Highlights & Happenings 4.23.20

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We’re still here, ready to help.  As a division of SCHA, Solvent Networks is committed to helping our hospitals and health systems respond to the COVID-19 emergency. This issue offers solutions that may help hospitals maintain continuity of both clinical and administrative operations. Please also continue to monitor SCHA’s COVID-19 webpage for the latest updates.

Collective Medical can help hospitals meet new CMS reporting rule
The CMS has released the Interoperability and Patient Access final rule, modifying its Conditions of Participation (CoPs). The change requires hospitals to send electronic patient event (admission, discharge, transfer) notifications to the patient’s primary care provider and any applicable post-acute providers. The rule will go into effect six months from the date it is recorded in the Federal Register. To satisfy the CoP, hospitals can use intermediaries, such as Collective Medical, a Solvent Networks endorsed partner and developer of the leading ADT-based network for real-time provider activation and care collaboration.
As an intermediary, Collective is offering a lightweight and cost-effective program that will fully meet your hospital’s compliance with the CoP notifications requirement. Collective can operate as a standalone solution for your hospital, offering full compliance without the need for additional intermediaries or EMR-based solutions. Collective can also work in conjunction with your existing EMR notification system as a supplemental solution for provider notifications. Contact Solvent Networks to set up a call.

An Option for Displaced Healthcare Workers
As hospitals and other providers slowly begin to resume surgical cases or procedures, there will be some currently licensed health professionals who still find themselves temporarily displaced from regular employment. These professionals can help other South Carolina hospitals respond to local or regional surges from COVID-19.

SCHA has coordinated with Aya Healthcare, the parent company of Qualivis, an endorsed partner of Solvent Networks, to stand up a temporary staffing pool made up of healthcare workers who have recently been furloughed or laid off. Hospitals will be able to access this temporary pool of S.C. licensed professionals for short-term assignments to help with COVID-19 response.

Please direct affected staff members to the link below. Through this process, SCHA will match furloughed staff members with hospitals in SC who need extra help.

https://www.ayahealthcare.com/staffing/south-carolina-hospital-assoc

Here are a few critical messages to convey to your leadership and staff who may be interested/available:
• Assignments would be short-term, 7 days or less, which could be renewed if all parties agree.
• Assignments would be to staff hospitals in S.C. only.
• Hospitals will have the ability to call for your staff members to return in the event of a surge.
• There will be two types of rates: one for staff filling roles within a 50-mile radius who do not require housing, and one for staff filling roles outside a 50-mile radius who will need housing.
• Staff who participate in this S.C. resource pool will see disruptions to their unemployment benefits only for the week that they pick up a short-term assignment, not for the duration of the furlough.

If you have any questions about this process, please contact Lara Hewitt at lhewitt@scha.org.

Tele-ICU, Tele-ID and Telehospitalist are the most requested telemedicine services
Telemedicine brings enormous benefits during and after the COVID-19 crisis. It leverages existing technology to deliver high quality care equivalent to on-site care, gives access to quality specialty care to keep patient care close to home, is ideal for hospitals facing a larger volume of patients than hospital is prepared to handle, offers preparedness if local hospitals lack physician resources, or if local physicians can’t practice because they are ill and changes to state licensing requirements allowing capability to quick start a telemedicine program in days vs months.

Eagle Telemedicine, a corporate sponsor of SCHA, currently provides services in 12 specialties. Tele-ICU, Tele-ID and Telehospitalist are the most requested telemedicine services. With more than five million patients treated in ICUs each year and the supply of qualified ICU intensivists on the decline, Tele-ICU program offers support for hospitals.
Critical care consults, vent and drip management and rounding are services among available. Infectious Disease telemedicine can keep hospitals performing at times of crisis. With the Tele-ID program, your medical staff is empowered to care for infection disease patients. Services available for consults, follow-ups and antibiotic stewardship. Patients can also receive real-time diagnoses and treatment from expert, remote Telehospitalists who are “beamed in” to the hospital via videoconferencing technology. This includes NP backup, surge protection, cross cover calls, patient change in status, rapid response, codes and admits

Ascension St. Michael and the seven other hospitals in the region needed to find new ways to reduce the number of patients transferred out of system. After one of their specialists left, leadership realized the gap in ID coverage was a major reason the facility was transferring 50% of its patients to hospitals out of network, sometimes to hospitals in Madison, more than an hour away. Eagle Telemedicine’s Tele-ID program provided hospitals with a sustainable ID solution for the long term.
• Transfers Decreased: “What we saved [by keeping the patients] far exceeded what we paid for the Tele-ID service,” said Dr. Robyn Schertz, MD Vice President of Medical Affairs.
• Patient Acceptance: The patients appreciate the time the ID specialist spends during consults. Clinical staff embraced the program, which Ascension credits to the quality of the Eagle team.
• Continued Growth: Ascension St. Michael’s is considering setting up a clinic for outpatient telemedicine ID consultations to support primary care providers in meeting complex patient care needs.

If you’re interested in expert care in telehealth services, please contact Ed Bonn at Ed.Bonn@EGLHP.com or 770.855.3070 direct.

Getting your team’s performance and financials focused during disruptive times and ready for the future
WebsterRogers LLP, a corporate sponsor of SCHA, is a leading South Carolina-based accounting and consulting firm that provides a broad spectrum of assurance, tax and advisory services to our clients. When you work with WebsterRogers, you gain the resources of a national firm while receiving the personal attention and dedication you would expect from a local firm.

We cannot point to a circumstance where this level of systemic volume and revenue challenge has faced virtually every healthcare provider in the country. In severe crisis, you have two responses: focus on what you know and deliver results; chaos and inefficiency and doing things haphazardly. Here is guidance for steps that can be taken to lessen impact and intervene on the domino effect occurring in your daily operations, and to get you back functioning better in days ahead.
1. Planning, logistics and modifications for seeing patients virtually and at the office.
a) Ensure staff and patients at the office use social distancing (avoid crowds, stay 6 feet away from others) as well as appropriate hand hygiene. CDC and OSHA have updated posters.
b) Consider reaching out to your highest risk patients (those over 60 with chronic underlying conditions) to inform them of safe practices such as avoiding crowds and non-essential travel.
c) Consider providing additional refills of chronic medications so patients have appropriate supplies.
d) Establish a good triage system at time of appointment scheduling and for patients arriving at the office.
e) Develop plans within your office for a positive or potential positive patient such as a separate exam room and screening patient temperature. Maintain appropriate cleaning and disinfection of your office – most anti-bacterial agents will kill the virus but be sure to check manufacturer’s specifications.
f) Assign lead person to stay aware of theCOVID-19 and influenza activity in your community. Continue following the CDC and DHEC guidelines.
2. Importance of communications with patients
a) Maintain constant communications with your patient base regarding the office operations. Now is the time to “over communicate” as patients are understandably anxious and in need of more extensive contact. Also communicate with your referral base and community resources.
b) Use your EHR system and portal capabilities to the fullest. Make this a priority.
c) Add other tools and means of communications with your patients- build loyalty and trust with them by ensuring them of safety precautions taken and support for their health and wellbeing.
3. Establish new and alternative means of seeing your patients.
a) Understand healthcare facilities plans related to elective procedures and services. Follow CMS Elective Surgeries and Procedures Recommendations in order to prevent unnecessary patient and staff exposure, and to expand healthcare system capacity and conserve supplies such as PPE.
b) Stay abreast of state laws regarding provider’s scope of services, telehealth, and other regulatory provisions as these may change abruptly.
c) Investigate liability insurance implications for incorporating changes in your practice, such as telehealth.
d) Become familiar with the list of CMS billable telehealth services.
4. Step up to deliver telehealth care now and beyond. CMS and other payers added many new services that can be provided as telehealth services during the Public Health Emergency (PHE) in order continue lowering exposure risk for clinicians and patients. The new guidelines are found on CMS website. Continue to monitor after the PHE for applicable updates and changes.
a) Telehealth Visits: For services starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency (PHE), Medicare will make payments for Medicare telehealth services furnished to patients in broadened circumstances. During the PHE, clinicians can use popular applications that allow for video chat such as Apple FaceTime and Skype. Also, clinicians may utilize telephone without video for other communication technology-based services.
b) Virtual Check-ins: New or established Medicare patients may have a brief communication service with practitioners from wherever they are located, including in their home, via a number of communication technology modalities including synchronous or real-time discussion over a telephone or exchange of information through video or image. Medicare pays for these “virtual check-ins.”
c) E-visits: These visits use an online patient portal. In all types of locations including the patient’s home, and in all areas (not just rural), new or established Medicare patients may have non-face-to-face patient-initiated communications with their doctors or other practitioners.
d) Enhance your Chronic Care Management services or implement a CCM program: Primary Care and Specialist office can enhancement patient care, revenues, and patient loyalty with CCM.
e) Implement Behavioral Health Integration: Patient service codes are expanded and reimbursable.
f) Look back to assess the services that have been given and ensure compliance. Closely evaluate your EHR and other resources to ensure compliance, efficiency, and improvements.
5. Financial relief options from Federal agencies are available. The funds are established for unique purposes and must be accounted for separately when the funds are received and used.
a) Small Business Administration loans- EIDL
b) Paycheck Protection Payment -PPP
c) CARES Act Relief for Healthcare providers
d) CMS Accelerated and Advance Payment Program
e) Stimulus Act and Tax Relief

During these times we fully recognize the significant impact this situation is having on you, and we are working to help relieve some of that burden by consolidating information and providing information for education and support for your needs. We also view these times as opportunities to adapt and make changes to be more pivotal and responsive to new ways of delivering healthcare.

For more information, please email Nelda D. Fields, FHFMA, FACMPE, MBA, Director Healthcare Service Group, WebsterRogers LLP at Nfields@websterrogers.com or Gordon Wilhoit, MD, Director Clinical Innovation, Value Health Partners at gordon.wilhoit@valuehealthpartners.org.

Contact Solvent Networks to set up a meeting with any of our endorsed partners and put their solutions to work for your facility.

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Important information about COVID-19 from Solvent Networks