Travis Kremmin (Pharm.D. ’11) is a clinical pharmacist at AdventHealth Shawnee Mission, a hospital in Merriam, Kansas. In March, the pandemic was just ramping up in the Kansas City area and Kremmin was looking to establish a COVID-19 response team of pharmacists when he received a text message.
A fourth-year student at the UMKC School of Pharmacy, Melinda Johnson, had made a lasting impression on Kremmin six months earlier while working together during a clinical rotation at the hospital. She had a general question for him about his specialty, infectious diseases. Kremmin had a question of his own – would Johnson consider coming back to join his team?
“It’s a very fast-moving environment right now with tons of literature and data to sort through both good and bad,” Kremmin said. “I was familiar with Melinda and the work she’d done with me before. I requested that she join my team. I knew when this was going on that not only could we help her gain experience, but we could utilize her skills. It was an ideal matchup.”
Johnson spent the month of April working as part of Kremmin’s team. She was largely responsible for helping develop the protocols for a convalescent plasma treatment program in partnership with the Mayo Clinic. Working in coordination with local blood banks and those in New York, plasma is received from New York patients who have recovered from the COVID-19 virus. Antibodies from those plasma sources are extracted and then used to treat the most severely ill COVID patients.
“This was a totally new concept, especially for a student being on a rotation. I don’t think we really knew what to expect going into it, but it turned out to be an amazing experience.”
Johnson was tasked with reading and understanding the Mayo Clinic’s institutional review board (IRB) treatment protocols for the procedure, and then develop a treatment plan for the Shawnee Mission hospital. That included developing the necessary checklists to ensure the required documentations were in place. On April 10, AdventHealth Shawnee Mission was the first hospital in Kansas City to use the treatment. The procedure is now being used across the 49-hospital AdventHealth system under Johnson’s designed protocol. Facilities throughout Kansas City have shown interest in the hospital’s convalescent plasma program as well.
“It was a team working on this,” Johnson said. “Travis initiated the process and we came up with the protocols. We were looking every day at patients to see if they would be candidates for the treatment at our facility. I’m grateful to have had this opportunity to work with AdventHealth and all the preceptors there.”
COVID-19 patients, particularly those on ventilators, have unique drug requirements. One of Johnson’s roles was to review emerging trials and data to calculate how much drugs are needed for the average patient to ensure that the hospital would have an adequate supply on hand.
“With all the information emerging for COVID, it’s almost a constant blast of information,” Johnson said. “I was sorting though what was most relevant, most important, and analyzing things to see what’s actually strong data versus studies that have come out that have been a little bit skewed.”
She also explored treatment options in light of caution flags that have raised of potential future drug shortages resulting from a coronavirus pandemic’s disruption of supply chains.
“I did work on potential treatment options, proposed treatment options” Johnson said. “I was looking at data for anything else beyond what are our first-line agents. Sometimes, we went down to our sixth and seventh options.”
Throughout April, Johnson and Kremmin met online daily for as long as two to four hours at a time to review the day’s patient consultations list and discuss the information being released on COVID-19. Kremmin said Johnson was instrumental in analyzing and deciphering the waves of data in order to develop treatment and dosing algorithms for COVID patients locally and across the AdventHealth network.
Twice a week, she and Kremmin met with physicians and pharmacists to discuss patient needs and the latest developments surrounding the virus. The process of working remotely worked out better than they imagined, Johnson said.
“This was a totally new concept, especially for a student being on a rotation,” Johnson said. “I don’t think we really knew what to expect going into it, but it turned out to be an amazing experience.”