April 17th, 2020

COVID-19 Physician Town Hall

2

ReflectionRobyn Parker, VP Strategy & Network Development

3

You

are

HOPE

4

Opening RemarksDon Franke, SVP, Population Health and CEO, AMITA Health Care Networks

5

Meeting Agenda

ReflectionRobyn Parker

VP Strategy & Network Development

OpeningDon Franke

SVP, Population Health and CEO, AMITA Health Care Networks

AMITA COVID-19 Command CenterDr. Stuart Marcus

EVP, Chief Clinical Officer

Testing GuidanceDr. Mark Collins

CIN Medical Director

Infectious Disease Clinical ApproachDr. Ram Ramani

Infectious Disease MD, Metro Infectious Disease Consultants

Cardiology Response

Dr. Daniel Sauri

Director of Noninvasive Cardiology and Cardiac Imaging, AMITA Heart and

Vascular Medical Group, Cardiovascular Associates

Medications and TreatmentSun Lee-Such

Vice President Pharmacy Services

Respiratory ClinicsDr. Reinhold Llerena

President, AMITA Medical Group

Closing RemarksDr. Joseph Lagattuta

CIN Board Chair

6

Updated Hours:

AMITA Physician Hotline Phone Number

224.273.3900 from 8am to 5pm weekdays for the foreseeable future

AMITA Physician Hotline Email

MedStaff-COVID19-Hotline@amitahealth.org

7

AMITA Health COVID-19 Resource PageAMITA Health COVID-19 Resources Playbooks can be found here: AMITAhealth.org/covid-19-AMITA

8

Playbook and Supplemental Documentation UpdatesA summary of newly available or updated resources on the AMITA COVID-19 site (AMITAhealth.org/covid-19-

AMITA) can be found in the “For Our Medical Staff” section of the nightly Leader and Physician Update.

9

AMITA COVID-19 Command Center Dr. Stuart Marcus, EVP, Chief Clinical Officer

10

Joe Impicciche Named to President Trump’s Economic Revival Task Force

11

AMITA Health COVID-19 Daily DashboardUpdated: April 16th

AMITAhealth.org/covid-19-AMITA

12

AMITA Health COVID-19 Daily DashboardUpdated: April 16th

AMITAhealth.org/covid-19-AMITA

13

AMITA Health COVID-19 Daily DashboardUpdated: April 16th

14

AMITA Health COVID-19 Daily DashboardUpdated: April 16th

15

Testing UpdateDr. Mark Collins, CIN Medical Director

16

CDC Guidelines for Testing Prioritization

Document can be found under Testing Guidance section at AMITAhealth.org/covid-19-AMITA

17

COVID-19 Commercial Testing Algorithm in Ambulatory Setting

Document can be found under Testing Guidance section at AMITAhealth.org/covid-19-AMITA

18

COVID-19 Commercial Testing Algorithm in Ambulatory Setting - continued

Table 2 – COVID-19 Evaluation and Testing (if indicated)Independent Physicians fax referral form and requested documents. Site will contact patient to schedule appointment

Location Address Referral required Pre-Registration

RequiredTimes Special Instructions

AMITA Health

Mount Prospect

1754 W Golf

Road. Mt

Prospect, Il

60056

Yes

Fax Referral form to

224-265-9041

or

(call 224-265-9000; option 2 if

unable to fax)

Yes

Patient will be

contacted once

referral is received

8am-5pmPatient stays in car and calls front desk upon arrival

224-265-9000 (press 2 for immediate care)

AMITA Health

Lincolnwood

7380 N Lincoln

Lincolnwood, IL

60712

Yes

Fax Referral Form to

847-568-7440

or

(call 847-568-7400 if unable to fax)

Yes

Patient will be

contacted once

referral is received

8am-5pmPatient stays in car and calls front desk upon arrival

847-568-7400

AMITA Health

Chicago-Archer

6084 S. Archer

Floor 1

Chicago, IL

60638

Yes

Fax Referral Form to

224-273-6099

or

(call 224-273-6000 if unable to fax)

Yes

Patient will be

contacted once

referral is received

8am-5pmPatient walks to the rear entrance and calls front

desk upon arrival 224-273-6004

Table 1 – COVID-19 Testing ONLYRegistrar will contact patient to schedule appointment and coordinate drive through testing. Tell patient to be prepared to answer the call.

Location AddressOrder

required Pre-Registration Required Times Special Instructions

AMITA Health

St Alexius

Medical Center

1555 Barrington

Rd

Hoffman Estates,

60169

Yes

Fax order to

847-590-2634

Yes

Email copy of order form to AMITA-MB-

Central.Sched.COVID-

19Testing@amitahealth.org

To initiate the scheduling process

10am-2pm

• Patients must obtain order from PCP

• Associates contact local Associate Health

• Medical Staff call Medical Staff Hotline at 224-273-

3900

AMITA Health

St Francis

Hospital

355 Ridge Ave

Evanston,

60202

Yes

Fax order to

312-770-2530

Yes

Email copy of order form to AMITA-MB-

Central.Sched.COVID-

19Testing@amitahealth.org

To initiate the scheduling process

1pm-5pm

• Patients must obtain order from PCP

• Associates contact local Associate Health

• Medical Staff call Medical Staff Hotline at 224-273-

3900

AMITA Health

St Joseph

Medical Center

– Joliet

333 N Madison

St

Joliet,

60435

Yes

Fax order to

844-569-4066

NO

Receipt of outpatient testing order form will

initiate scheduling

9am-3pm

Document can be found under Testing Guidance section at AMITAhealth.org/covid-19-AMITA

19

Regional Drive-Through Testing Locations

• Northwest: AMITA Health St.

Alexius Medical Center Hoffman

Estates

• Chicago Metro: AMITA Health

Saint Francis Hospital Evanston

• South: AMITA Health Saint Joseph

Medical Center Joliet

AMITA Health is offering drive-through COVID-19 testing at three regional sites for physicians, support staff,

associates, and patients who have been screened and deemed appropriate for testing. Orders are required.

1

2

3

1

2

3

20

Tests Available – Not Yet FDA Approved

While we are continually assessing all available tests, the state of testing is in flux. As of now there is no FDA

approved test, so any test is only as good as the physician’s ability to interpret and utilize it clinically. That said,

below is an overview of currently available Antibody, PCR Rapid, and PCR tests.

Abbott is developing an additional antibody test to determine immunity status to

COVID-19. The test is anticipated to be released at the end of April or early May 2020.

Test Name Test Type Methodology Run TimeTurnaround Time

Depending on local

process

Sensitivity@ AMITA /

Alverno

IgM/IgG Antibody

Blood Test1 Antibody Blood test 15 minutes 60 minutesPending further

testing

Abbott ID NOW

Test1,2

PCR

RAPID

Nasopharyngeal

Swab15 minutes 60 minutes

>1,000 cp/ml*Yes

Cepheid Xpert

Xpress

SARS-CoV-2

PCR

RAPID

Nasopharyngeal

Swab45 minutes 60 minutes 250 cp/ml

DiaSorin PCR

Nasopharyngeal

Swab 90 minutes 3-6 hours 500 cp/ml Yes

AB7500 PCR

Nasopharyngeal

Swab Up to 8 hours 12-24 hours 80 cp/ml

Abbott M2000 PCRNasopharyngeal

SwabUp to 8 hours 12-24 hours 100 cp/ml Yes

1 - A negative result in patients with COVID-19 like illness does not rule out infection and may require additional testing

2 - Additional validation testing pending

21

Infectious Disease Clinical ApproachDr. Ram Ramani, Infectious Disease MD, Metro Infectious Disease Consultants

22

Simplified Representation of Severe Acute Respiratory Syndrome

Coronavirus 2 (SARS-CoV-2) Viral Lifecycle and Potential Drug Targets

https://jamanetwork.com/journals/jama/fullarticle/2764727?guestAccessKey=d26e67ea-de1c-43de-91cf-

fd5afe0ef099&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=041320

23

Summary of Pharmacology for Select Proposed COVID-19 Treatments

https://jamanetwork.com/journals/jama/fullarticle/2764727?guestAccessKey=d26e67ea-de1c-43de-91cf-

fd5afe0ef099&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=041320

24

Summary of Pharmacology for Select Proposed COVID-19 Treatments

Continued

https://jamanetwork.com/journals/jama/fullarticle/2764727?guestAccessKey=d26e67ea-de1c-43de-91cf-

fd5afe0ef099&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=041320

25

CardiologyDr. Daniel Sauri, Director of Noninvasive Cardiology and Cardiac Imaging, AMITA

Heart and Vascular Medical Group, Cardiovascular Associates

26

Guidance for Patients Taking ACE/ARBs

• CONCERN: Angiotensin converting enzyme 2 (ACE2) receptors have been shown to be the

entry point into human cells for SARS-CoV-2, and ACEs/ ARBs have been shown to

upregulate ACE2 expression in the heart and even perhaps alveolar cells in the lung. This

prompted the question of whether ACEs/ARBs should be discontinued for patients at

high risk of COVID-19.

• EVIDENCE: Currently there are no experimental or clinical data demonstrating

beneficial or adverse outcomes with background use of ACE inhibitors, ARBs or

other RAAS antagonists in COVID-19 or among COVID-19 patients with a history of

cardiovascular disease.

• The HFSA, ACC, and AHA recommend continuation of RAAS antagonists for those

patients who currently take them for heart failure, hypertension, or ischemic heart disease.

• In the event patients with cardiovascular disease are diagnosed with COVID-19,

individualized treatment decisions should be made according to each patient's

hemodynamic status.

Sources:

https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19

https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/04/07/12/25/coronavirus-disease-2019-infection-and-ras

27

ECG Monitoring with Hydroxychloroquine

• CONCERN: Hydroxychloroquine (HCQ) is being utilized a treatment for COVID-19, but can

put patients at risk for prolonged QT and torsade de pointes.

• EVIDENCE: Chloroquine and HCQ were developed as anti-malarial drugs and are utilized

experimentally for COVID-19 because they inhibit pH-dependent effects of viral replication.

• When used with any other known QTc prolonging agents (lopinavir/ritonavir, amiodarone,

sotalol, haloperidol, ondansetron) these agents can have additive QTc-prolonging effects

and therefore, increased associated risk of arrhythmic death.

• If differential diagnosis includes bacterial pneumonia, avoid antibiotics that also prolong

QTc interval (e.g. levofloxacin, azithromycin, etc.). If atypical coverage is needed, use

doxycycline as an alternative.

• Seriously ill patients often have comorbidities that can increase risk of arrhythmias

including: hypokalemia, hypomagnesemia, fever and an inflammatory state.

Reference: https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.120.047521

28

Tisdale Risk Score for Drug Associated QTc Prolongation

29

Prior to Prescribing QTc Prolonging Medications

30

ECG Monitoring with Hydroxychloroquine

• Inpatient Monitoring Recommendations:

• To minimize healthcare associate exposure and PPE usage:• EKGs can be done by either the ECG technician (if available) or the bedside nurse during the

normal course of patient care.

• ECGs may be performed to coincide with "clustered" care between 2 and 4 hours after dosing.

• To further reduce exposure or save PPE resources, QTc monitoring may be performed

using surrogates for 12-lead ECG assessment, including:

• QTc monitoring via inpatient telemetry

• Standard protocol will be followed to decontaminate EKG equipment following their use

in COVID+ patients (i.e., same protocol used in patients positive for MRSA or C.

difficile).

• Consider initiation of hydroxychloroquine and then checking ECG on day 3 of

therapy. QTc by telemetry can be followed otherwise.

31

COVID-19 and Anticoagulation

• There is clear evidence that COVID-19 increases the risk of both venous and arterial

clotting with microvascular organ thrombosis and PE perhaps playing a role in

worse outcome.

• D-dimer appears to be the best single predictor of patients who will develop venous

thromboembolic disease.

• D-dimer >1,500 ng/ml had an 85% sensitivity and 89% specificity for predicting which

patients would develop DVT. This supports the concept of empiric anticoagulation for

patients with markedly elevated D-dimers (especially in situations where frequent CT

angiography is impossible due to logistic restraints).

• Until additional data is available, when to initiate full anticoagulation will remain

controversial. Among patients without risk factors for hemorrhage, empiric

anticoagulation may be reasonable for patients with elevated D-dimer levels.

Reference: https://emcrit.org/pulmcrit/dimer-cutoff-covid/

32

Anticoagulation and COVID-19: AMITA Joint PolicyAll COVID-19 patients should receive VTE prophylaxis with enoxaparin unless contraindicated. If D-dimer

>3mcg/mL and critically ill, increase to intermediate-dose weight-based VTE prophylaxis. If confirmed VTE,

begin therapeutic enoxaparin unless contraindicated.

Document can be found under Pulmonary & Critical Care Resources section at AMITAhealth.org/covid-19-AMITA

33

JAMA Clinical Guidelines for Volume Status Management in

COVID-19 Patients

• For acute resuscitation of adults with shock, the following are suggested:

• measuring dynamic parameters to assess fluid responsiveness

• using a conservative fluid administration strategy

• using crystalloids over colloids

• For adults with shock, the following are suggested:

• using norepinephrine as the first-line vasoactive

• use of either vasopressin or epinephrine as the first line if norepinephrine is not available

• dopamine is not recommended if norepinephrine is not available

• Adding vasopressin as a second-line agent is suggested if the target (60-65 mm

Hg) mean arterial pressure cannot be achieved by norepinephrine alone

Poston, J.T., Patel, B.K., Davis, A.M. (2020). Management of Critically Ill Adults with COVID-19. JAMA

Guidelines. https://jamanetwork.com/journals/jama/fullarticle/2763879

34

Caution with Interpretation of Troponin and BNP in COVID-19

Patients

• Brain Natriuretic Peptide (BNP) is an indicator of myocardial stress and frequently

elevated in patients diagnosed with COVID-19 and other severe respiratory illnesses at a

later course in the disease irrespective of volume status.

• HOWEVER, elevated BNP is negative prognostic indicators for patients with ARDS and

critical COVID-19 illness

• Clinical use: Can follow BNP to assess worse prognosis but also to clinically consider more

aggressive diuresis.

Reference: https://www.acc.org/latest-in-cardiology/articles/2020/03/18/15/25/troponin-and-bnp-use-in-

covid19, https://www.medscape.com/viewarticle/927205

35

Caution with Interpretation of Troponin and BNP in COVID-19

Patients

• Multiple studies have noted that Troponin are often elevated in critically ill COVID-19

patients. Worse prognostic outcomes.

• Given presence of abundant distribution of ACE2 – the binding site for the SARS-CoV-2 – in

cardiomyocytes, some have postulated that myocarditis and subsequent LV failure might

explain rise of troponin

• Causes for elevated Troponin can include:

• Ischemic ST changes who needs revascularization Type 1 MI plaque rupture

• Lower level troponin elevation in setting of supply demand mismatch Type 2 MI

• Higher degrees of troponin elevation associated with hyperinflammation and direct

myocardial injury (Myocarditis -trials for anakinra (IL-1 inhibitor) and colchicine

underway)

• Clinical use: Troponin elevation is consistent with worsening prognosis and

consideration for alternative therapies. If develops late in course could be

demand ischemia but be suspicious of myocarditis which usually presents late in

course and often as people are getting better.

https://www.acc.org/latest-in-cardiology/articles/2020/03/18/15/25/troponin-and-bnp-use-in-covid19

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext

36

Echo Safety Guidelines for COVID-19 Patients

• Echocardiography may be necessary to assess EF and fluid volume status in acutely ill

COVID-19 patients

• TTE or handheld echocardiography is preferred as it minimizes risks to providers (TEE is a

high risk procedure)

• AMITA procured numerous Phillips Lumify Handheld echo units for use by cardiology,

emergency medicine and critical care staff

• Guidelines for use can be located at: https://www.youtube.com/watch?v=mNVpGvUD6iQ

37

TEE Safety Guidelines for COVID-19 Patients

1. TEE is considered a high-risk procedure given the exposure to aerosolized respiratory products of the patients. As such, while COVID-19 cases are endemic to the area, a TEE should not be performed unless the result would yield an immediate change in patient management.

2. TEE should be urgent or emergent to require being done irrespective of COVID status at this point given high risk nature of TEE and asymptomatic transmission with COVID.

3. Decision to do a TEE should be multidisciplinary if necessary and assure absolute necessity at this time. The non invasive lab director can help adjudicate if there is disagreement about the necessity of the case.

4. If TEE is determined to be necessary, all providers in the room should have appropriate PPE including N95, impervious gown and face shield irrespective of COVID status.

5. If a short delay to determine COVID status can be determined by testing and will change management then testing should be considered.

6. All exams should have a patient with anesthesia facemask and port for placement of the TEE probe to reduce aerosolized respiratory products irrespective of COVID status

7. Consider alternatives to TEE imaging for certain questions. For example, CTA to rule out LAA thrombus rather then TEE. MRI use to rule out cardioembolic source. PET scan if available for evaluation of endocarditis. Of course if clinical question can be sufficiently answered by TTE that would be optimal.

8. Anesthesia can consider keeping the patient deep and proceduralist can use minimal ultrasound gel to avoid cough.

9. If a confirmed COVID-19 patient or PUI requires an emergent TEE for management, in consultation with anesthesia or intensivist staff, consider elective endotracheal intubation prior to performing TEE for airway isolation.

38

Medications and TreatmentSun Lee-Such, Vice President Pharmacy Services

39

COVID-19 Treatment – What do we know?

• No evidence from large randomized clinical trials that any potential

therapy improves outcomes in patients with either suspected or

confirmed COVID-19

• Mix of small trial results available – some showing efficacy, others

showing no difference vs. standard supportive care

• No clinical trial data supporting any prophylactic therapy

• More than 300 active clinical treatment trials underway with 109 including

pharmacologic therapy

• Chloroquine (CQ) and hydroxychloroquine (HCQ) reported as effective

from early reported experience and small studies in China and France

• CQ and HCQ became drugs of choice for large-scale due to its

availability and relatively low cost

Sanders JM, et al. Pharmacologic treatments for Coronavirus disease 2019 (COVID-19) –

A review. JAMA (2020), Published online April 13, 2020. doi:10.1001/jama.2020.6019

40

HCQ & Azithromycin in COVID-19 Treatment – Timeline

Data showing

Efficacy of

Hydroxychloroquine

with/without

Azithromycin

•Results from China

showed that HCQ can

efficiently inhibit

SARS-CoV-2 in vitro

•French non-

randomized study:

improved virologic

clearance (Subset of

6 w/ Azithromycin

show beneficial

results but baseline

viral load less)

Data showing

Lack of Efficacy of

Hydroxychloroquine

with/without

Azithromycin

US Government

Endorsement of

Hydroxychloroquine

for COVID-19

Treatment

CloroCovid-19

Clinical Trial

Halted due to

Toxicity and QTc

Prolongation

Recommendations

Emphasized in

AMITA COVID-19

Treatment and

QTc Monitoring

Guidance

Feb-

March

2020

April 13,

2020

March

2020

Mid-late

March

2020

March 29-

April 10,

2020

April 11,

2020

ACC/AHA

Releases

Guidance and

Warnings on

QTc Risks

•Shanghai study: No difference in clinical outcome

•French study on same HCQ + azithromycin regimen shows no benefit: 8/10 still COVID-positive on PCR – 1 patient died, 2 required transfer to ICU, 1 pt treatment discontinued due to QT prolongation

•3/19: President publicly endorses HCQ as “approved” therapy –within 24 hours, HCQ is on national shortage

•3/29: FDA issues emergency use authorization to treat hospitalized COVID-19 patients >50 kg

•3/30: AMITA Critical Drug Task Force formed

•3/29-4/10: ACC releases

Ventricular Arrhythmia Risk

Warning & ACC-AHA Joint

Statement on Drug

Interactions for QTc

•3/28: AMITA CV

published QTc

Monitoring guidance

•4/1: AMITA COVID-19 Tx

Guidelines Updated –

recommended

HCQ monotherapy &

defined HCQ use criteria

for COVID-19 positive

patients

•4/11: Brazilian high vs. low dose HCQ study (planned for 440 pts) halted due to higher mortality and QTc prolongation after 81 pts - all on ceftriaxone and azithromycin – no difference in efficacy

•4/13: AMITA COVID-19 Treatment Guidelines updatedto AVOID HCQ-Azithromycin combination therapy

•4/16: HCQ-Azithromycin

combination use

decreased by 95%

41

AMITA COVID-19 Treatment Triage Algorithm

Confirmed COVID-19 Positive

Admitted to Medical Floor

Admitted to ICU and

COVID-19 Positive or

Strong Clinical Suspicion

with Progressive Disease

Heart, lung, liver or renal disease, DM, on immune

modulators or immunosuppressants (e.g. equivalent to

prednisone ≥ 20mg/day), HIV, malignancy or asplenia

AND

At least ONE of the below are present:

SpO2 <90% on RA or PaO2 <70 mmHg or Alveolar-

arterial O2 gradient ≥ 35 mmHg

OR

HR >125 beats/min or respiratory rate >24

breaths/min

OR

SOFA ≥ 4, D-dimer ≥ 1 mg/L, or Lymphopenia

Consider treatment

with

Hydroxychloroquine*

Meets

Criteria

Does NOT

Meet Criteria

Supportive Care,

Close Monitoring

* Key Considerations with Hydroxychloroquine Use

• Hydroxychloroquine can cause QT-prolongation. Baseline EKG is

recommended. Review medication profile for other QT-prolonging

agents (e.g. azithromycin, levofloxacin, sotalol, amiodarone, etc.).

• When used with other known QTc prolonging agents, these agents

can have additive QTc-prolonging effects and therefore, increased

associated risk of arrhythmic death. Refer to COVID-19 Cardiac

Monitoring and QTc Assessment Guidelines.

• If differential diagnosis includes bacterial pneumonia, avoid antibiotics

that also prolong QTc interval (e.g. levofloxacin, azithromycin, etc.).

If atypical coverage is needed, use doxycycline as an alternative.

42

Cardiac Toxicity and QT Prolongation

COVID-19 Treatments:

Hydroxychloroquine,

Azithromycin,

Lopinavir/Ritonavir

Antibiotics with

QT-prolonging potential

(e.g. Azithromycin,

levofloxacin, etc.)

Other QT-prolonging medications*

(e.g. Amiodarone, sotalol, haloperidol,

quetiapine, etc.)

Increased

potential

for QT

prolongation

Increased risk

for drug-induced

arrhythmias

Increased risk

for drug-induced

torsades de

pointes

Increased risk of

drug-induced

cardiac death

Other factors with increased risk of

torsades de pointes

(Structural heart disease, congenital long-

QT syndromes, electrolyte disturbances,

hepatic/renal failure, female sex)

+/–

+/–

+/–

*Complete list of QT prolonging agents available at: https://www.crediblemeds.org/

• Discontinue and avoid all other non-critical QT-prolonging agents

• Assess baseline ECG, renal function, hepatic function, serum potassium

and magnesium levels

• Consult Cardiology and monitor QTc interval periodically based on

baseline measurement

43

HCQ and Azithromycin Use for COVID-19 – Key Points

1. Due to the risk of potential significant cardiac toxicity, including sudden

death and lack of evidence displaying clinical benefit, the addition of

azithromycin to hydroxychloroquine for the management of COVID-19

should be avoided.

2. Criteria have been added for when HCQ should be considered and avoided

in patients with suspected or confirmed COVID-19 in AMITA COVID-19

Treatment Guideline.

3. The decision to start HCQ should be based on shared clinical decision-

making, in which the patient is informed about possible benefits—such as

low-quality evidence—and potential side effects, particularly QTc prolonging

effects. In addition, the patient's condition should be sufficiently severe to

warrant this investigational therapy. Please click here for more information.

4. If differential diagnosis includes bacterial pneumonia, avoid antibiotics that

also prolong QTc interval, such as levofloxacin, azithromycin, etc. If atypical

coverage is needed, use doxycycline as an alternative.

44

Respiratory ClinicsDr. Reinhold Llerena, President, AMITA Medical Group

45

AMITA Health Respiratory Centers

Mount Prospect1754 W. Golf Rd.

Mt. Prospect, IL 60056

Phone: 224.265.9000 or

224.265.9010;

press 2 (for Immediate Care)

Fax: 224.265.9041

Lincolnwood7380 N. Lincoln

Lincolnwood, IL 60712

Phone: 847.568.7400

Fax: 847.568.7440

*Adults only location

Chicago / Archer6084 S. Archer Ave., Floor 1

Chicago, IL 60638

Phone: 224.273.6000

Fax: 224.273.6099

The new AMITA Health Respiratory Centers will offer a comprehensive assessment in a safe, controlled

environment for patients with acute respiratory symptoms having an impact on chronic conditions such as

COPD, Asthma, DM, cardiac conditions or acute newly developed symptoms related to COVID-19-like illness.

1

2

3

1

2

3

Note: AHMG PCPs should schedule internally through their Epic or Athena EMRs

46

Seeking Care at AMITA Health Respiratory Centers

Symptoms Addressed• Flu symptoms

• Sore throat

• Fever

• Cold symptoms

• Diarrhea

• Acute asthma: wheezing or chest tightening

• COPD exacerbation: shortness of breath

• Congestive Heart Failure

• Respiratory infections

Referring a Patient to the Respiratory Center

1. Ordering physician to fax (required) referral

2. Respiratory Center to contact patient to schedule

appointment

3. Patient to bring ID, insurance card and all respiratory

medication, including inhalers to visit

The new AMITA Health Respiratory Centers will have the ability to provide interim care including oxygen,

respiratory treatments and physical assessment, with the intent to transition patients back to their regular

primary care provider.

Documents under Testing Guidance section at AMITAhealth.org/covid-19-AMITA

47

Insurances Accepted at AMITA Health Respiratory Centers

• Ascension Complete MA

• BCBS Medicare Advantage HMO Sites 741, 760, 761, 762, 763, 764, 765

• BCBS MA PPO

• BCBS PPO ACO

• Bright Health MA HMO

• Clear Spring MA HMO

• Clear Spring Health

• Cigna Health Spring MA HMO, MA PPO

• Humana MA HMO/PPO/PFFS

• Medicare FFS

Medicare

Commercial

• ACTIN PPO

• BCBS HMO-197, 488, 494, 495, 496, 497, 498, 499, 500

• HMOI Blue Advantage HMO

• Blue Precision

• Humana HMO

• Cigna One Health

• Cigna PPO/POS/CAC

• Cigna Local Plus

• Cigna Connect IFP HMO

• HFN PPO

• HealthLInk PPO/Unicare

• Humana PPO/POS/ChoiceCare

• MultiPlan/Beech Street PPO

• PHCS PPO

• SmartHealth PPO

• Unite Here Health

Documents under Testing Guidance section at AMITAhealth.org/covid-19-AMITA

48

Closing RemarksDr. Joseph Lagattuta, CIN Board Chair

49

Redeploying Available Clinicians

Contact Amy Kinnett-Calhoun

(Amy.Kinnett-Calhoun@amitahealth.org)

Clinicians (MD, DO, APN, PA, RN, MA, etc.) with extra capacity to volunteer clinical skills or provide support,

particularly (but not limited to) those with expertise in pulmonary, critical care or emergency medicine may be

in need across the AMITA Health system.

Family / Internal Medicine Physicians OR

Inpatient Hospitalists

Complete one of the following to volunteer:

1. Complete form: Click Here for Form

2. Call: AMITA Physician Hotline at 224.273.3900 weekdays 8am-5pm

3. Email: MedStaff-COVID19-Hotline@amitahealth.org

Physician Specialists OR

Other Clinical Staff

50

Thank you!

Updated Hours:

AMITA Physician Hotline Phone Number

224.273.3900 from 8am to 5pm weekdays for the foreseeable future

AMITA Physician Hotline Email

MedStaff-COVID19-Hotline@amitahealth.org