Challenges as Opportunities: Adapting Tele-Education for Physicians Collaborative Response to COVID-19 Pandemic

Covid-19 pandemic challenge provided us with impetus to innovate and provide rapid solutions. We have successfully launched multiple tele-education online learning programs through a Pakistani diaspora and local physician collaborative that have been extremely effective. The programs were launched form the platform of Association of Physicians of Pakistani Descent of North America (APPNA) and include Daily Covid-19 Webinars, Weekly Case Discussions, online discussion groups, themed webinars on psychosocial health of physicians, ventilator management, critical care nursing and primary care. So far 40 webinars have been hosted for over 1800 physicians with multiple institutional partners and are developing online short courses on these topics. We have used this as a learning opportunity, creation of new collaboration with Pakistani institutions and diaspora organization. We take this challenge as an opportunity to rapidly learn successful ways and avenues of collaborating in future with our Pakistani physician partners in Pakistan.

Paper Published in Annals KEMU

https://www.annalskemu.org/journal/index.php/annals/article/view/3617

Figure 1. APPNA MERIT YouTube ® Channel with recordings of the webinar.
https://www.youtube.com/channel/UCg4wPG-bFfwF8Bh-GYfj34g?view_as=subscriber

Table 1. MERIT Covid-19 Webinars

Table 2. Repository of Shared Resources from APPNA MERIT Covid-19 Webinars

Scores and Risk assessments, Do-it-yourself Tools

H score” calculator (helpful to screen for cytokine storm/cytokine activation syndrome without having to check IL-6 levels – when considering tocilizumab): https://www.mdcalc.com/hscore-reactive-hemophagocytic-syndrome

Https://www.houstonmethodist.org/research/covid19/prototypedesigns/

Example of a slit lamp breath shield: https://premierop.com/3-pack-slit-lamp-breath-shields-universal/

Biofire respiratory panel: https://www.biofiredx.com/products/the-filmarray-panels/filmarrayrp/?gclid=Cj0KCQjw-Mr0BRDyARIsAKEFbecCUxGhcnlSmgRC6j8HBLMLDViC8w5XdTGpADNZ8Zrpz-96L8UFeL4aAqIDEALw_wcB

Engineering specs for negative pressure rooms: (by CDC) https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/air.html#table6

https://www.healthcareitnews.com/news/caregility-unveils-mobile-telehealth-app-gives-it-away-fight-pandemic

RISK ASSESMENT SCORE

https://gov.wales/covid-19-workforce-risk-assessment-tool

Useful Articles, Quick reading and Short Videos

Home-based pulse oximetry – pearls and pitfalls: https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.202005-418FR

Keeping the Coronavirus from Infecting Health-Care Workers” – a very useful article with lessons on what to focus on: https://www.newyorker.com/news/news-desk/keeping-the-coronavirus-from-infecting-health-care-workers

https://tansan.com.tr/a-possible-role-for-single-dose-hydroxychloroquine-for-prevention-of-lethal-coronavirus-infection/

please see the reference for anticoagulation

https://www.medpagetoday.com/infectiousdisease/covid19/85865

Excellent review of specific ICU management strategies being implemented with encouraging results in New Orleans

https://www.youtube.com/watch?v=Ngu5-iOHdS4

Stick to the basics of evidence-based critical care medicine, as physicians are increasingly learning: https://www.washingtonpost.com/outlook/2020/04/10/ventilators-icu-safety-bundle/

Quick review of what to do – and what NOT to do – for each of your ICU patients:

https://www.youtube.com/watch?v=Ngu5-iOHdS4

Here is the donning and doffing video that Alberta Health Services has created. :

https://ahamms01.https.internapcdn.net/ahamms01/Content/AHS_Website/Information_For/if-hp-ipc-donning-and-doffing.mp4

CDC: “Patients can be discharged from the healthcare facility whenever clinically indicated.”

Nice list of FAQs from CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html

https://www.theguardian.com/us-news/2020/jun/06/us-health-workers-dying-coronavirus-stats-data

https://www.kevinmd.com/blog/post-author/zheala-qayyum

https://www.wbur.org/cognoscenti/2020/05/21/army-reserve-pandemic-queens-new-york-zheala-qayyum

Online Trainings and short courses

http://www.hsa.edu.pk and click on COVID BASIC Trainings link. Register Yourself and We will contact asap

https://www.aic.cuhk.edu.hk/basic/courses_ad.php?country=Pakistan

This has a lot of Chest X-Ray and CT images for covid-19

https://radiopaedia.org/articles/covid-19

Great Harvard Ex online course on ventilator management specifically for COVID patients: https://www.edx.org/course/mechanical-ventilation-for-covid-19

Protocols and Guidelines

Link for continuously updated protocols: https://covidprotocols.org/

https://www.medscape.org/viewarticle/927708?nlid=134799_2707&src=wnl_cmemp_200403_mscpedu_obgy&uac=127647HN&impID=2334790&faf=1

https://covid19.sccm.org/nonicu.htm

Crisis Standards of Care – published by the Institute of Medicine: https://www.ncbi.nlm.nih.gov/books/NBK219958/pdf/Bookshelf_NBK219958.pdf

Study on safety of convalescent plasma:

https://clinicaltrials.gov/ct2/show/NCT04333355?cond=convalescent+plasma&draw=2&rank=2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562879/#s1title

some sources of information on Royal College of Psychiatrists website https://www.rcpsych.ac.uk/about-us/responding-to-covid-19

https://www.aao.org/coronavirus

For Thrombosis and anti-coagulation

https://thrombosiscanada.ca/thrombosiscovid19/

For Gynecology and Obstetrics

https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics

REFERENCES

  1. “APPNA Covid-19 Relief Efforts”. Association of Physicians of Pakistani Descent of North America. https://appna.org/appna-covid19-relief-efforts/ accessed July 02, 2020
  2. ‘MERIT Covid-19 Webinars”. APPNA MERIT. https://www.appnamerit.com/covid-webinar/ accessed July 02, 2020
  3. “MERIT Covid-19 Webinar Schedule”. APPNA MERIT. https://www.appnamerit.com/covid-webinar-schedule/ accessed July 02, 2020
  4. “APPNA MERIT YouTube Chanel”. YouTube®. https://www.youtube.com/channel/UCg4wPG-bFfwF8Bh-GYfj34g accessed July 02, 2020
  5. “A Webinar and Tele-Training Series on Covid-19”. Yaran-e-watan, https://yaranewatan.gov.pk/a-tele-training-series-on-covid-19 accessed July 02, 2020
  6. “MERIT Covid-19 Webinar Repository”. APPNA MERIT. https://appnamerit.com/covid-webinar-resources/ accessed July 02, 2020
  7. Paper Published in Annals KEMU
    https://www.annalskemu.org/journal/index.php/annals/article/view/3617

I am a Movement Disorder neurologist interested in innovative medical education and use of technology in education and clinical care of my patients. My primary interest is in Parkinson Disease and am currently involved in online courses in Movement Disorders and Research with Parkinson Study Group in Neuro-protection. My hobby is biosensors and smartphone applications for diagnosis

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About Me

This is a blog about various aspects of my professional side. I am a Movement Disorder Neurologist with strong focus on Parkinson's disease program development with clinical care and research, outreach and patient education. I'm an educator with a strong interest and passion in innovative methods including online learning and blended learning as they apply to clinical education or education of the medical students or more often physicians in training and practice (Continuing Medical Education). I am also using this platform to share personal achievements and sometimes general ideas which I believe are worth sharing.

I am a Movement Disorder neurologist interested in innovative medical education and use of technology in education and clinical care of my patients. My primary interest is in Parkinson Disease and am currently involved in online courses in Movement Disorders and Research with Parkinson Study Group in Neuro-protection. My hobby is biosensors and smartphone applications for diagnosis.

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