12-10-21 Monoclonal Antibody Therapy – Weekend Ordering

December 10, 2021

Monoclonal Antibody Therapy – Weekend Ordering

To: Members of the LMH Health Medical Staff

From: Dr. Christopher Brychel, Dr. Christopher Penn, Dr. Jennifer Schrimsher, Caitlin Johnston, APRN

LMH Heath has been notified of a significant reduction in the amount of monoclonal antibody we are allocated.

Due to the sudden interruption in the monoclonal supply chain, BMI and symptom duration criteria have changed to ensure greatest benefit for our highest risk patients is prioritized. Until further notice, the following monoclonal criteria changes will apply:

  • BMI > 35 (previously > 25)
  • Symptom duration <7 days (previously <10 days)
  • Remainder of criteria unchanged

We will return to the selection criteria previously attached to the November 30 communication when resources allow. Given the concomitant uptick in COVID positive patients, direct ordering of monoclonals will be delayed until December 13 and we will maintain our current referral process in the interim. Updates will be communicated as soon possible and we recommend closely monitoring your LMH Health communications platform. 

If you have a patient that you are not sure meets criteria or may be borderline on the time criteria, feel free to reach out to Dr. Brychel, Caitlin Johnston or Chris Lawrenz to discuss these on a case by case basis.

Monoclonal Antibody Workflow beginning December 13, 2021:

1. Identification of mAb candidate by EUA criteria (see attached) by provider.

a. LMH Providers: utilize SharePoint document

b. Non-LMH Providers: please make copy of the attached.  

i. Updates to order sets will be sent by an LMH representative.

2. Ordering provider will contact the patient to review EUA consent directly.

3. Fully completed order sheet (attached) and a copy of the positive test result will be faxed to Treatment and Procedure Center (TPC) 

a. TPC Fax: 785-505-5253

b. TPC Phone: 785-505-2860 (You are strongly encouraged to call and verify receipt of order.)

c. If you do not have access to fax during the weekend, you can email a PDF copy of the completed order sheet to Treatment_and_Procedure_Center@lmh.org. You can use a scanner app like Simple Scanner to convert the order to a PDF and email it to the TPC.

4. TPC staff will review and, if patient fulfills mAb criteria, contact the patient to arrange for mAb infusion appointment and provide appointment instructions.

5.  Ordering providers external to LMH will be notified directly by TPC staff once mAb infusion is complete.

a. Verification within chart/Cerner will be present for LMH providers.

6. Further management and follow-up will be the responsibility of the ordering provider.

For any clarifying questions, call 785-505-5182 or contact Dr. Christopher Brychel, Caitlin Johnston APRN, or Christina Lawrenz RPh.

Sincerely,

Chris Brychel, M.D.

Caitlin Johnston, APRN