Steve Noblett

by Steve Noblett


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Working To Stay Ahead Of The Curve

Ten days ago, Alabama reported that they had zero confirmed cases of COVID-19. When pressed, it turns out that Alabama had done almost no testing. This inspired Dr. Robert Record, CEO for Christ Health Center (CHC) in Birmingham, to take the initiative to find testing for their patients. Last week Christ Health Center, in partnership with Church of the Highlands and a local testing lab, opened a drive-through testing center. In five days they performed 2267 tests. They have received just over 2200 results back, and had 73 people test positive for COVID-19.

Robert had a contact with the founder of a private testing lab who had been trying to implement testing, but was overwhelmed. He visited his friend one Saturday, and listened to him talk about the challenges that the lab was not prepared to meet. Robert proposed that Christ Health set up and do the tests, while allowing the lab to process the respiratory panels, which is what they were good at doing. Robert and his team met with the leaders of Church of the Highlands, a mega church where Dr. Record and a number of the staff attend, and a church that has been a close partner throughout the development of CHC. In only a few days they designed a drive-through testing model that is a national model of efficiency, trained staff and a small army of volunteers, published a video, and implemented the largest testing center in the state, and one of the largest in the country.

If all of this sounds like something slapped together, watch this nine-minute video:

https://www.covid19-testing.churchofthehighlands.com.

It is impressive.

Almost immediately, Dr. Record and his team began thinking about how those who would test positive would receive care. As he was praying early one morning, he got a picture in his head of what they should do. They trained UAB (University of Alabama at Birmingham), which is the largest hospital system and employer in the state, how to do the testing. Christ Health has now turned their drive-through testing over to them. Simultaneously, they constructed four “bubble rooms” in the building next to their clinic to care for sick patients. These plywood and plexiglass exam rooms allow the doctor to interact with the patient, but from the safety of being on the other side of the glass. They instituted a text-to-access system for positive patients. They started seeing COVID+ patients today (3/25) to work out any bugs in their system.

Christ Health’s medical director, Dr. Cleon Rogers, is overseeing “COVID-Care” for the 73 positive cases that they tested who are not hospitalized, plus is taking non-UAB patients who test positive through UAB’s efforts.

  • They provide safe, best-practice care for all of their COVID positive patients primarily through telehealth calls and visits.
  • They do frequent telehealth check-ins—daily for high severity patients, and every other day for low severity patients.
  • They created an internal “off label” use protocol in conjunction with academic infectious disease and cardiology to offer hydroxychloroquine/azithromycin treatment with informed consent for their high risk COVID positive patients.
  • They provide wholistic care for their COVID positive patients, including, where needed, food and prescription delivery, and spiritual care. They do this in collaboration with their church partners.

While they are only six days into this COVID-Care program, so far none of their patients have required hospitalization. “Being able to keep 73 people at home is huge! And we are not just providing for those 73. Each one of them live with family members, and we are providing this care to everyone in the house during their quarantine”, said Dr. Rogers. If this model proves fruitful, Dr. Rogers will be sharing this resource with the medical community soon via a paper and video. We post those links on the CCHF website when they become available.

How has this impacted their other primary care efforts? Christ Health does a fairly large volume of behavioral health work, and those visits seem unphased so far. In terms of medical visits, they continue to see their mental health and higher risk patients, but in-office volume is down by about 50%. The rest of their work is going forward through telehealth.

You might wonder how all of their efforts are funded. Christ Health is an FQHC, and some of the visits and testing are billable. But uninsured patients are tested for free, and they opted to not collect any copays for their insured patients. They raised no money for any of this. “We were ‘action first’, and then trust God for resources. We don’t want to be fiscally irresponsible, but God has met both us and our patients.” said Dr. Record. “We saw what was and wasn’t happening, and we entered into the pain of our patients and my friend at the lab. We knew we had to do something, and show that it could be done quickly.” Private funders, having heard about their work, have sent unrequested donations after the fact. That has helped. The state health department has provided little or no help. The government mechanism was simply moving too slow. To date, 80% of COVID-19 testing statewide is being done by the private lab that partners with Christ Health; and 25% of all COVID positive patients in Alabama are now receiving care through Christ Health.

Dr. Record, Dr. Rogers, and their team are well ahead of most of us in the CCHF community, and wide open to share processes and procedures with other CCHF clinics. Dr. Record: “If you are going to share one thing with the other clinics, tell them that we need to turn our attentions, energy, and resources from testing to treatment. That is where we need to be leading at this point in the curve.” Dr. Rogers: “We should not underestimate the impact of spiritual care for these patients. God has opened doors for me to provide meaningful spiritual ministry to my patients every day.”

Download full ebook "A Healthcare Worker's Response to COVID-19" here​

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