Every Sick Visit Starts as a Telemedicine Visit.

Telemedicine: Last year, telemedicine represented 1% of total visits; since Monday, March 16 that number is 65%. What is most encouraging is that we are receiving consistent feedback from providers that they are confident in the level of care they have been able to provide.

In Person Visits: We are doing as much as we can to  keep people at home by 

• using telemedicine whenever possible for planned visits like Medicine Reviews
• limiting chaperones to one healthy adult (as possible),
• postponing visits that can wait. 
• telemedicine has been extremely helpful for providers to determine which sick visits must absolutely need to be treated in person and in our office.

What Steps Are We Taking to Keep Staff and Families Safe in Our Offices: 

Ann Arbor (Well Visit office):

• Screening families for transmission risk factors
• Denying entrance to the office to anyone with fever or respiratory symptoms and to anyone with sick contacts at home
• Requiring remote check in for visits
• The door is locked and we are limiting access to the office space to GTP team members whose presence is clinically necessary and patients (to be accompanied ideally by a single healthy chaperone)
• Staff is engaging in daily temp monitoring before coming to work to ensure the absence of fever and any person who enters the office space for an appointment has their temperature taken at the door. 
• We are engaging in social distancing in the office among staff, including at lunchtime and to the extent possible during a patient visit
• We are wearing masks and gloves for all patient contact.
• We have switched out the non-alcohol-based hand sanitizer for alcohol-based hand sanitizer
• We are cleaning and wiping down surfaces extensively
• We are complying with new lab pick up procedures to limit contact for ourselves and the lab drivers

Chelsea (Sick Visit Office):

• Everything we are doing in Ann Arbor office, except we are not taking temps of patients and chaperone upon entry and we are allowing entry of persons with sick contacts at home
• Heat has been turned off and we are using space heaters to reduce air circulation
• We are systematically rotating rooms to ensure time lapse between uses
• All doors are closed inside the office building 
• Almost every visit starts as a telemedicine visit to determine whether it makes sense to bring the patient into the office: sometimes, the patient can be assessed and managed via telemedicine and if they need to be seen, we have a safety plan in place before the family arrives at the office 
• GTP team is wearing masks and masks are offered to parent chaperone and to patient (if age appropriate), as well as other appropriate PPE
• We are limiting high risk procedures, including nebulizer treatments and swabbing for possible strep, to what is absolutely unavoidable, for the protection of the team

In observance of Yom Kippur, only the Chelsea office will be open today. The Ann Arbor phones are programmed to ring in Chelsea today, and we are able to assist all Ann Arbor families with any needs you have today. Wishing those observing this holiday an easy fast and may you be inscribed in the Book of Life for a good year.

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