Tina Sary, nurse practitioner, is on staff at Cottage Health and sees patients through the new phone and video virtual visits called Cottage CareNow. | Credit: Courtesy

As the only hospitals in south Santa Barbara County, Cottage Health is ready if community spread of COVID-19 brings it patients. Santa Barbara’s hospital has 47 negative-pressure rooms that are used to isolate contagious patients. The hospital in Goleta has 11, and in Santa Ynez, there are two.

At Cottage, the emergency room personnel routinely ask patients about their recent travel history. With outbreaks beyond China in Italy, Japan, South Korea, and every continent but Antarctica, the geographic questions have expanded as well, said Maria Zate, a spokesperson for Cottage Health. But Cottage is counting on cooperation and knowledge among the community to prevent the spread of germs — people who might have been exposed are asked to limit their contact with other people and to call before coming in. Signs outside Cottage and its clinics ask patients and visitors who suspect COVID-19 to stop and call before entering.

Given what is known about COVID-19 symptoms, any patient in severe respiratory distress is a consideration for testing, Zate said. That includes a patient who telephones the Cottage CareNow clinicians, a new program Cottage has been testing with its employees since last August and opened to the public in December. Patients can phone or video conference with a doctor or nurse rather than making the trek to the hospital emergency room. It enables them to stay home and shields the emergency room workers and patients should a caller be found to have COVID-19.

The virtual visit begins with a questionnaire that goes over the patient’s symptoms and history in detail. Tina Sary, who has been a nurse practitioner for four years, “sees” patients during the week’s working hours, with the rest of the 24/7 duties going to United Concierge Group, whose doctors are credentialed providers with Cottage Health.

It’s a system of triage, explained Dr. Alan Brown, a cardiologist who is head of telemedicine for Cottage. The quick phone call or video connection allows a patient, and the clinician, to know how seriously ill he or she might be, he said. From there, recommendations can be made for a prescription or a referral to a primary care doctor or the ER if necessary. The prescriptions written are overseen by Cottage’s antibiotic stewardship committee, which reviews for use and overuse of antibiotics.

The visit price — $29 for a telephone review and $39 for online — is rescinded if the patient must be referred for further workup. More information can be found at cottagehealth.org/carenow.


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