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Case Study

Recovery Clinics for Covid-19 Long-Haulers

15 Minute Read

Overview

The challenge

Even after clearing the virus, 10% or more of Covid-19 survivors report prolonged symptoms impacting their quality of life. These survivors, also known as “long-haulers,” report persistent “brain fog” and difficulty concentrating, body aches, fatigue, shortness of breadth, chest pain, heart palpitations, cough, and other symptoms. There is nascent clinical research to inform underlying causes of symptoms. Additionally, the multi-organ system manifestation of symptoms makes care coordination and treatment difficult.

The approach

Several health systems have set up dedicated recovery clinics to help treat long-haulers. These clinics provide a centralized point of intake where patients can receive comprehensive assessments of symptoms and access specialized physicians with experience treating Covid-19 complications.

The organizations

The University of Iowa Hospitals and Clinics (UIHC) and the University of Pennsylvania Medicine (Penn Medicine) are among the early adopters of dedicated recovery clinics for Covid-19 long-haulers. UIHC is a teaching hospital and 200+ clinic health system that serves the greater Iowa City region. Penn Medicine comprises six acute care teaching hospitals and hundreds of affiliated clinics that serve the greater Philadelphia region.

 

Approaches

The two models

Both UIHC and Penn Medicine seek to address long-haulers’ spectrum of clinical needs. This resource will provide an overview of each model and key considerations for other health systems considering a Covid-19 recovery clinic.

  • Model

    UIHC’s Respiratory Illness Clinic

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  • Model

    Penn Medicine’s Post-COVID Recovery Clinic

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Considerations for opening a recovery clinic

Establishing a dedicated recovery clinic for Covid-19 survivors might not be the right answer for everyone. Below are considerations for assessing whether this model is a fit for your organization and how to optimize its design:

1. Determine whether there is sufficient demand in your community. While Covid-19 has impacted nearly all communities across the country, not all areas will have sufficient disease burden to dedicate staff and resources to this model. Consider whether competitors are already offering post-Covid-19 recovery treatment options and whether in-house clinicians are reporting issues with care coordination, access, and adequate treatment for Covid-19 survivors.

2. Start small and scale up. Even with minimal demand, organizations can pursue a recovery clinic model without a lot of financial investment by using existing underutilized clinic space and telehealth. Additionally, identify staff that have unfilled time slots on certain days of the week rather than committing staff fully to this model.

3. Connect clinics to ongoing research and clinical trials. Health systems can be an active participant in answering the many unknowns about the long-term effects of Covid-19 on survivors. Consider developing a disease registry so that patients can be contacted in the future for future clinical trials and studies on the virus.

4. Establish standardized intake, assessment, and referral protocols to deliver a positive experience. Because of the multi-system nature of Covid-19 complications, patients will likely need to be seen by multiple specialists. Determine how you can minimize the number of patient visits by collocating staff and equipment, and by utilizing pre- and post-visit telehealth options.

5. Develop clear patient selection criteria and messaging about the benefits of the clinic. Educate both referring physicians and self-referrers about who can most benefit from the model. Collecting data on long-term clinical outcomes will be important for demonstrating value over time.

6. Consider alternative avenues for building Covid-19 treatment expertise. Instead of building a designated clinic for long-haulers, organizations may instead disseminate best practice treatment guidelines and referral protocols to all physicians across the network who see long-haulers.

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