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Keesler uses post-vaccine waiting period to identify routine care gaps

Military health personnel wearing a face mask administering the COVID-19 vaccine Air Force Master Sgt. La'Kisha Mays, 81st Healthcare Operations Squadron medical specialties flight chief, administers the COVID-19 vaccine to Air Force Col. (Dr.) Wayne Latack, 81st Medical Group internal medicine residency program director, at Keesler Medical Center (Photo by: Air Force Senior Airman Kimberly Mueller, 81st Training Wing Public Affairs).

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Adaptation has been a common theme over the past year, especially within the medical community.

A perfect example is at Keesler Medical Center on Keesler Air Force Base in Biloxi, Mississippi. During the Centers for Disease Control and Prevention's recommended 15-minute waiting period after a COVID-19 vaccines is given, staff here have been talking to patients about making appointments for routine care that may have been missed due to increased focus on the virus.

Using CarePoint, the Defense Health Agency's information delivery portal, Keesler personnel look at the medical records of each patient who comes in for a vaccine and note whether they are behind on routine care. They then use the waiting period required after vaccination to speak with patients who are behind, make an appointment on the spot, or refer them to another clinic if they don't have appointments readily available.

The process was the brainchild of Air Force Col. (Dr.) Assy Yacoub, chief of medical staff for the 81st Medical Group, located at Keesler. It was facilitated by health care integrators Air Force Lt. Col. Wanda Stauffer and Air Force Lt. Col. Clementine Duke after discussions with DHA leadership regarding what could be done about COVID-19's impact on routine medical care across the enterprise.

"We had a need to improve our contact numbers with our patients, getting their overdue preventative screenings done, and this seemed like a prime opportunity," said Stauffer. "Our nurses were in place the very next day, and we've assisted more than 1,500 patients since the end of January."

Stauffer said the fact that vaccinations are done by appointment at Keesler allows them to review individuals' records before their arrival and address any issues with the beneficiaries on-site.

"We're then looking at the appointment list for the COVID vaccine line that we get from CarePoint, and it tells us what items people are overdue for," said Stauffer. "Out of 300 people that may be coming in on a given day, we sort that list into people who are overdue for items like breast, cervical and colon cancer screenings, and hemoglobin A1c tests for diabetics."

After vaccines are administered and the waiting period is over, patients are directed to a nurses' station where any outstanding issues are discussed, appointments are booked, or they are referred to their primary care manager.

"There have been several issues caught that wouldn't have been had we not been doing this," said Stauffer.

Additional benefits of this process are that personnel at Keesler have been able to both encourage individuals who are not primary patients of the medical center to resume their normal medical care, as well as to request information from patients who may have had appointments at outside facilities and update their records.

"Right now, we've had about 175 patients who have completed procedures that we didn't have records of," said Stauffer.

People have either been putting off other routine medical care out of fear of going to a medical facility during the pandemic or simply because there hasn't been enough personnel to perform that routine care.

Now that resources are becoming available, it is extremely important that military medical treatment facilities and the medical community at large, as well as individuals, begin to re-focus on things that have gone overlooked during the pandemic, Stauffer said.

"When COVID started, facilities didn't want people in the building that didn't need to be there due to risk of infection. A lot of care was put off by patients and medical facilities," said Stauffer. "This may be the first time a person has been in a medical facility since the pandemic started, so it's also the perfect opportunity to identify what may have been missed, especially now that the vaccine is relieving some of that fear."

The success of Keesler's process is in the numbers.

"We've had around 600 patients who have either had appointments scheduled or have been given instructions to make appointments, and we try to schedule as many in-person as we can," said Stauffer.

Keesler plans to continue this process throughout its vaccination effort.

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