Becker's Hospital Review

52 CIO / HEALTH IT How Cleveland Clinic rapidly scaled its telehealth program during the pandemic: 8 key notes By Laura Dyrda C leveland Clinic released its COVID-19 Digital Health Playbook, including a guide for healthcare organizations to rapidly scale their telehealth offerings. At the beginning of the year, telehealth represented 2 percent of the total care delivered at Cleveland Clinic; however, when it became clear that in-person visits were no longer safe amid the COVID-19 pandemic, pa- tients turned to remote care and virtual visits. Cleveland Clinic had to rapidly scale its remote care program. Here are key steps it took: 1. Cleveland Clinic's legal department developed guidance for providers to deliver virtual care to established patients in any state using multiple modalities, in accordance with state and federal guidelines. It also pro- vided information to clinicians about prescribing controlled substances to established patients during the virtual visits. 2. e health system needed to expand its digital platforms to accom- modate its 19 clinical institutes that include around 4,000 physicians. IT leaders ramped up platforms that providers and patients could use for re- mote interaction, including FaceTime, Google Duo and Doximity Dialer. 3. The health system provided training to the primary care and specialty physicians and clinicians about how to use the telehealth technology. There were 350 providers trained in six virtual sessions during the first week who learned how to navigate the virtual portal and access Epic workpools as well as interact with patients over the video or telephone. Cleveland Clinic developed a "unified dynamic playbook" within its internal COVID-19 website, which improved use and efficiency in the platform. 4. Daily leadership huddles across workgroups improved communi- cation, and the transparency promoted innovation, quick uptake and initial success. 5. e finance and legal teams worked together to remove payment bar- riers for telehealth services so patients could quickly access care. CMS and private payers updated their policies to allow virtual care during the pandemic. 6. e system created new documentation templates within its Epic EHR for virtual visits, eVisits and phone encounters to track activity. Cleve- land Clinic also used Express Care Online, a third-party platform, to provide patient-initiated visits, primarily by those who were exposed or potentially exposed to COVID-19. 7. e team also developed specialty-specific documentation templates and workflows to shi outpatient care to telehealth. e teams now schedule virtual visits two to four weeks in advance and enroll patients in the MyChart portal. Cleveland Clinic had to implement changes to its scheduling template for both central and practice-based teams to offer the virtual visits. 8. A work group developed a system for remotely monitoring COVID-19 patients to monitor their symptoms and escalate concerns quickly. e program has enrolled more than 1,000 patients. n Beaumont Health alerts 112,000 patients to phishing attack By Jackie Drees S outhfield, Mich.-based Beaumont Health April 17 notified about 112,000 patients that their protected health information may have been exposed in a data security incident. On March 29, the health system discovered that one or more Beaumont Health employee email ac- counts had been accessed by an unauthorized third party between May 23, 2019, and June 3, 2019. Af- ter completing a forensic investigation, Beaumont Health was unable to determine if any information was acquired by the unauthorized third party. Patient data that may have been exposed by in- cluded names, dates of birth, diagnoses, patient account numbers and medical record numbers. A limited number of Social Security numbers, finan- cial account information, health insurance informa- tion and driver's license or state ID numbers may also have been affected. Beaumont Health implemented additional tech- nical safeguards and provided extra training and education to employees on handling malicious emails, the health system said in an April 17 notice posted to its website. n Michigan nurse was terminated for HIPAA violation, Mercy Health says By Laura Dyrda M ercy Health said it terminated a nurse at its Hackley Hospital in Muskegon, Mich., for inappropriately viewing medical records of several patients, according to a local ABC affiliate. The former Mercy Health nurse, Justin Howe, was ter- minated April 3. Mr. Howe and the Michigan Nurses Association said the health system terminated him af- ter he raised concerns about the hospital's prepared- ness and safety during the COVID-19 pandemic. But the health system said it terminated Mr. Howe for unnecessarily viewing the EHR charts of sever- al patients who were treated at a different hospital campus within the system, a violation of HIPAA. Other employees were fired for inappropriate patient records access during Mercy Health's investigation, it said. n

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