Becker's Hospital Review

34 CIO / HEALTH IT Viewpoint: 5 ways to preserve team-based care in telemedicine By Jackie Drees A s the COVID-19 pandemic emerged, Cleveland Clinic decided it must ad- just the role of team-based care in the shi to telemedicine, according to Kevin Hopkins, MD, primary care medical director at the health system. During a presentation for the American Med- ical Association, Dr. Hopkins explained how Cleveland Clinic incorporated team-based care models during its rapid shi to virtual care at the start of the pandemic, according to a Nov. 9 AMA report. Five ways to incorporate team-based care in telemedicine, according to Dr. Hopkins: 1. Engage in telemedicine with the team and discuss the opportunities it brings to improve care not just for patients but also physicians, advanced-practice providers, IT partners, nursing and clerical leadership. 2. Project leaders should discuss tele- medicine model options with their teams and how they relate to each person's skill sets. Some team-based care models in- clude synchronous, real-time support with a nurse or medical assistant guiding the ap- pointment from start to finish and asynchro- nous, which is when the nurse or medical as- sistant is not present for the entire visit. 3. Establish team-based care work- flows by clearly defining roles and respon- sibilities together as a team, Dr. Hopkins said, adding that it's important to "look at existing standard work as a starting point and then adapt those existing workflows for the tele- medicine platform or co-create new ones." 4. Start simple when implementing workflows by making one straightforward change that can help secure a "quick win," and remain flexible with the plan schedule. 5. Optimize the model by continuing to practice it and hold team meetings to address new experiences or changes that should be made. "If our overall goal is to advance the care that we deliver to our pa- tients and improve the engagement and sat- isfaction of all stakeholders involved in their care, including ourselves in our teams, be patient and show grace to one another," Dr. Hopkins said. n CMS adds 60+ services to Medicare's telehealth list in final rule: 7 things to know By Laura Dyrda C MS released Dec. 1 annual changes to the physician fee schedule for 2021, which updates the payment rates for physician services and expands the list of telehealth services covered by Medicare. Seven takeaways from the rule related to telehealth: 1. CMS added more than 60 services to the Medicare telehealth list. 2. The agency finalized a third temporary category of criteria for adding to the Medicare telehealth list during the pandemic. Those services will stay on the Medicare telehealth list until the public health emergency related to COVID-19 ends. 3. CMS added 12 services to the Medicare telehealth list on a Category 3 basis, including emergency department visits, therapy services and hospital discharge day management. 4. The final rule sets a limit for nursing facility telehealth visits of one visit every 14 days. 5. CMS established two new Healthcare Common Procedural Coding System codes for licensed clinical social workers, clinical psychologists, physical therapists, occupational therapies and speech-language pathologists to provide telehealth services. The agency also clarified they can provide brief online assessments and management services as well as virtual check-ins and remote evaluation. 6. The final rule clarified telehealth rules don't apply if the clinician and patient are in the same location during virtual visits to limit COVID-19 exposure. 7. CMS established a separate payment for audio-only services in the March 31, 2020, COVID-19 interim final rule. The agency didn't propose to continue those codes in the physician fee schedule after the pandemic, but did establish payment on an interim final basis for a new HCPCS G-code for a medical discussion to determine whether an in-person visit was necessary. n

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