Week In Review

You have our backs; you keep us safe. Help us work to have your back and keep you safe, too.

Here is this week's link to the survey on how COVID-19 is impacting your practice.

The Larry A. Green Center, now partnering with both the Primary Care Collaborative and 3rd Conversation, is conducting a quick clinician survey to better understand COVID-19 response and capacity for U.S. primary care practices. The survey takes 3 minutes to complete.
 
Your answers will continue to inform public policy in real-time, and will be helpful for future planning on the pandemic response at the federal and state levels. Responses for this week's survey are required by Mon., June 1, at 11:59pm PT.

KEY FINDINGS FROM LAST WEEK

Patients value having a relationship with their health professionals. A large majority of patient respondents to last week's survey said they would feel distress at practice closures, perhaps contributing to their fears about "opening the country." 

• 83% of patients surveyed would feel distress at the loss of a relationship with their doctor.
• 17% of patients surveyed would feel panicked, 17% would be heartbroken, and 37% would feel the loss of someone they trust.
• Half of patients surveyed felt certain the country should remain closed; only 22% of patients surveyed agreed it should open. 

Digital platforms can aid access, but for many they create obstacles. According to survey findings, nearly 7 in 10 patients prefer in-person care.

• 29% of patients surveyed do not have the broadband access required to support most digital health care platforms.
• 28% of patients surveyed do not have tablets or computers at home able to support digital health care.
• A third of patients surveyed were not comfortable with digital care (18% video; 12% phone), and another 25% were unsure of their level of comfort.
• 12% of patients surveyed were not comfortable with phone-based visits and 12% were unsure how they felt.

Asked to rank their preferences for common primary care settings, 72% of patients surveyed identified traditional primary care practice as their first choice.
•    9% of respondents chose walk-in/urgent care as their first choice, a distant second to traditional settings.
•    Settings in rank order were: (1) traditional primary care practice, (2) walk-in/urgent-care clinic, (3) concierge or member-based practice, (4) retail-based clinic, (5) online only doctor platform, and (6) clinic based on-site at the office.
 

• From Health Affairs: Structural Discrimination in COVID-19 Workplace Protections
• From Health Affairs: Inequities Amplified by COVID-19: Opportunities for Medicaid to Address Disparities
• From Kaiser Health News: As COVID Cuts Deadly Path Through Indiana Prisons, Inmates Say Symptoms Ignored
• From Kaiser Health News: Experts Say Emerging Data is Clear: Masks Work and Course of Pandemic Will Be Shaped By Their Use
• From the Washington Post: Reopening Too Soon: Lessons from the Deadly Second Wave of the 1918 Flu Pandemic

Please Note: Moving forward, IssueWatch will be transitioned to a weekly feature on MyAGSOnline.

On Tues., May 26, the AGS sent a letter to Congressional leadership supporting the Healthcare Workforce Resilience Act (H.R. 6788/S. 3599). This important legislation would ensure the U.S. expands the number of International Medical Graduates (IMGs) and other qualified healthcare workers available for older adults during the current emergency and beyond. The Healthcare Workforce Resilience Act is a bipartisan bill included in the HEROES Act, which passed in the U.S. House of Representatives on Fri., May 15.

If your institution has a student or resident AGS chapter, remember to fill out your annual progress report! Submitting your report will ensure renewed AGS support for the upcoming academic year. 

Please note: We understand that school and event cancellations have impacted normal activity your ability to operate as you typically would. There is no expectation that chapters will have events to report from the spring semester. This report provides the opportunity for you to describe how the pandemic has affected your chapter and institution, and to help identify ways the AGS can assist your chapter during the COVID-19 pandemic.

If you have a student or resident geriatrics interest group (or would like to start one!) and you have not yet applied for support from AGS, please contact Lauren Kopchik at lkopchik@americangeriatrics.org to get registered.

This new toolkit will collate and publish educational tools developed by members of the AGS and Association of Directors of Geriatrics Academic Programs (ADGAP).

Available on GeriatricsCareOnline.org, the toolkit will serve as a convenient, easy to-use resource for all.

If you would like to submit a tool or resource for inclusion, please email Marianna Drootin at mdrootin@americangeriatrics.org. Along with the resource, each submission should include the following information:

1. Name of tool
2. Author(s) name(s), title(s), institution(s)
3. Brief description (2-3 sentences)
4. Intended audience(s)
5. Intended setting(s)

All tools will be reviewed and, if accepted, posted on GeriatricsCareOnline.org. All authors will be acknowledged in the toolkit and will receive a citation to include on CVs. Please contact Marianna if you have any questions.

Asking questions of our political candidates can help us understand where they stand on issues. To support that aim, AGS leaders and public policy experts have developed a compendium of questions that AGS members and others can use to ascertain where candidates stand on issues important to achieving our vision for health care and older adults. This question guide will help hold officials accountable by encouraging those who run for any office—including and perhaps especially the presidency—to articulate a clear, actionable vision to meet the needs of all older Americans.

Read our special article in the Journal of the American Geriatrics Society (JAGS), or visit AmericanGeriatrics.org/Decision2020 to learn more and access customizable content for contacting candidates about issues important to older adults.

AGS CoCare: HELP™ has released the following free resources:

• A Delirium Prevention Toolkit Amidst COVID-19. Delirium is a common symptom of severe illness in older adults. Thus, with a suspected case of COVID-19, mental status should be assessed. With this toolkit, we provide resources relevant to COVID-19 and delirium to assist you in the care of older adults. Click here to access the toolkit.
• AGS CoCare: HELP™ & COVID-19 Resources Recorded Webinar. The AGS CoCare: HELP™ team hosted the Delirium & COVID-19 Resources Webinar earlier this month to discuss our newest resources and toolkit, and to assist colleagues in the care of older adults during the COVID-19 pandemic. The webinar also featured four programs (University of Utah, California Pacific Medical Center, Peterborough Regional Health Centre, and University of Pittsburgh) sharing their first-hand experience adapted to serve their older adult patients during this time. Click here to access the webinar materials.

Formerly the Hospital Elder Life Program (HELP) developed by Sharon Inouye, AGS CoCare: HELP™ is available at help.agscocare.org. The new website includes streamlined access to many of the program's original materials, as well as a host of additional training tools created exclusively for AGS CoCare: HELP™. For institutional subscriptions and more information, visit us online or contact Deena Sandos at dsandos@americangeriatrics.org.

Last week, the Society for Post-Acute and Long-Term Care Medicine (AMDA) issued a policy statement, "COVID-19 Testing Strategies Should be Tailored to the Clinical Situation." The statement outlines a number of considerations regarding the implementation of universal testing, and calls for individualized testing decisions for each institution, with a clear understanding of the accessibility and capacity for such policies. Read the full statement here.

The blog at HealthinAging.org takes some of the latest studies from the Journal of the American Geriatrics Society (JAGS) and summarizes them in quick, easy-to-read informational posts for older adults, caregivers, and families. Each post links to the full, open-access study, too. Check out some recent highlights:

• Are Older Adults Getting the Most Effective Cancer Care?
• After a Hospitalization, Older Adults Prescribed Potentially Inappropriate Medications May Face Health Risks

The blog has also published several posts about the coronavirus crisis, providing older adults with trusted information to help us all stay safe during the pandemic. Check out COVID-19 posts on the blog, or see them all (and more!) in a curated COVID-19 section on HealthinAging.org.

• We congratulate Louise Aronson, MD, MFA, whose best-selling book, Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life, is a Pulitzer Prize finalist!