Communicating COVID: Case/Scenario Submission Form

Returning?

A A A

Thank you for your interest in sharing a case or scenario with our learning community. Please take a few minutes to fill out the survey below. After you submit, a member of our team will be in touch to confirm session details. We ask that submitters be prepared to briefly describe their case/scenario to our learning community during the live ECHO sessions. This presentation is brief (~5 minutes) and is followed by group discussion to identify shared challenges and provide strategies for next steps.

PLEASE NOTE that Project ECHO case consultations do not create or otherwise establish a provider-patient relationship between any UTHSA clinician and any individual presented in a Project ECHO setting. Always use ECHO ID# or other non-identifiable language when presenting a patient in clinic. Sharing patient name, initials or other identifying information violates HIPAA privacy laws.

What is Health Literacy? The degree to which individuals have the capacity to obtain process and understand basic information and services needed to make appropriate health decisions.

Your name:

* must provide value

Credentials:

Email:

* must provide value

Your organization's name:

* must provide value

Briefly describe (1-4 sentences) a situation or scenario that demonstrated a challenge to communicating about COVID-19 or facilitating services for a community member:

* must provide value

Expand

Where did this situation or scenario take place?

* must provide value

In the community

In a clinic setting

reset

What is your role in this setting (either in clinic or community)?

* must provide value

What were the health and needs of the patient/community member (e.g. Information translation, resource sharing, addressing stigma, referrals for care, etc.)?

* must provide value

Expand

What is the challenge or issue in facilitating care for this patient/community member?

* must provide value

Expand

What strengths or resources does the patient/community member have to help with this situation (e.g. family support, church community, etc)?

* must provide value

Expand

What are your questions for the ECHO Learning Community?

* must provide value

Expand

Question 2:

Expand

Question 3:

Expand

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.