Screening, Testing, Laboratory Guidance
Latest COVID-19 updates from the NC Department of Health and Human Services (8/2/2021)
With COVID-19 cases again on the rise due to the more contagious Delta variant of the virus, here is the latest guidance from the state and the federal Centers for Disease Control and Prevention (CDC). You can keep up with all state COVID-19 updates at this website.
- The NC Department of Health and Human Services (NCDHHS) announced last week that anyone who works or volunteers at a state-run health care facility in North Carolina will need to be fully vaccinated against COVID-19 by the end of September. NCDHHS also urged private facilities to follow suit. Several large health systems did announce vaccine mandates for employees.
- The state will begin verifying COVID-19 vaccination status for all its employees and those state workers who are not vaccinated are required to wear a mask and be tested at least once a week, as announced last week by Gov. Roy Cooper and NCDHHS Secretary Mandy Cohen, MD, MPH.
- NCDHHS – and the NCMS – strongly urge all North Carolinians age 12 and older to get a COVID-19 vaccine. Data shows that the rapid increase in COVID-19 cases is largely due to those who are unvaccinated.
- The Governor and Secretary Cohen also released updated guidance for the state’s K-12 students, which urges that everything possible be done to keep students in schools and emphasizes continued masking. This guidance became effective July 30. Review the guidance here.
NCDHHS Guidance
UPDATED: Latest guidance from the NC Department of Public Health. (5/6/2021)
NCDHHS Vaccination Information
Guidance for physicians on vaccines
COVID-19 Vaccine Management System (CVMS): CVMS is a secure, cloud-based system that enables vaccine management and data sharing across recipients, care providers, hospitals, agencies, and local, state, and federal governments on one common platform. Through CVMS, North Carolina health care providers are able to:
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- Enroll in the COVID-19 Vaccine Program
- Manage COVID-19 vaccine inventory
- Track COVID-19 vaccine administration
- Invite their employees to register for vaccination
- Schedule appointments
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- NCDHHS Interim Provider Guidance for Vaccinating North Carolinians (April 30, 2021)
- Summary Sheet of Updates – Interim Provider Guidance for Vaccinating North Carolinians (April 30, 2021)
- Statewide Standing Order for FDA Authorized Pfizer and Moderna COVID-19 Vaccine Administration (April 21, 2021)
- Statewide Standing Order for FDA Authorized Johnson and Johnson (Janssen) COVID-19 Vaccine Administration (April 21, 2021)
- Strategies to Fill COVID-19 Vaccination Appointments
- Helping You Get Started as a COVID-19 Vaccine Provider
- Secretarial Order 8 (March 3, 2021) – Allows licensed dentists to administer COVID-19 vaccinations
Updated resources for you and your patients (5/10/2021)
• ‘Pop-Up’ testing sites listed by county.
• Ongoing Outbreaks in Congregate Living Facilities by county and facility (updated May 7, 2021)
• Risk Factors for Severe Illness (updated Jan. 26, 2021)
• Demographics of Contact Tracers hired by state (updated every Wednesday by 4 p.m.)
• ‘Why Should I Be Tested’ fact sheet for your non-English speaking patients in four new languages in addition to Spanish.(Burmese, Haitian-Creole, Karen, Swahili)
• The Health Care Guidance for Providers page includes information for pregnant women, standing orders for testing and reporting and other information.
Tools offered by NCDHHS:
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- Find My Local Vaccine Provider
- Download the SlowCOVIDNC app and be notified if you have been in close contact with someone who has shared a positive COVID-19 test result in the app.Once you opt-in to the notification system, you can also anonymously share a positive COVID-19 test result in the app. SlowCOVIDNC protects your identity and privacy while empowering you to protect yourself, your family, and your community.
- Check My Symptoms web page that allows people to enter their symptoms and determine if they should get tested for COVID-19.
- Find My Testing Place website, where the public can enter their county or ZIP code and find a list of nearby testing sites.
- NC COVID-19 text information and updates are available. To sign up, text COVIDNC to 898211
- COVID-19 Community Team. This effort was recently launched and the team is made up of trained contact tracers. Team members reach out to people who have tested positive for COVID-19, or anyone who has been near someone with COVID-19, and get them the information and support they need. This support can include helping someone understand what it means to have been exposed to COVID-19, how to monitor their symptoms, when to get tested, if needed, and how to protect their loved ones.When the COVID-19 Community Team reaches out, it is important that people answer the call. Individuals being contacted would get an initial text from the number 45394 or email from [email protected] with follow-up phone calls from NC OUTREACH (844-628-7223) or the Local Health Department. The Community Team represents North Carolinians across the state and will be available to provide support and information in multiple languages. NCDHHS has created a toolkit to help you disseminate this information to your patients via printed materials and social media posts. Access the toolkit here.
LabCorp Guidance
To facilitate greater access to testing for the virus that causes Covid-19, NCDHHS is encouraging providers to submit specimens to LabCorp when ALL of the following conditions are met:
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- Fever
- Signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath)
- Negative influenza test (rapid or PCR).
Guidance for testing at LabCorp is available here.
Additional Resources
Our friends at The Pediatric Center in Wilmington have shared their testing flowchart.
Personal Protective Equipment Guidance
NCDHHS Guidance
The state is working to secure adequate supplies of personal protective equipment (PPE). Nationwide, there are shortages.
NCDHHS and the state Office of Emergency Management is instructing health care providers to work through existing vendors and contracts to secure PPE. If you encounter a shortage, they advised that you contact your local health department or county emergency management department to request supplies. If you have questions or concerns, please contact Hattie Gawande ([email protected] or call 919-906-1899)
CDC Guidance and Resources
CDC Latest Personal Protective Equipment recommendations
Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Health Care Settings (CDC, updated February 23, 2021)
Strategies for Optimizing Supply of N95 Respirators (CDC, updated April 9. 2021)
Alternative Care Sites and Isolation Sites (CDC, updated April 24, 2020)
Personal Protective Equipment (PPE) Burn Rate Calculator (CDC, updated March 24, 2021)
Disinfecting Your Facility if Someone is Sick (CDC, updated April 5, 2021)
Hand Hygiene Recommendations for Healthcare Providers (CDC, updated May 17, 2020)
Strategies for Optimizing the Supply of PPE (CDC, July 16, 2020)
Health Care Supply of Personal Protective Equipment (CDC, July 16, 2020)
Health Care Infection Prevention and Control FAQs for COVID-19 (CDC, updated March 4. 2021)
Interim U.S. Guidance for Risk Assessment and Public Health Management of Health Care Personnel with Potential Exposure in a Health Care Setting to Patients with COVID-19 (CDC, March 7, 2020)
Health Care Supply of Personal Protective Equipment (CDC, updated March 11, 2021)
How to properly put on, use, and remove PPE (CDC)
Additional PPE Guidance
Addressing COVID-19 Face Mask Shortages (Stanford Medicine, March 25, 2020)
N95 Filtering Facepiece Respirator Ultraviolet Germicidal Irradiation (UVGI) Process for Decontamination and Reuse (University of Nebraska)
Guidance for Use of Certain Industrial Respirators by Health Care Personnel (CMS, March 10, 2020)
Novel Coronavirus (COVID-19) – Fighting Products (Center for Biocide Chemistries) (via DSHS)
Guidance for use of Certain Industrial Respirators by Health Care Personnel (CMS, March 10, 2020)
EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2, the Cause of COVID-19 (EPA, March 3, 2020)
Surgical N95 vs Standard N95 Which to Consider (3M, January 2020)
Telehealth
To help protect patients and staff from spread of Covid-19 many practices are looking to telehealth technology. Below is guidance and policies from public and private insurers and additional resources.
NCMS Offers Telemedicine Help Through New Platform “Presence”
Commercial insurers
UPDATED: NCMS Compilation of Payers’ Telehealth Policies (8/6/2020)
List of telehealth policies and guidance from Aetna, Blue Cross and Blue Shield of NC, Cigna, Humana and United Healthcare. (Updated 3/18/20)
NC Medicaid
NC Medicaid will allow practices to bill for defined telehealth services. Review the updated policies in this special NC Medicaid Bulletin.
FAQs for telehealth in Federally Qualified Health Centers (FQHC) and Rural Health Centers are in this chart.
Medicare
On March 17, CMS announced expanded Medicare telehealth coverage. Beginning on March 6, 2020, Medicare will temporarily pay clinicians to provide telehealth services.
NEW! Video Available on Medicare Coverage and Payment of Virtual Services
CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. View the Video
Read the Fact Sheet on this announcement
Frequently Asked Questions about Medicare telehealth (3/17/2020)
General Medicine Toolkit (3/20/20)
End Stage Renal Disease Provider Toolkit (3/20/20)
Workers’ Comp/NC Industrial Commission
The Industrial Commission has received several inquiries from health care providers regarding telehealth visits in lieu of in-person office visits, in light of health and safety concerns about COVID-19 transmission raised by nurse case managers, injured employees, and the health care providers. Please click here for answers to the most frequently asked questions about the telehealth visits.
HIPAA Compliance
The US Department of Health and Human Services Office for Civil Rights will not impose penalties on physicians using telehealth in the event of noncompliance with the regulatory requirements under the Health Insurance Portability and Accountability Act (HIPAA). Learn more here.
Telehealth Vendors
| Company | Website | Fee Structure |
| Presence | https://therecoveryplatform.com/presence/ | Free |
| Doxy | https://doxy.me | Free |
| Trimed | http://www.trimedtech.com | Free |
| Updox | https://www.updox.com | Free |
| DocsInk | https://docsInk.com | Fee Based |
| Dr. First | https://drfirst.com | Fee Based |
| CGM | https://www.cgm.com/us/index.en.jsp | Fee Based |
Telehealth Resources
- NEW! Toolkit on Telehealth for Chronic Care and Wellness Services (NCAHEC)
- The Physicians Foundation has begun a new initiative to help physicians implement telehealth services: https://physiciansfoundation.org/the-telehealth-initiative/
- AMA quick guide to telemedicine in practice
- Healthsperien has compiled helpful telehealth guidance (4/14/2020)
- Mid-Atlantic Telehealth Resource Center
- If you are interested in learning more about how to implement telehealth into your practice, Curi, a Medical Mutual Company, offers this quick one-page summary offering guidance on the structure/execution of clinical telehealth services, as well as a number of links to resources and regulatory bodies. Curi Telehealth Overview.
- Telehealth Tipsheet provided by NC AHEC
- National Consortium of Telehealth Resources is offering this free toolkit
NC Medical Board Position on Telehealth
Review the North Carolina Medical Board’s position on telehealth as of March 17, 2020.
Additional News & REsources
Resources as You Reopen
- Dermatology – American Academy of Dermatology
Everyday Health & Preparedness Steps in Clinic - Internal Medicine – American College of Physicians
COVID-19: An ACP Physician’s Guide + Resource - Neurology – American Academy of Neurology
Key Considerations for Reopening a Neurology Practice – Webinar - Ob/Gyn – American College of Obstetrics & Gynecology
Resumption of Comprehensive Women’s Health Care Policies and Processes - Ophthalmology – American Academy of Ophthalmology
Reopening and Recovery Tips - Orthopaedics – American Academy of Orthopaedic Surgery
Navigating the COVID-19 Pandemic - Otolaryngology – American Society of Otolaryngology-Head & Neck Surgeons
Guidance for Return to Practice for Otolaryngology-Head and Neck Surgery - Pathology – College of American Pathologists
CAP Responds to Your COVID-19 Questions
Volunteering
NC Department of Health and Human Services Secretary Mandy Cohen, MD, MPH, has called on medical professionals to volunteer to help in the state’s response to COVID-19. Read her letter to the medical community.
For more information or to volunteer, please visit the state’s online platform to sign-up.
NC Medical Board Adopts Emergency Rules in Response to COVID-19
Other Resources
NCMS Compilation of Federal and State Regulatory Changes in Response to COVID-19
AMA Articles and Resources
5 ways medical students can assist during the COVID-19 pandemic
What to do when COVID-19 enters your physician practice
National Specialty Society Resources
View this compilation of national specialty societies and their COVID-19 resources (Excel)
General Practice Management Guidance for COVID-19
NCMS Business Alliance member Poyner Spruill has compiled numerous resources for employers:
- Work in the Time of COVID-19: FAQs for Employers (Poyner Spruill)
- Of Furlough and Other Benefits: How Employers Can Supplement State Unemployment Benefits for Former Employees (Poyner Spruill)
- Relief Storm: Providing Tax-Free Benefits During the COVID-19 Emergency (Poyner Spruill)
- One Hundred Days of Solitude: Facetime, Skype, and HIPAA Compliance (Poyner Spruill)
- The Top Ten Employer Cybersecurity Concerns For Employees Regarding Remote Work (Poyner Spruill)
NCMS Business Alliance member Curi has compiled a helpful page of resources, including additional information on telemedicine, practice workflows, disaster planning, helpful webinars and more. Access Curi’s COVID-19 Resource page.
Toolkit for Independent Physicians
Thanks to our friends at Avance Care, who have shared this toolkit (updated 9/21/2020) for independent practices grappling with their response to Covid-19. The kit includes practical advice and resources to protect staff; recommendations for room decontamination; sample scripts for patients who may demand testing even if it’s not warranted by clinical guidelines and links to other resources.
Access the toolkit. (updated 7/24/2020)
Rural Health Resources
- Rural Impact of the Latest COVID-19 Stimulus Package (National Rural Health Association)
- COVID-19 Urgent Rural Health Legislative Information (NCRHLA)
Covid-19 & Pets
Animals and Coronavirus: Frequently Asked Questions (NC State School of Veterinary Medicine)
Hand hygiene videos
This New England Journal of Medicine video on hand hygiene is excellent and pretty technical. It’s 14 minutes long.
For patients, this National Health Service hand hygiene video has no words, just a great demo and lasts just 44 seconds.
COVID-19 Symptoms
COVID-19 Symptoms one sheet (NC Drug Card)
CDC Hand Hygiene Fact Sheets and Posters
Provider Poster: Clean-Hands-Count
Poster Clean Hands Count For My Patients
Archived White House Coronavirus Guidance
Articles of interest
Coronavirus (Covid-19): New Telehealth Rules and Procedure Codes for Testing (FPM Journal, 3-10-20)