The following is a brief summary of the many efforts faculty and staff have undertaken.
William E. Chavey II, M.D., M.S., associate professor and department service chief, oversaw the internal and external deployment efforts system-wide. In anticipation of the surge, this included reconfiguring inpatient services, which doubled staffing levels and department services at University Hospital and St. Joseph Mercy – Chelsea, to increase physician capacity. Additionally, Dr. Chavey served on Michigan Medicine’s Scarce Resource Allocation Committee, which creates policies on how to allocate resources such as ventilators, blood products and masks in an emergency. And, he appeared on the New England Journal of Medicine’s Journal Watch Podcast 263 where he discussed Michigan Medicine and the department’s response to COVID-19.
Steven M. Wampler, M.D., assistant professor and service director of Chelsea Family Medicine, Anita K. Hernandez, M.D., assistant professor and service director of Family-Mother-Baby (FMB), and Masahito Jimbo, M.D., Ph.D., M.P.H., professor and service director of University Family Medicine (UFM), led their respective services through vast and rapid transitions. Dr. Wampler expanded Chelsea’s service to accommodate transfers from Michigan Medicine to match patients with the level of care needed. Dr. Jimbo led the expansion of UFM, which provides care for patients, including those with COVID-19, that were not family medicine patients to assist University Hospital in the management of the patient surge. Dr. Hernandez changed the format of FMB to reduce the number of faculty needed to allow for increased staffing elsewhere.
Michael M. McKee, M.D., M.P.H., associate professor, created a video explaining the coronavirus in American Sign Language. Reliable information from health experts is often difficult to identify and interpret for persons with hearing loss. Getting informed is even more challenging for individuals whose first language is not English, including Deaf individuals who primarily learn and communicate using ASL. Dr. McKee also was part of a coalition of deaf and hard of hearing consumer advocacy organizations, deaf doctors, and other experts who worked together to provide special guidelines for deaf, hard of hearing, and DeafBlind people and medical personnel to use during the coronavirus pandemic.
David C. Serlin, M.D., assistant professor and ambulatory care clinical chief, led a major transition of our outpatient clinics to maximize patient, clinician and staff safety. In sum, four family medicine clinics consolidated into two hubs, while the other two sites maintained operations on alternate days. This restructuring ensured the Department had the capacity to provide additional clinicians on hospital services. The faculty transitioned to various types of virtual patient encounters to allow patients to receive necessary care. Dr. Serlin’s expertise and guidance, and daily updates, directed a rapid and effective response during this pandemic.
Kathryn M. Harmes, M.D., assistant professor and associate clinical officer for primary care, oversaw the COVID-19 response of all of Michigan Medicine’s primary care locations – Family Medicine, General Medicine, General Pediatrics, Geriatrics, and Medicine-Pediatrics. As the primary care physician lead in Michigan Medicine’s COVID-19 command center, she worked to create programs and develop policies for the major initiatives of outpatient clinics’ ramp down, the establishment of respiratory clinics for patients with COVID-19 and the establishment of the COVID-19 patient hotline.
Oluwaferanmi O. Okanlami, M.D., M.S., assistant professor, is the physician lead for Michigan Medicine’s (MM) “COVID-19 hotline.” The hotline was created to streamline a process for MM patients to access testing. Dr. Okanlami leads a team of nurses, advanced practice providers and physicians who staff the hotline for 16 hours a day, 7 days a week, while closely monitoring changes in testing criteria, supply chain issues and workflow. This hotline team also has started “Michigan Patient Outreach Texting Application” to track patients who have been asked to monitor their symptoms at home. On April 7, 2020, Dr. Okanlami appeared on Your World with Neil Cavuto discussing COVID-19 and his work with the hotline. Robert J. Heizelman, M.D., instructor and director of medical informatics, is a member of the hotline team as well.
Anna R. Laurie, M.D., assistant professor and director of population medicine, coordinated the Department’s rapid expansion of telemedicine services. Dr. Laurie and project manager, Devon Kinney, served as Virtual Care Champions in leading the rollout of video visits department-wide. As a primary care leader in virtual care, the Department progressed from 13 video visits in February 2020 to 585 in March and 2,670 in April – a testament to the commitment and expertise of both staff and faculty members in serving the patients. Overseeing and implementing this major transition at each site are the medical directors; Keri L. Denay, M.D., assistant professor; Jill N. Fenske, M.D., assistant professor; Manasi Ramakrishnan, M.D., lecturer; Pamela G. Rockwell, D.O., associate professor; Christine J. Medaugh, M.D., lecturer; and Ebony C. Parker-Featherstone, M.D., assistant professor.
As the virtual care services across the institution have expanded, Laura Heinrich, M.D., lecturer, in her appointment with the Virtual Care Department worked with a team to develop the roll-out of COVID-19 self-triage, e-visits and planning for the patient self-schedule COVID-19 video visits. She, along with Drs. Laurie and Heizelman and Devon Kinney, are now serving together as a virtual care task force to scale this technology for even more widespread and continued use in the future.
Joel J. Heidelbaugh, M.D., professor and director of medical student education, is coordinating with U-M medical students to implement ways for them to stay involved, utilize their skills and help the effort in caring for patients throughout the pandemic. Currently, he has arranged students to volunteer at the Ypsilanti Health Center to assist patients in enrolling in Michigan Medicine’s online patient portal. This leads to greater communication between physicians and patients. And, it allows patients to participate in video visits so they can receive health care, while also practicing social distancing. In April, the student team had already contacted hundreds of patients.
Manasi Ramakrishnan, M.D., lecturer and medical director of the Dexter Health Center, oversaw the temporary family medicine space at West Ann Arbor Health Center, where most family medicine clinics consolidated. She coordinated and led this consolidation of the department’s clinics through their closure and reallocation of faculty to provide face-to-face visits to appropriate patients at the West Ann Arbor site.
Jill N. Fenske, M. D., assistant professor, led a medical team in the development of Guidance for Outpatient Management of COVID-19, a living document available to the public. The document, regularly updated, has been shared nationally and provides family physicians and others basic, straightforward information and best practices. Additional contributors include: Jenna B. Greenberg, M.D.; Elizabeth K. Jones, M.D.; Nell B. Kirst, M.D.; Oluwaferanmi O. Okanlami, M.D., M.S.; Daniel S. Oram, M.D.; Jacob Wasag, M.D. and Wendy Furst. The document is accessible online at: https://bit.ly/OutpatientCOVID19.
James E. Aikens, Ph.D., professor, Thomas W. Bishop, Psy.D., M.A., assistant professor, Golfo K. Tzilos Wernette, Ph.D., assistant professor, Jill R. Schneiderhan, M.D., assistant professor and co-director of Integrative Family Medicine, Katherine J. Gold, M.D., M.S.W., M.S., associate professor, Suzanna M. Zick, N.D., M.P.H., associate professor and co-director of Integrative Family Medicine, and Angela L. Kuznia, M.D., M.P.H., lecturer, each developed programs to provide psychological and wellness support to faculty and staff members. They have offered one-on-one tele-support, virtual drop-in sessions focused on work/life balance and burnout, guided group mindfulness meditation and relaxation sessions and managed the coordination of gift baskets for service teams.
Anita K. Hernandez, M.D., assistant professor and service director of Family-Mother-Baby, along with Drs. Gold and Kuznia, are participating in a program with obstetricians and midwives to develop prenatal support groups. The providers work closely with medical students who help provide education, psychosocial support and social work services to pregnant patients during the pandemic.
The co-chief residents, Kristen A. McElreath, M.D., Garret T Roe, M.D., and Olivia Yost, M.D., have been an invaluable resource in crisis management during the COVID-19 pandemic. They have been stalwarts, supporting and advocating for their fellow residents through unprecedented changes. Dr. Yost led the group and Jean H.C. Wong, M.D., assistant professor and residency program director, noted, “Dr. Yost spent untold hours digging through spreadsheets and debriefing with me, the service chiefs, and her fellow residents, assessing the latest updates across all our sites, integrating that information, processing all the changes, and troubleshooting new solutions on a daily, and sometimes hourly, basis. She handled the organizational and emotional toll with real grace and true fortitude.”
The Annals of Family Medicine, led by editor-in-chief Caroline R. Richardson, M.D., the Dr. Max and Buena Lichter Research Professor of Family Medicine, has mounted a rapid response to fulfill the need for information sharing during the coronavirus. The Annals has created a COVID-19 collection of original research, open data sets, and other timely information relevant to the primary care pandemic response. A call for papers is active. The journal also is partnering with leaders at the Association of Departments of Family Medicine and the Journal of the American Board of Family Medicine to host a blog that is open to the primary care community called Family Medicine Case Notes from the COVID-19 Frontlines. It publishes personal reflections from family physicians and primary care teams, best practices, and community resources.
Michael D. Fetters, M.D., M.P.H., M.A., professor and co-editor in chief of the Journal of Mixed Methods Research, launched a call for papers for a forthcoming special issue, COVID-19 and Novel Mixed Methods Methodological Approaches During Catastrophic Social Changes.
Tammy Chang, M.D., M.P.H., M.S., assistant professor, penned a March 25, 2020 essay in The Conversation titled “I’m a family doctor fighting against fear and struggling with distancing while trying to keep my patients healthy.”
Phillip E. Rodgers, M.D., professor and associate director for clinical programs with the Adult Palliative Medicine Program, led the institution’s hospice and palliative care team who were on the front-lines of the care for COVID patients at University Hospital. This included rounding on critically ill patients with COVID-19 and providing consultations on their care. He also made a presentation for medical students entitled “The Ethics and Trauma Involved in Pandemic Medical Decision-Making.”
Department faculty also were extensively involved in the planning and implementation of multiple endeavors that have not yet been needed due to the success of social distancing in the area.
- Dr. Chavey developed a plan for deployment of family physicians throughout Michigan Medicine to augment other services.
- Dr. Chavey, along with Eric P. Skye, M.D., professor, participated in the leadership team to plan and execute a field hospital.
- Dr. Richardson was on the planning team in anticipation of the creation of a temporary emergency department at the East Ann Arbor Health Center to handle overflow of urgent patients.