Becker's Hospital Review

62 CIO / HEALTH IT How Cleveland Clinic created a telehealth team and new documentation to tackle coding, billing changes By Jackie Drees W hen CMS issued sweeping regulatory changes March 30 to address COVID-19 patient surges, Cleveland Clinic assembled a team of IT, coding and billing ex- perts to help translate the new telehealth policies and waivers into clinician-friendly electronic workflows. While the health system already adopted telehealth pre- COVID-19 in ambulatory settings and select emergency and in- patient uses such as stroke and intensive care, the widespread use of inpatient virtual visits was new for Cleveland Clinic, according to the June 25 news release. "With everything that our providers were going through, we knew we couldn't expect them to also become instant experts on CMS waivers and other regulatory changes," said Allison Weathers, MD, associate chief medical information officer. "We had to think through how the EHR could be leveraged to allow our providers to put their time and attention on what mattered most — caring for their patients, not knowing the intricacies of documenting and coding of providing virtual care." Here are three things to know about Cleveland Clinic's telehealth strategy: 1. e health system created an inpatient distant health multi- disciplinary team with members representing physicians, nurs- es, coding, IT and administration. e group used its collective coding and clinical informatics expertise to create new telehealth documentation that helped streamline new billing guidelines and support remote care for hospitalized patients. 2. Dr. Weathers, Katina Nicolacakis, MD, medical compliance, billing and reimbursement director, and Leslie Wong, MD, as- sistant director of Cleveland Clinic's Medical ACO, teamed up during daily meetings with IT and coding colleagues to analyze the new CMS telehealth waivers and help create new inpatient telehealth documentation and billing templates. 3. e IT and coding teams modified existing electronic work- flows for physician documentation and billing designed for in-person care to meet the new requirements for telehealth. e teams also created user-friendly documentation templates in the EHR that can be easily adapted across the different specialty ser- vices at Cleveland Clinic. "What we learned was how invaluable it was for physicians to be involved in how a telehealth strategy is deployed, and to use an interdisciplinary approach to ensure proper documentation and reimbursement, but also good communication between caregiv- ers," Dr. Wong said. n VA's EHR rollout will take 10 years, Cerner exec says By Jackie Drees S ince striking a partnership with Cerner in 2018 the De- partment of Veterans Affairs' $16 billion EHR implemen- tation has encountered various delays, but project lead- ers anticipate the final go-live in about 10 years, according to Federal News Network. During the publication's podcast episode, Cerner Vice Pres- ident of Government Services Julie Stoner said the initial plan for the project is to deploy the new EHR in nine years and six months across the VA network. "The biggest lift is kind of landing that enterprise – we're landing, what is it that we want to deploy what makes sense at all VA locations," she said. "And so we've been focused on that and then look forward to going live at the initial sites in the Pacific Northwest so that we can refine those workloads, make sure they really meet the needs, and then begin rolling out. But we're looking at about 10 years." In February, VA postponed its anticipated March EHR go-live at its first site in Spokane, Wash., because it needed more time to build the system. Once the COVID-19 pandemic hit the U.S., the department confirmed in April that it would fur- ther delay the project to focus on pandemic response. On June 3, Politico reported that the VA likely will not de- ploy the new Cerner EHR system at its first facility until at least this fall. n UPMC to build tech operations center in Ireland to support international expansion By Alia Paavola P ittsburgh-based UPMC will build a technology oper- ations center in Kilkenny, Ireland, to help support the system's overseas expansion. The UPMC Global Technology Operations Center will em- ploy more than 60 technology workers and other support staff when it opens. Specifically, UPMC will hire network, sys- tems and security engineers, security and privacy analysts, and other IT managers. "Our multinational business requires a technology platform that allows us to consistently provide the highest-quality care at the lowest cost, regardless of location," said Ed McCallis- ter, CIO of UPMC. "As we considered locations worldwide that would best meet our needs, Ireland — and its centrally located, multi-cultural workforce — quickly rose to the top." n

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