The Primary Care COVID-19 Integrated Pathway: A Rapid Response to Health and Social Impacts of COVID-19

Abstract

Background The first wave of COVID-19 in Calgary, Alberta accelerated the integration of primary care with the province’s centrally managed health system. This integration aimed to deliver wraparound in-community patient care through two interventions that combined to create the COVID-19 Integrated Pathway (CIP). The CIP’s interventions were: 1) a data sharing platform that ensured COVID-19 test results were directly available to family physicians (FPs), and 2) a clinical algorithm that supported FPs in delivering in-community follow up to improve patient outcomes. We evaluate the CIP by describing its function and capacity to facilitate FP follow-up with COVID-19 patients. Method We generated descriptive statistics by analyzing data from a Calgary Zone hub clinic called the Calgary COVID-19 Care Clinic (C4), provincially maintained records of hospitalization, Emergency Department (ED) visits, and physician claims. Results Between Apr. 16 and Sep. 27, 2020, 7289 patients were referred by the Calgary Public Health team to the C4 clinic. Of those, 48.6% were female, the median age was 37.4 y. 97% of patients had at least one visit with a healthcare professional, where follow-up was conducted using the CIP’s algorithm. 5.1% of patients visited an ED and 1.9% were hospitalized within 30 days of diagnosis. 75% of patients had a median of 4 visits with their FP. Discussion Our data suggest that that information exchange between PC and central systems facilitates primary care-based management of patients with COVID-19 in the community and has potential to reduce acute care visit.