COVID-19’s Second Wave: A Reexamining of the Five-Stage Framework for Managing the Coronavirus Pandemic [Infographic]

In March of this year, we introduced the five-stage framework for healthcare’s management of the COVID-19 pandemic. As the second wave of COVID-19 is sweeping the US, we thought it important to readdress the five stages and new digital health solutions, as many states are reverting back to Stage 3 after a calmer summer.

New digital health solutions have arisen since March that can help clinics and health systems minimize disruption to their daily workflows even while their state may revert back to Stage 3 – Peak Infection & Crisis Management, during the second wave of COVID-19. Zero Contact Check-In and Waiting Rooms minimize face-to-face interactions, for example, while Broadcast messaging solutions enable you to communicate with your patient population en masse around renewed office closures or telehealth options.

Here we take a deeper look at the five stages health systems and providers across the country are continuing to navigate.

Stage 1 – Readying for Disruption

Stage one can be thought of as a crisis management readying stage — providers are readying their clinics for disruption. While healthcare teams have the capacity to operate at or near their normal level, this is the time to make precautionary adjustments, communicate with patients, and work to assess risks and identify infections. During this stage in the second wave of COVID-19, healthcare teams should take steps to:

  1. Proactively communicate with patients: Healthcare teams should send mass messages to educate patients about potential health risks. Providers can share general information about precautions that broad patient populations should take to protect themselves and their families. Outreach could also be sent to high-risk populations to let them know that they may be more susceptible to complications related to COVID-19 because of their age or pre-existing conditions.
  2. Communicate appointment and operational changes: During stage one, clinics may need to implement new policies for scheduling appointments, change their clinic hours or service offerings, or make other operational adjustments. Providers need to communicate these policy changes to patients.
  3. Assess risks and identify COVID-19 cases: Providers need to adopt new screening policies as early as possible.

Stage 2 – Urgent Crisis Management

Stage two involves more urgent crisis management. During this stage, it is necessary for providers to act swiftly to address the spread of COVID-19 and deal with rising pressure. Communities in stage two have declared public health emergencies, but providers can still plan ahead and work proactively to meet patients’ needs. Priorities for providers in this stage include:

Healthcare teams need to communicate about mass cancellations and rescheduling appointments.
  1. Large-scale patient outreach: Healthcare teams need to communicate about mass cancellations and rescheduling appointments. At this stage, many providers will need to reschedule non-essential appointments to protect patients and staff. Many patients will be hesitant to visit healthcare settings. Ideally, teams will be able to reschedule cancelled appointments as telehealth virtual visits.
  2. Screening patients for COVID-19: Screening patients becomes more critical in stage two. Healthcare teams can require patients to complete survey forms prior to appointments to help identify potential COVID-19 cases.
  3. Communicating information related to specific conditions: Checking in with patients who have chronic conditions and ensuring their needs are met is essential when routine chronic care appointments are cancelled.
  4. Scheduling telehealth virtual visits: Rescheduling in-office appointments as telehealth virtual visits benefits patients and providers. Not only is telehealth important from a patient access standpoint, telehealth enables providers to continue providing billable care.

Stage 3 – Peak Crisis Mode

Stage three is peak crisis mode. This is where healthcare experiences the most stress. Communities in stage three are virtually shut down except for essential services. Providers are scrambling to respond to overwhelming challenges. Clinics that treat COVID-19 patients may see their resources depleted and healthcare workers exhausted. Clinics that do not provide critical care may be temporarily closed, or primarily operating virtually. In stage three of the second wave of COVID-19, some of the primary areas of focus for healthcare providers include:

  1. Crisis response: Communication continues to be important, although it has shifted from preventive messages to reactionary messages.
  2. High-risk check-ins: Providers will want to monitor patients who are at home with critical needs—whether those needs are related to COVID-19 or chronic conditions.
  3. Telehealth virtual visits: Outside of critical care, telehealth becomes the most accessible patient care.
Providers in stage three need to have the ability to schedule telehealth virtual visits so they can continue delivering care for non-COVID patients.
  1. Provider safety and burnout management: Continued screening efforts are important to protect providers and maximize the availability of healthy staff that can provide patient care.

Stage 4 — Pivotal

For most healthcare providers, the shortest response stage will be stage four. In this stage, healthcare providers are no longer completely overwhelmed. COVID-19 is still a threat, but it has subsided to a point where resources are available to meet demands. This stage is pivotal because it can either be the first step toward recovery, or a path that leads back to a repeat of an earlier stage. In stage four, healthcare teams need to take steps to:

  1. Continue screening for ongoing spread of COVID-19: Stopping screening at this point can easily send a community back to stage two or three of the curve. Continued screening is necessary because COVID-19 still exists.
  2. Continue seeing patients via telehealth virtual visits: As healthcare takes steps to recover from the pandemic, telehealth will continue to be essential. Providers can easily schedule telehealth visits to provide care to patients with a wide-range of needs.

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  1. Conduct outreach to schedule high-priority patients: At-risk patients that had appointments for semi-urgent procedures delayed can be rescheduled during stage four. Providers will need to determine where to begin outreach and work to reschedule procedures such as colonoscopies or mammograms for high-risk patients.
  2. Resume health campaigns and encourage patient recall­: Providers can begin working to resume care for non-urgent primary and chronic care patients in stage four. Getting back on track will require outreach, and these efforts will continue into stage five.

Stage 5 — The New Normal

Stage five is the obvious goal for healthcare. Communities will return to normal life during stage five — although, there will be lasting healthcare changes and a “new normal” post-COVID19. During stage five, areas of focus for healthcare will be:

  1. Prioritizing and rescheduling all backlogged appointments: It will take time to work through the backlog of patients who are overdue for care in stage five. Healthcare teams will need to work efficiently, leverage automated outreach and scheduling tools, and make use of all openings in their daily schedule to maximize care accessibility.
  2. Recovering revenue: The financial effects of the coronavirus pandemic will be felt across healthcare even after the crisis ends. This is another reason healthcare teams will need to work during stage five to reschedule backlogged appointments—so they can make up for lost revenue.
  3. Population health management: Population health will once again become a priority in stage five when providers can resume patient outreach to promote routine preventive and chronic care.
  4. Telehealth virtual visits: After a huge push to convert appointments to virtual visits during the pandemic, many providers and patients will want to continue to take advantage of the benefits telehealth offers.  

One important note about these stages is that timing isn’t the only variable. The duration of these five stages will be different for healthcare providers across the U.S. Having an understanding of the different stages and how your clinic may bounce between them, repeat them, and eventually overcome them can help you identify critical actions to take.

Luma Health is a leader in digital innovation solutions that clinics and health systems can implement between all stages of the pandemic, especially as the second wave of COVID-19 surges again this winter.

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