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Mayo Clinic launches COVID-19 tracking tool

Mayo Clinic has introduced an online tracking tool that features the latest COVID-19 data for every county in all 50 states and Washington, D.C., as well as insight on how to assess risk and plan accordingly.

“U.S. Coronavirus Map: What Do the Trends Mean for You?” (https://tinyurl.com/mp-covid-map) presents key data and trends. Data include the total number of cases by county and state, new cases per day, positive test rate, and fatality rate, all presented with trends over time and Mayo Clinic guidance on how to take action.

“COVID-19 infections continue to rise and fall in many areas of the country, and information at the local level on the prevalence of disease and future trends are more important than ever to help people prevent the spread of infection,” said Henry Ting, MD, a cardiologist, health services researcher, and educator at Mayo Clinic. “This interactive map, enriched with Mayo Clinic expertise, is designed to be easy to use, with the most current data available and correlated with the latest Mayo Clinic guidance.”

Ting, who is Mayo Clinic’s chief value officer, worked with a team of Mayo Clinic data scientists to develop content sources, validate information, and correlate expertise for the tracker—all of which will be enhanced with more real-time data and predictive modeling.

Mayo Clinic’s COVID-19 resource center provides guidance on how to wear a mask properly, maintain social distancing, wash hands frequently, and clean and disinfect surfaces. It also includes a self-assessment tool for users to determine whether they have symptoms and should seek medical care, and information for COVID-19 survivors on how to donate plasma to help others.

New CPT codes released for COVID-19 services

The American Medical Association (AMA) has published an update to the Current Procedural Terminology (CPT) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic. Both have been approved for immediate use.

The first addition, CPT code 99072, was approved in response to sweeping measures adopted by medical practices and health care organizations to stem the spread of the novel coronavirus (SARS-CoV-2), while safely providing patients with access to high quality care during in-person interactions with health care professionals. The additional supplies and clinical staff time to perform safety protocols described by code 99072 allow for the provision of evaluation, treatment, or procedural services during a public health emergency in a setting where extra precautions are taken to ensure the safety of patients as well as health care professionals.

The second addition, CPT code 86413, was approved in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) of SARS-CoV-2 antibodies provided by laboratory tests reported by other CPT codes. By measuring antibodies to SARS-CoV-2, the tests reported by 86413 can investigate a person’s adaptive immune response to the virus and help assess the effectiveness of treatments used against the infection.

Code numbers and long descriptors for each addition:

• 99072: Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.
• 86413: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative.

In addition to the long descriptors, short and medium descriptors for codes 99072 and 86413 can be accessed on the AMA website at https://tinyurl.com/mp-covid-codes, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SARS-CoV-2 virus and the COVID-19 disease.

Allina, Blue Cross form value-based agreement

Allina Health and Blue Cross and Blue Shield of Minnesota have announced a six-year, value-based payment agreement that aims to reduce the cost of care by 10% over five years.

The agreement will share data to inform care delivery and enhance the patient experience in an effort to foster more proactive and preventive care and to reduce unacceptably high rates of health disparities. It also strives to maximize the time available for doctor-patient relationships, streamline the care delivery experience, and simplify administrative requirements.

The new agreement is expected to reduce costs. Currently, the portion of payments made by Blue Cross that are tied to achieving optimal patient outcomes are five to 10 times larger than what is outlined in typical outcomes-based risk arrangements.

By de-emphasizing the reliance on payments for each health care service delivered, providers can be protected from loss of revenue during periods of reduced volume—such as the recent pause on scheduled procedures during the pandemic.

An increasingly popular alternative in health care contracts, value-based agreements can maintain revenue for a health care system, but with larger payment portions for optimal patient outcomes and quality of care.

Allina Health and Blue Cross said they had been planning on the collaboration prior to the pandemic.

St. Luke’s participating in CDC study

St. Luke’s is one of six organizations nationally participating in a Centers for Disease Control and Prevention (CDC) study that could have major implications for the treatment of COVID-19.

Harmony Tyner, MD, infectious disease specialist at St. Luke’s, will lead the team’s involvement with the RECOVER study (Research on the Epidemiology of COVID-19 in Emergency Response and Healthcare Personnel). In March, with input from her colleagues, she sketched out an idea for a study on the epidemiology of COVID-19, which she submitted to the CDC for grant funding. Since the proposal was similar to another new study, she and St. Luke’s were asked to participate.

Along with St. Luke’s, Kaiser Permanente; the University of Arizona; University of Miami; University of Utah; and Baylor, Scott & White are also involved. St. Luke’s is partnering with the Whiteside Institute for Clinical Research, a joint effort between St. Luke’s and the University of Minnesota Medical School Duluth campus, to conduct the study in Duluth. Researchers will review what percentage of patients with COVID-19 are symptomatic, how long the virus sheds, if antibodies to COVID-19 protect people from being re-infected, how long it takes to develop antibodies to COVID-19, and how long immunity lasts.

“This project is groundbreaking and it’s exciting to be a part of,” Dr. Tyner said. “It will help us answer many of the questions that everyone is trying to answer about the epidemiology of COVID-19. It will also allow us to learn more about what infection with COVID-19 looks like in real time. That knowledge, in turn, enables us to limit the impact of this virus locally and globally.”

St. Luke’s will enroll 500 health care workers to participate in the study. Efforts will be made to fill demographic criteria based on age, gender, and occupation, to ensure that individuals from all demographics are represented. Potential participants will be asked to fill out a questionnaire to see if they qualify. Participants will be asked to complete weekly symptom assessments via text messages, swab their own noses for COVID-19 every week, and have blood drawn periodically to test for COVID-19 antibodies. Research will conclude by May 2021.

University studies antibodies as possible COVID-19 treatment

The National Institutes of Health (NIH) and Operation Warp Speed have chosen a University of Minnesota School of Public Health research team to begin a global clinical trial of synthetic versions of natural human antibodies—called neutralizing monoclonal antibodies—as a treatment for COVID-19.

The collaborative study, named ACTIV-3, will investigate whether these antibodies can prevent the virus that causes COVID-19 from infecting more cells in adults hospitalized with the disease.

For use in the trial, antibodies specific to the virus were singled out from the blood of recovered COVID-19 patients and then reproduced. When infused into people sick with the illness, the monoclonal antibodies will cling to the protein spikes surrounding the virus and keep it from infecting healthy cells—in effect, “neutralizing” it. The process may mimic what’s happening naturally in people who can handle the virus relatively well.

In stage 1, 300 patient volunteers will be randomly assigned to receive either a placebo or LY-CoV555, a neutralizing monoclonal antibody. All will receive the antiviral drug remdesivir as part of the study design. If LY-CoV555 appears safe and effective, the trial will advance to stage 2 and an additional 700 patients will be randomized and enrolled.

Researchers will then compare the number of study participants in each randomized group who achieve sustained recovery, defined as discharge from the hospital and at home for 14 consecutive days. All participants will be followed for 90 days.

Four NIH-funded clinical trial networks with hospitals across the globe are carrying out ACTIV-3. The lead network is the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), which is led by Professor Jim Neaton in the University of Minnesota School of Public Health.

“An advantage of the collaboration among the four networks is that hospitals can be activated to enroll participants in epidemic hot spots in the U.S. and around the world in order to more rapidly obtain answers concerning the safety and efficacy of the treatments to be studied,” said Neaton. 

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​  Medicus

Renée Crichlow, MD, assistant professor and director of Advocacy and Policy in the University of Minnesota Medical School’s Department of Family Medicine and Community Health, has been named as the inaugural Mac Baird Endowed Chair in Family Medicine Advocacy and Policy. Dr. Crichlow is the co-founder of a youth health career mentorship program in North Minneapolis called The Ladder, which engages both physicians and students.

TJ Ridley, MD, a sports medicine fellowship-trained orthopedic surgeon specializing in sports medicine and arthroscopic surgery, as well as minimally invasive knee and shoulder replacement, has joined Twin Cities Orthopedics. He offers care for all musculoskeletal conditions as well as activity-related sports injuries, and provides treatments ranging from medications and therapies to surgical and non-surgical procedures.

Mindi Kvaal Anderson, MD, a hospitalist, has joined Essentia Health–St. Mary’s Medical Center. As part of the hospitalist team, Dr. Kvaal Anderson cares for patients who are hospitalized due to illness or injury. She earned her medical degree at the University of Minnesota Medical School in Duluth, and completed her residency in family medicine at the Duluth Family Medicine Residency Program.

David Ingbar, MD, a critical care and pulmonary physician at the M Health Fairview University of Minnesota Medical Center, is leading a study to determine the safety and effectiveness of mesenchymal stem cells (MSCs) aimed at halting “cytokine storms” related to COVID-19. A patient with COVID-19 and lung failure is the first to be treated in the U.S. under the new FDA-approved clinical trial.

Mariya Skube, MD, MPH, has joined St. Luke’s in Duluth. Dr. Skube earned her medical degree and completed her general surgery residency at the University of Minnesota Medical School in Minneapolis. During residency, she also earned her MPH and completed a NIH T32 research fellowship in pancreatology.