UVA School of Medicine

2 VIRGINIA MEDICINE UVA Health Independently Develops COVID-19 Tests T hanks to a determined, whirlwind effort on the part of a team of physicians and collaboration and support from across the University of Virginia community, UVA Health began administering its own COVID-19 tests in late-March 2020, becoming the first health system in Virginia to develop an in-house test. Shortly after the pandemic began spreading across the U.S., UVA Health Laboratory's efforts to develop COVID-19 testing hit a wall in the form of severe national shortages of critical reagents needed for the tests. A call quickly went out to basic research laboratories in the health system and across the University to find needed reagents and technology. It was answered by an immediate outpouring of donations that enabled UVA Health to develop its own testing and deploy it much sooner than having to wait on commercial supply chains. The testing capability allowed UVA Health to more broadly and immediately advance its service to the public during the crisis and provide health officials with a better idea of the spread of COVID-19 in the Charlottesville area. Eventually the in-house testing was also made available to other hospitals in Virginia as well as North Carolina. Mendy Poulter, PhD, and Amy Mathers, MD, Fel '09, were instrumental in developing the UVA test. Along with many other medical team members at UVA Health, they worked tirelessly on the test development and in preparing operations for COVID-19's impact. "This was truly a remarkable team effort across the entire institution at an incredibly challenging time," said Executive Vice President for Health Affairs K. Craig Kent, MD. "It was amazing to see how swiftly everyone rose to the challenge and made this happen in order to serve the community during this time of need. As someone new to UVA Health, I'm extremely proud of our team and thankful for the support across the University." In an interview with Reuters, Mathers discussed the challenges of developing the test and the teamwork involved in successfully rolling it out. "We're all in this together. There's never been a better example of that," she said. Telemedicine Responds to COVID-19 Karen S. Rheuban, MD, Res '78, Fel '80, director of the UVA Center for Telehealth, shared this account of UVA's efforts to support the COVID-19 response through telemedicine. U VA Health is home to a longstanding telemedicine program through which we support clinical consultations and follow up visits, tele-ICU care, remote patient monitoring, store forward services, eConsults and virtual education to patients and providers. Our 150-site network includes community and critical access hospitals, skilled nursing and long-term care facilities. We also connect with federally- qualified health centers, free clinics, medical practices, correctional facilities, schools and emergency medical services providers. We provide telemedicine services spanning more than 60 clinical subspecialties. As a state-designated special pathogens hospital, following the Ebola outbreak in 2015, UVA Health developed a model, referred to as iSOCOMS, in which we configured all rooms within our special pathogens unit with videoconferencing to reduce provider exposure, improve the patient experience and conserve PPE. Although our telemedicine program has primarily been externally facing, last year, heartened by the telehealth and telemedicine provisions of the Medicare 2019 Physician Fee Schedule, and by clear messages from our patients seeking new models of care, we underwent a multi- stakeholder strategic planning process to further expand our virtual care offerings. The COVID-19 public health emergency catapulted us into action to rapidly scale all elements of our strategic plan. The 1135 waivers and changes implemented in the recent Medicare Interim Final Rule have further enabled us to advance that plan. Our state Medicaid program has taken similar action. Our clinics have rapidly transformed ambulatory care by replacing in-person visits with virtual care provided to the homes of our patients. Less than three weeks S P O T L I G H T : C O V I D - 1 9 R E S P O N S E Mendy Poulter, PhD Amy Mathers, MD, Fel '09

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