COVID-19 Checklist: Elements of Planning for Restarting Physician Practices

With COVID-19 cases still on the rise, now is the perfect time to start planning to re-start your practice. We understand things have been overwhelming and difficult. You may not have been prepared to utilize your Telehealth resources for the first time, had a shortage of supplies, had to make crucial decisions when discussing the current state of your providers’ employment or how to deal with the financial impact during the crisis.

Despite all the chaos and confusion, the time is now to step back and be sure your practice is ready when it’s time to reengage in a more “normal” way when this is all over. If you wait too long, unnecessary challenges can arise, making restarting much more difficult.

You’ll need to address the safety of your providers and staff, determine triage protocols, plan on reengaging your staff and providers within the practice, and become an expert in utilizing your telemedicine and patient portal.

To help you get setup for your practice’s restart, we’ve created a checklist to help you ensure you’re taking all the necessary steps to open back up the right way and not expose your practice and your physicians to risk.

"Despite all the chaos and confusion, the time is now to step back and be sure your practice is ready when it’s time to reengage in a more “normal” way when this is all over."

Checklist for restarting your practice

According to SE Healthcare’s Kevin Mosser, MD, here are some important elements you should consider.

Staff and provider safety

1. Project PPE needs and availability to project what caseloads will be manageable. If supplies are limited, you may not be able to see same volumes as you did before the pandemic. For procedure-based specialties, this may require collaboration between your practice and your surgical center or hospital.
2. Carefully plan social distancing guidelines with particular attention to the physical layout and flow of your office.
3. Consider and protect older workers and providers by careful role definition.
4. Develop a sanitation and sterilization plan.
5. Consider rotating teams for on-site personnel or extending hours to accommodate fewer people in the office simultaneously while maintaining overall volumes.
6. As outlined below, create clarity for your team around triage. They will feel safer if they know you are balancing patient needs and staff safety.

Financial management

1. You may want to look at your practice as a new business. Sit down and rework your budget using the new information on volumes you now have.
2. Do a cash flow analysis to determine if you have enough cash flow to sustain the business. Plan your use of a line of credit if you have one; consider getting one if not.
3. Do you need to apply for an SBA 7aPPP Loan? The terms of these are now available, and it’s important to remember that only a portion of the loan will be forgiven. Start a list of questions and fill in the blanks as you review the information.
4. Now is the time to re-energize your collection efforts.
5. Consider having a professional review your books and offer knowledgeable advice.

Determine triage protocols

1. Determine which patients get priority of personal appointments.
2. Clarify going forward what you will treat with telemedicine, and what you won’t and develop a strong communication plan for your patients.
3. For specialties performing significant numbers of outpatient procedures, consider which patients should have their elective procedures performed first. This may require a review of all patients in the queue. Remember as stated above that your volumes could be limited by availability of PPE.
4. As tests for coronavirus become more available, provide continuing clarity to all as far as what the guidelines for testing on request will be.

Re-imagine schedules and roles

1. How will staff and providers be optimally scheduled for phone and telemedicine duties? The split between in-office visits and telemedicine visits will be very different than they are pre-pandemic and practices should anticipate optimal use of provider and staff skill set.
2. Project practical surgical volumes to the extent possible. Look to work down the queue as quickly as possible by optimizing surgical schedules in all locations, shifting providers to most availability, while taking care to avoid excessive stress, hours and burnout.

Solidify your knowledge and compliance surrounding telemedicine

1. How well supported is it by your EMR
2. Privacy and security
3. Documentation protocols
4. Billing accuracy and optimization
5. Consider working with an expert to review your procedures

We will get through this!

Being prepared is the best solution to the next round of upcoming challenges. Remember that being open doesn’t ensure you are busy! Well wishes to you all.