recording this Cancer Survivorship ECHO for educational and quality improvement purposes. By participating in this ECHO clinic you are consenting to be recorded. https://echo.unm.edu/

Some Helpful Hints • Test both audio & video​ • Mute microphone when not speaking • Bottom left of your screen • Remember to unmute before speaking • Your participation is important! • Speak clearly​ • Short and to the point comments are best • Use chat function • Position webcam effectively​ • Show your face • Have a good light source from the front • Avoid being backlit

Polling Questions Poll Question Share Group Response

Lets Try Out a Poll Question: Answer by Poll or in Chat Box Do you feel adequately informed about COVID-19 and the impact on cancer care delivery in your organization?

https://public.tableau.com/profile/kdhe.epidemiology#!/vizhome/COVID-19Data_15851817634470/KSCOVID-19CaseData

Kansas Department of Health & Environment https://govstatus.egov.com/coronavirus

Example: Wyandotte County, Kansas • 129 test positive cases, 6 deaths • 2 Church Clusters, 1 Rehabilitation Center (15 positives, 5 hospitalized) • University of Kansas Health System – • On 4/4/20: 33 positive inpatients, 19 inpatients awaiting test results*, about half in ICU and on Vents • Limited testing capacity – working HARD to expand *changes daily

Wyandotte County Health Department COVID-19 Testing Protocol Patient self-reports symptoms online at: https://alpha.wycokck.org/Coronavirus- COVID-19-Information Referral for testing from area Patient seeks care from local Probable COVID-19 case: healthcare provider: Healthcare provider Other symptoms Fever >100F sometime in last https://us.openforms.com/Form/23 48hrs de1a07-7522-47ef-b02e- 5c6649b35a43 Called by healthcare professional: do you want COVID-19 testing? Called by healthcare Provider fills out on behalf of professional with patient: Form received instructions: Check temp https://us.openforms.com/Form/23 via auto-email daily; isolate if fever and de1a07-7522-47ef-b02e- To WyCo HD re-report symptoms 5c6649b35a43 online Copy of patient information to HD lab and scheduler/EMR Patient called within 24 hours 2 call-back with appointment Sample labeled w/ requisition Patient arrives for NP sample collected numbers time (scheduled and placed on ice in cooler testing at HD parking lot obtained from q15minuts); asked immediately patient to bring cell phone.

Case Question? If a patient is positive, what types of symptoms result in an admission to the hospital and is there a problem with ICU beds at this time?

IHME Measuring What Matters COVID-19 projections assuming full social distancing through May 2020 Last updated April 7, 2020 (Pacific Time). https://covid19.healthdata.org/united-states-of-america/kansas

Cancer and COVID-19 Patients with cancer had a higher risk of COVID-19 and with a poorer prognosis than those without cancer. • Men >65y/o more likely (in this study) • Patients with lung cancer • Evidence indicates that overwhelming inflammation and cytokine-associated lung injury could be important in instigating these severe events in patients with COVID-19. • History of smoking is an independent risk factor in severe COVID-19 cases. Liang, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020; (published online Feb 14.)

Encourage Everyone to Stay Home!

Precautions Should Cancer Patients Stay Isolated or Practice Social Distancing within their Home? Hand Washing/Hand Sanitizer Who should wear a mask?? According to the CDC this week, a • face covering is a good idea  less likely to emit if you have the virus and asymptomatic or pre-symptomatic

Case Example: Palliative Care Workflow • Get the tech right • then let the tech fall away • Teamwork even more important • Enlist family • For tech support • For camera work • For exam • For psychological support • Use a script if you need it • Non-verbal even more important

Cancer and COVID-19 • Check in with patients • Resources • VitalTalk COVID-19 Resource Guide • Lots of anxiety and fear • https://www.vitaltalk.org/guides/c • What questions do you have? ovid-19-communication-skills/ • For high risk patients • risk of hospitalization • being sick enough to die • Make plans for household • Ensure secure food, housing, meds • Reassure about clinical availability • Encourage reaching out if sicker