Curbside Testing And Care In Some Areas A New Normal Over Indoor Clinic Visits
A growing number of clinics around Iowa have adopted curbside or drive-thru testing for COVID-19 and other health needs. This helps reduce the risk of exposing a patient who might have COVID-19 to other people and limits the number of people who actually go inside a health center for care.
Doctors at Community Health Care, Inc. in eastern Iowa and western Illinois see patients by telehealth first. If a patient has a respiratory illness, their doctor will direct them to curbside care.
The health centers have tents set up outside. People can get tested for COVID-19 in their cars and get a flu vaccine or even a physical exam. CEO Tom Bowman said keeping people outside of the clinics helps reduce potential spread of the novel coronavirus.
“We really are looking at this as the only reason somebody would come into the clinic is because it’s worth the risk of potential exposure for our staff because it’s in the best interest of the patient,” Bowman said, “but that is a high bar to cross.”
Bowman said there are very few exceptions, like if an elderly patient needs a physical exam that requires them to undress.
Bowman estimates that they’ve been running 50 to 100 patients through a curbside care location per day. Around 10 to 15 of those patients will be screened for COVID-19.
“We are still pretty strict on the parameters around who qualifies for that,” Bowman said on COVID-19 testing. “If they’re not short of breath and their symptoms aren’t advanced, we’re going to have them go home and do home care and self-isolate.”
We serve a large rural area with an elderly population. We don't want to get them sick, we don't want our staff to fall sick and we don't want to give it to other people either. -Cynthia Hoque, Knoxville Hospital and Clinics
Other community health centers have been offering curbside or drive-thru testing as well. Siouxland Community Health Center in Sioux City started drive-thru testing last week. People need a doctor’s authorization before they can show up at a checkpoint. Once they’re checked in, they’re given directions to the actual testing site. Woodbury County's health department, Siouxland District Health Department, has not disclosed where the testing is actually happening.
According to the Iowa Primary Care Association, Primary Health Care in Des Moines, Community Health Care Center of Fort Dodge and Promise Community Health Center in Sioux Center are also offering some form of drive-thru or curbside testing. Aaron Todd, the CEO of the Iowa Primary Care Association, said there isn’t a one-size-fits-all approach for community testing. It depends on what each community needs.
“We’re encouraging each of our health centers to play the role that is needed in their community,” Todd said.
Todd said the value of drive-thru and curbside testing is convenience. It protects both patients and providers because people stay in their vehicles and don’t go into clinics. To limit potential exposure of a patient with COVID-19, the association is asking people to call their health centers before they show up for an appointment. And like Community Health Care, Inc. has done, these testing sites can also take care of additional services that people may need while they’re at the site.
“If they haven’t gotten their flu shot, we could give them a flu shot in that moment as well, potentially,” Todd said. “I don’t want to necessarily suggest this is a full visit … but if there are other issues we could quickly remedy or if we can make referrals for other types of services, we would do that too.”
Knoxville Hospital and Clinics in south-central Iowa screens patients over the phone before they set up an appointment for anything. Providers see patients in their cars in the parking lot of the facility. They take patients' blood pressure, temperature and other vital signs, and will test them for COVID-19 if they determine they need the test.
Cynthia Hoque, a family medicine physician at Knoxville Hospital and Clinics, said staff are trying to take care of people in the safest way possible.
“We serve a large rural area with an elderly population,” Hoque said. “We don’t want to get them sick, we don’t want our staff to fall sick and we don’t want to give it to other people either.”
Knoxville Hospital and Clinics has “drastically reduced” the number of patients it sees inside the clinic daily to limit exposure, Hoque said.
“I believe our numbers are down about 75 to 80 percent from normal,” Hoque said. “And we have really started pushing our virtual visit program. We’re starting to see a lot of patients for routine things like medication refills, rashes … that we can do over this secure platform that we have with a camera and speaker.”
Curbside and drive-thru testing also cut down on the amount of personal protective equipment or PPE used. Hoque said only one provider per day is doing this testing at Knoxville Hospital and Clinics, they wear the same suit and hood, which includes a face shield, all day. They clean their PPE in between patients.