From preparation to ramp-up: United Digestive shares its COVID-19 plans

Private equity-backed management service organization United Digestive responded to the COVID-19 pandemic in full force and has begun talks on how it will restart its practice once the pandemic begins to subside.

Neal C. Patel, MD, vice president of clinical development at Atlanta-based United Digestive, shared details of the organization's response and offered insights into how it's preparing for the ramp-up of elective procedures.

Note: Responses were edited for style and content.

Question: How has United Digestive responded to the COVID-19 pandemic?

Dr. Neal Patel: Early on, we established a multidisciplinary COVID-19 response team, which included executive leadership, clinician leaders, and representatives from compliance, communications and supply management.

From daily response team meetings, we:

  • implemented clinical safety (reviewed by a third-party infection control specialist) and physical distancing protocols to protect both patients and staff, including screening patients at the point of scheduling and check-in
  • transitioned central business office and call center team members to remote work platforms
  • approved extra paid time off for all employees to allow for personal considerations specific to the pandemic
  • immediately adopted [gastroenterology] society guidelines to reschedule all elective procedures, resulting in scaled-back ASC and office footprint
  • expedited a HIPAA-compliant telehealth platform across all affiliated practices, which is integrated with our existing EHR
  • distributed telehealth guidelines specific to individual payers to achieve full reimbursement
  • leveraged our network to secure the recommended personal protective equipment for our patients and team members
  • developed real-time supply chain management of PPE; this initiative has allowed us to donate surplus items to local hospital systems in times of need
  • developed an outreach program in which our partner clinicians are offering their extra time during this slower period to support fellowship programs with lectures and mentoring
  • implemented a clinician wellness program, which includes virtual support groups and access to one-on-one coaching appointments during this highly stressful time
  • shared the above protocols, initiatives and messaging to offer support to fellow GI groups across the country

Q: How has the management services organization platform allowed United Digestive to respond in this way?

NP: United Digestive is uniquely positioned to handle the current, extraordinary challenges clinician practices are experiencing. The amount of both intellectual and financial capital required to develop the robust response described above is no small task and would not have been possible without our managerial expertise and resources. Further, our disciplined investment thesis led by our private equity partner Frazier Healthcare has allowed us to have minimal leverage risk and only reinforced our desire for sustainable growth with our strong financial position. Despite the circumstances, we continue to actively recruit new clinician associates, to implement new ancillary service lines, and to evaluate merger and acquisition opportunities.

Q: Once the COVID-19 cases start to subside, do you expect there to be a surge of GI procedures? How will you respond to those cases?

NP: Our clinicians are eager to serve their patients once the timing is appropriate; furthermore, clinical and business leaders understand it is incumbent upon us to implement protocols and policies that prevent COVID-19 spread through our centers. We anticipate a gradual and strategic ramp-up period while also ensuring patients get the necessary GI care. I believe an initial surge of patients who have deferred procedures will occur, especially since we rescheduled over 3,500 elective procedures and are already seeing over 60 percent of our typical office volume via telehealth. With 15 ASCs, we have the capacity to accommodate the volume, and, if necessary, we will offer additional hours and weekend appointments.

Q: What sort of preparations are you taking today to prepare for the ramp-up?

NP: Discussions in our COVID-19 response team meetings have partly turned toward creating and implementing new protocols for the near term. Considerations are wide-ranging and at the very least will ensure adequate PPE for all team members, physical distancing of patients and family members, and enhanced screening protocols. Additionally, we are evaluating less conventional approaches such as creating negative pressure rooms, having dedicated upper endoscopy rooms with additional PPE, increasing procedure block times to diffuse throughput and evaluating new testing options as they become available. Optimistically, an ideal test would have a high negative predictive value during acute infection, would be administered at the point of care with rapid results and would be cost-effective. Ultimately, United Digestive is committed to being a thought leader during these unprecedented times and will take steps to ensure patient safety and confidence.

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