Here are lessons learned from Mi-COVID19 Initiative

As you’ve read in the Update over the past year and a half, our Collaborative Quality Initiative structure has helped hospitals statewide collect meaningful patient data and share information on COVID‑19 treatment protocols. These protocols have helped influence care and treatment statewide. This article contains some of the most recent data and findings.

The Mi-COVID19 Initiative, a joint CQI across numerous Blue Cross Blue Shield of Michigan quality initiatives, has played a key role in Michigan’s response to the pandemic.

“This has been a journey that we have taken together over the last year,” said Scott Flanders, M.D., the initiative’s program director and chief clinical strategy officer at Michigan Medicine. “A large group of health professionals shared crucial information, which significantly improved the outcomes of our patients here in Michigan.”

Data collection

By the end of January 2021, data on more than 3,500 COVID‑19 positive patients had been abstracted and analyzed. In addition to sharing best practices in more than 30 webinars, four peer-reviewed papers have been published, with another seven currently under review.

Key insights

In June 2021, the Mi-COVID19 registry leaders presented a webinar to Michigan hospitals, physicians and other health care leaders on the lessons learned during the COVID‑19 pandemic. They shared the following key insights:

• Early on, about 1 in 5 patients presented with nausea, vomiting and diarrhea. The collaborative was able to inform hospitals and ER staff statewide, so COVID‑19 tests, which were limited at the time, could be appropriately administered to patients with these symptoms.
• A review of antibiotic use in hospitalized patients identified the situations in which someone should or should not be given antibiotics when hospitalized with COVID‑19.
• One in 10 patients who survived an ICU stay died within 60 days of leaving the hospital. With this knowledge, providers could target the ICU patients to plan post-discharge care more carefully.
• A large portion of patients who were hospitalized with COVID‑19 experienced severe physical, mental and financial challenges in the 60 days following hospital discharge. This finding helped hospitals develop important follow-up programs to connect patients to needed health, mental health and social services.
• Preventive anticoagulation therapy during hospitalization is associated with lower mortality. Mi-COVID19 participants significantly decreased the percentage of hospitalized patients who missed two or more doses of prophylactic anticoagulation.

“This rate of change in clinical care is unprecedented in my time practicing medicine,” Dr. Flanders said. “We continue to look at the registry and at our learnings on COVID‑19 to develop additional best practices that lead to better patient outcomes.”

In addition, initiative leaders have developed a mortality risk assessment model, which enables providers to assess a patient’s risk of death at the time of admission. This allows providers to use appropriate treatment protocols more quickly.

“All of us can be proud of the important work we were able to accomplish in coordinating resources to best treat COVID‑19,” said Amy McKenzie, M.D., associate chief medical officer, Blue Cross Blue Shield of Michigan and one of the Mi-COVID19 CQI steering committee members. “We were able to get the CQI up and running and collecting data within a month and determine notable variations in care and arrive at best practices within a relatively short period of time. All this helped provide our hospitalized COVID patients across Michigan access to cutting-edge care.”

More information on the Mi-COVID19 initiative can be found here.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.