Cook County team targets myths, historic health care shortcomings — and ‘every possible patient who is at risk’
Besides helping the residents sort through all the information and misinformation out there, the team does regular telephone check-ins, makes sure people can get their medicine and educates them about the coronavirus.
On top of caring for high-risk patients, Dr. Nimmi Rajagopal has taken on a new role for some: myth buster.
She has one patient who “probably every week” sends her a text passing along info from an article or a friend suggesting ways to avoid getting the coronavirus.
Does gargling with Listerine twice a day keep the COVID-19 away?
“I think most of it is harmless — things like if you drink citrus everyday or if you take these pills, these vitamins, then it will keep you from getting COVID,” Rajagopal said.
“I think it’s just people looking for things that will help them feel better, but I think it’s important for patients to know it’s not that simple, and when they do show symptoms, it’s really important to isolate, especially if there’s elderly patients or patients with other illnesses living in the same home.”
Providing credible information and advice – and debunking the myths – is just part of what Rajagopal and a team that includes other doctors, clinical managers and data analysts provide as they reach out to people who are at a higher risk of contracting the virus.
About 2,500 potential patients were identified for Cook County Health’s high-risk patient outreach project. So far, 628 appointments have been set up with those patients through the outreach team’s efforts, which began at the end of March, said Dr. Charles Edoigiawerie, who is also on the team.
Besides helping the county residents sort through all the information and misinformation, the team does regular telephone check-ins, makes sure people can get their medicine, answers their questions and educates them about the coronavirus.
Though the doctors who spoke to the Chicago Sun-Times couldn’t offer a racial breakdown of the list of patients, Dr. Titilayo Abiona said she’d imagine that it includes “quite a significant portion of black and Hispanic patients.”
Both of those communities have been hit hard by the pandemic. Despite making up less than one-fifth of the state’s population, Latinos in the state now have the highest number of confirmed coronavirus cases. They eclipsed the African American community, which still has a staggering number of positive cases and deaths.
Rajagopal said looking at those disparities means acknowledging “there’s a significant amount of history in these populations being the hardest hit for anything.”
“It’s coming to light in a different manner because of COVID, but these disparities have been there, which is why we’re in these communities and working with these communities ... that typically have a lack of access to health care,” Rajagopal said.
The residents they are reaching out to were identified through a registry of patients. Doctors pored over the data, picking patients who’ve visited emergency rooms across the county two or more times over the last three months, Rajagopal said.
Then the team looked at the county’s ambulatory clinics, or community health centers, to divvy up patients and looked at whether the patients have been seen since their last visit to a county emergency department.
If the would-be patient has one of a number of high-risk conditions — such as diabetes, asthma, obesity or hypertension — then the team reaches out to them “so they don’t just end up back in the emergency room,” Rajagopal said.
Abiona said the team’s work is focused on those frequent emergency room visitors who may not seek care just because of concerns about the virus. The goal is to make sure that they are able to manage their health conditions. Earlier intervention could mean a milder case of the virus, should they contract it.
“We felt that we need to reach out to these people to be sure that, one, their chronic conditions are being taken care of thereby preventing them from having to visit the emergency room, and then, two, we will be able to identify people that have COVID-19 symptoms, and we can take care of them from that point onward,” Abiona said.
Edoigiawerie said it’s “an ongoing project,” and “our goal is to target every possible patient who is at risk.” Rajagopal said the team’s outreach efforts are a “framework” for the future.
“The majority of [my colleagues] are working with underserved populations in one way or another, and I think that says a lot, too,” Rajagopal said.
“There’s a lot of people working very, very hard for a very long time to try and decrease the disparities, and it’s just not that easy. And so, the more programs like this the better, the more sustainable we can make them better. As we get through COVID, then we can help to continue decreasing these disparities over time.”