5 key COVID-19 insights for GI leaders

Five key COVID-19 insights for gastroenterology leaders to know:

1. COVID-19 has dramatically accelerated telemedicine adoption. Within months, Cleveland Clinic's gastroenterology, hepatology and nutrition department plans to conduct all new and established patient visits via telemedicine — far ahead of its 2024 goal. It's among many healthcare organizations pivoting to digital strategies during elective procedure standstills. The American Gastroenterological Association and Rx.Health have partnered to launch a nationwide digital health platform for GI practices, and the American College of Gastroenterology created a comprehensive guide for groups incorporating telemedicine services.

2. Despite stopgap telemedicine solutions, some GI groups are struggling to stay afloat. James Leavitt, MD, a gastroenterologist with Miami-based Gastro Health, said his 17-clinician group has furloughed half of its staff in an effort to stay solvent. If financial relief from the government doesn't come quickly, Rajeev Jain, MD, a Dallas-based gastroenterologist, said he fears "a death to small, independent practices because they're not going to have the financial wherewithal to tolerate this for too long."

3. GI groups are developing ramp-up strategies. As of April 23, at least seven states were either resuming elective procedures or heading that direction. Practices will need to ensure they have adequate staffing, supplies and safety protocols in place before bringing patients back into their offices. Private equity-backed management service organization United Digestive, based in Atlanta, established a COVID-19 response team early on and plans to offer additional hours and weekend appointments as necessary when cases resume as normal.

4. COVID-19 is affecting clinical GI care. Recent studies have suggested COVID-19 can affect the digestive tract. While there haven't been indications that patients with inflammatory bowel disease are at higher risk of contracting COVID-19, the AGA encouraged GIs to stop using certain therapies if IBD patients have symptoms of the virus. Separately, five GIs in New York City recommended that physicians generally keep outpatients out of clinics and offices. However, they said face-to-face visits may be necessary for urgent procedures such as upper and lower gastrointestinal bleeding, dysphagia impacting oral intake, cholangitis and symptomatic pancreaticobiliary disease. These sentiments are echoed in joint recommendations from four GI societies.

5. Elective cases aren't the only activities on hold. In-person recruitment is on hold for Lakewood Ranch-based Florida Digestive Health Specialists, which is working to onboard new hires via telehealth. In early April, Rochester, Minn.-based Mayo Clinic unveiled a $65 million expansion plan that would culminate in new cardiology and GI services. But by April 13, the system said it would be stopping all new construction due to a $3 billion systemwide deficit stemming from COVID-19 delays.

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