Four algorithms that answer key questions about COVID-19

To help his practice navigate the coronavirus waters, family physician James Dom Dera, MD, FAAFP, developed the following algorithms that address four key questions about COVID-19.

• What kind of virtual visit is this?
• When can COVID-19 patients discontinue home isolation and return to work?
• What should the workflow look like for scheduling or rescheduling patient appointments during COVID-19?
• What staffing strategy should practices adopt during COVID-19, particularly if a staff member becomes infected?

This algorithm provides a quick way to tell whether a virtual visit is considered a telehealth visit, e-visit, virtual check-in, or telephone E/M visit — and which code to assign for reimbursement.

This algorithm (technically, three algorithms) explains the CDC’s advice for discontinuing home isolation, which depends on whether the patient is symptomatic or asymptomatic and whether testing is available.

This algorithm explains which patients should be scheduled for a virtual visit, scheduled for an office visit (and how soon), instructed to self-treat at home, or sent to the emergency department.

This algorithm explains the tactics practices should take depending on which stage they are in: prevention (lessen the risk of exposure), exposure (lessen the chance of infection), infected (mitigate the spread of infection), or crisis (close the office due to critical mass of staff or providers infected; manage patients remotely or via other providers).