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Pandemic spurs Telehealth collaboration and expansion

By Jessica Canterbury

The experts in Payer Relations and Finance/Coding who were well-versed in Telehealth were able to translate and implement unbelievable amounts of information and guidance that was changing daily.

Cincinnati Children’s is always looking for better ways to meet the needs of patients and families, and during the COVID-19 pandemic, that meant expanding the use of Telehealth. The phrase "expanding the use" might even be an understatement. Just a few months ago, the Center for Telehealth was averaging 10 to 20 visits per day. In the month of March 2020 alone, it launched or added to 109 clinical programs. Now the visits are averaging more than 1,000 each day.

One such program is CincyKids Health Connect, a service for parents in Ohio and Kentucky that was enhanced to include COVID-19 screening for their child without leaving home. This screening service is free for all. Others may seek on-demand Telehealth service for minor illnesses and injuries. For adults and children covered by a Cincinnati Children’s health insurance plan, the visits are covered at 100 percent (with coupon code CCHMC). While some divisions that had used Telehealth in the past were adding providers and services to their offerings, there were 23 new Epic builds for divisions who had never used it, says Jen Ruschman, senior director of the Center for Telehealth. “We always had plans to scale the Telehealth services at Cincinnati Children’s to be a significant portion of how clinical care was delivered, but we had no idea that scale would be so rapid. The pandemic really impacted a normal curve which typically includes early adopters, then most providers and patients, and then those who are hesitant to using new technology. The current situation forced that curve to be scaled in an almost immediate sense.”

Fortunately, the Center for Telehealth already had the infrastructure, staffing and processes in place. However, it had never handled the volumes it sees today. Several groups throughout the medical center made the new offerings and expansion possible. “The Epic team provided a scalable model for documentation, which allowed for navigating the billing complexities,” Ruschman said. “The experts in Payer Relations and Finance/Coding who were well-versed in Telehealth were able to translate and implement unbelievable amounts of information and guidance that was changing daily. We also had a technical Telehealth team and other critical Information Services staff to maintain and push systems to perform at new levels.

We always had plans to scale the Telehealth services at Cincinnati Children’s to be a significant portion of how clinical care was delivered, but we had no idea that scale would be so rapid.

Stats

In March 2020:

  • 1,000 new software accounts created
  • 566 providers completed video training
  • 109 clinical programs launched or expanded user’s Telehealth (200 percent typical annual rate)

“The partnership of our new medical director for Telehealth, Ken Tegtmeyer, has been crucial,” Ruschman continued. “Additionally, much Telehealth clinical care was done outside of typical clinics and flow, and working with the Patient Services teams to think about that workflow and how to optimize care for the patients has been very rewarding. Working with the App Development team on automating some pieces of workflow has been educational for me as well.” The icing on the cake was the fact that the Center for Telehealth staff had just gone through a LEAN process looking at new program implementation—this was key to the group’s agility. “This pandemic and rapid scale has definitely also highlighted opportunities for improvement in a process where manual work-arounds with prior volume were not noticeable,” Ruschman said. “Those manual processes can create much larger issues when scaled.”

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