Patagonia Health: Adapt & Innovate, At Speed

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Patagonia Health: Adapt & Innovate, At Speed

“As a company, and as a country, we are vaccinating millions of people quickly. It is fascinating to see how people nationwide are contributing to fight COVID-19 to get us back to normal. There is no playbook thus, as a nation, it is all hands on deck,” Ashok Mathur, Founder & CEO, Patagonia Health.

COVID-19 has taken a toll on countless industries, and health care providers have not been spared from the impact. Communities and medical centers nationwide have had to adapt and innovate efficiently to remain competitive. This past year has shown us the importance of being agile, not only in life, but also in work. In order to properly treat America, manufacturers of the COVID-19 virus are learning to use their resources best by innovating the vaccine process; manufacturing at larger scales, delivering shipments more efficiently, and working through clinics to reach communities. 

Vaccine Innovation, posthaste: Due to the novel nature of the virus, the necessity to produce a quality vaccine quickly could not be deterred. To get our communities back to normal, we needed a vaccine, fast. Many pharmaceutical companies stepped up their manufacturing; they received funding and government relief to produce the vaccine at record times using the same safeguards and checking processes required of other vaccines. Although skepticism is understandable, we can rest in the fact that all proper safety measures are being taken in the development of the vaccines. 

Manufacturing, at scale: Getting the vaccines approved was only half the battle; now the challenges moved to the manufacturing process. Companies are overcoming numerous bottlenecks to manufacture at massive volumes. There is no playbook for such massive production at the scale necessary. Currently, international drug manufacturing companies are teaming up with US manufacturers to ease the production of the vaccine. In addition to the struggle of producing billions of doses, corporations are endeavoring to find new staff for assembly lines. Due to the increased demand for assembly lines to produce larger masses, manufacturers are needing greater amounts of assembly workers educated on the assembly of medical resources. Another major obstacle for vaccine distribution is the weather. With production at an all time high in the winter months; ice, snow, and polar storms are major problems when moving supplies through the north and the Midwest. With mass amounts of doses, comes quite a few large obstacles; however, with monetary allocations from the CDC, healthcare companies are actively finding solutions.

Vaccines Delivery, in droves: As vaccines are being manufactured at record levels, challenges with delivery and predictability emerge. When distribution started in late December 2020, FedEx was one of the first companies to aid in shipping. Being the world’s largest express transportation service, it is only natural for FedEx to step into this role. FedEx is delivering shipments of vaccines as well as committing $4 million in the effort to reach under-served communities in these nations. In addition to FedEx, the US National Guard is stepping up their game in the coronavirus relief effort. The National Guard is aiding the delivery of vaccines using their resources to transport shipments to healthcare workers and state personnel. Due to the contribution of transportation services, the delivery is being expedited and can be efficiently dispersed throughout the nation.

Vaccination by clinics, en masse: Our county health departments and other healthcare agencies are dealing with a myriad of challenges to scale up vaccinations. Staff is being reallocated and seasonal employees are being hired to meet the demand for contact tracing and vaccination at clinics. There is no playbook, and it is all hands on deck. With the need for medical staff at an all time high in 2020, facilities are moving towards telehealth services including use of electronic health records and coronavirus screening software. Automated medical help eliminates the need for essential health care workers and allows patients to organize their medical data and learn to diagnose their symptoms and contact using screening software. With software acting as the primary initial contact for those needing care, health care workers can further analyze requests and determine who is the most jeopardized and who needs immediate care. Medical professionals are also utilizing technology to communicate with patients who have the resources to connect for virtual appointments. This allows time and effort to be allocated properly to those who do not have the capability to connect and communicate with doctors online. Clinics are using software to its full capacity to schedule and treat patients with the vaccine through drive-in testing and administration.

Patagonia Health Responsiveness, at speed: To fight the pandemic, Patagonia Health’s R&D team innovated and collaborated with its customers to develop many resources to aid in the response to COVID-19, including an all new Mass Vaccination App, in a record time. Against the clock, we methodically designed, tested every scenario and rolled out this new feature in phases. While we too experienced the COVID-19 challenges, our rapid deployment enables us to meet the needs of our customers and their ever-changing workflows/needs. There is no playbook. “We have very smart people and it is great to see our staff jumping in, adapting and innovating”said Ashok Mathur, CEO, Patagonia Health. It’s all hands on deck. Adapting and Innovating continue.  “We can not rest until we do our part to fight this public health pandemic. Public Health agencies (and their communities) need us and we have been ready.  I am glad that we have an opportunity to serve” stated Mathur. 

CDC Beefs up on COVID-19 Reimbursement

The CDC and NCHS are making great strides to fund the relief effort of COVID-19. With vaccine distribution at an all time high, clinics across America are searching for ways to provide care to communities through doses, screenings, and hospital care.

With the ongoing pandemic, clinicians across the United States are in need of assistance to continue to provide care to communities. With resources stretched thin, medical practitioners require reimbursement if they are to continue aiding the public. Thankfully, in early February 2021, the Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics (NCHS) teamed together to announce their plans for relief funding for health care clinics across the United States. Starting with a new release of ICD codes and requirements for reimbursement, the CDC is making rapid steps towards aiding the relief effort in Spring 2021.

Throughout 2020, the CDC has released ICD codes for monitoring the novel coronavirus as it spreads throughout the United States. These codes detail how hospitals, private practitioners, and the public can safely protect against the virus and handle the development of the pandemic. January 1, 2021 saw a new release of these ICD regulations. The CDC and the NCHS have implemented new codes for the classification COVID-19, screening techniques, indirect and direct contact, history with the virus, and effects of the virus on pneumonia, connective tissues, and multisystem inflammatory syndrome. The new codes and classification of the virus help healthcare centers to properly treat and diagnose COVID-19 cases as they come.

With updates on the codes to be published in the near future, many healthcare providers and hospitals are anticipating how this development will affect them. A crucial resource for practitioners has been the CDC guidelines. These guidelines have proved useful in delineating treatment, screening, and disbursement in 2020 and 2019. Treating a great volume of COVID-19 patients has been a great burden for healthcare providers across the nation. In addition to treatment, clinics now face the monumental task of vaccine distribution in the following months. 

The CDC and NCHS are making great strides to fund the relief effort of the virus, as the vaccine is being progressively administered across the country.  Having an electronic health record solution that encompasses all the current codes, COVID-19 screening, and mass vaccination functionality can amplify the success of the response to the virus for treatment and vaccinations.

Patagonia Health Provides Tools to Public Health Departments for Successful Mass Vaccination Initiatives

Patagonia Health’s fully-integrated Mass Vaccination App. efficiently manages the administration, tracking, and reporting of the COVID-19 vaccine.

To manage the distribution of the COVID-19 vaccine, health departments across the country need to efficiently manage vaccine administration, tracking, and reporting on a large scale. In response to the current environment, Patagonia Health launched a fully-integrated Mass Vaccination App. This secure, HIPAA-compliant solution allows patients to self-register for and self-schedule their vaccination appointment.  Patients are also able to view their consents, while clinicians are able to conduct and document mass vaccination (including off-site) visits directly within the EHR. 

As an expert in Public Health software, Patagonia Health already has the capabilities of vaccine inventory management and administration, including seamlessly sending vaccination data to state immunization registries. Making vaccination data available at the state, and thus national, level is key to effective pandemic response. Patagonia Health’s development team expanded these tools to include patient pre-registration and the ability to manage mass vaccination patients separately from a health department’s regular schedule. Additionally, the app will track multiple COVID vaccine doses based on manufacturer and Center of Disease Control and Prevention (CDC). 

“Many of our customers are in the middle of the largest mass vaccination campaign they have ever performed,” says Ashok Mathur, Founder and CEO, Patagonia Health. “Working with our customers, our team immediately began the process of developing a Mass Vaccination App to meet the demand for the management, delivery and administration of vaccination services at an unprecedented level. Public health department’s staff are stretched due to the pandemic response and they appreciate the time and effort saved by the app. We are proud to contribute to the COVID-19 solution.”

Patagonia Health developed the Mass Vaccination App as an important part of their overall COVID-19 response. To support their customers, the software company rapidly deployed a COVID-19 screening tool and a fully-integrated telehealth solution earlier this year. Patagonia Health aims to provide rapid responses to meet customer needs, especially when faced with unexpected public health challenges.

Telehealth Part 2: New Rules and Regulations from CMS

Telehealth: New Rules from CMS and Resources

During these unprecedented times, many adjustments are put into action to accommodate the new normal of social distancing. As previously discussed in our New Rules for Telehealth Technology blog post, the COVID-19 pandemic is causing a large spike in virtual healthcare visits. In these times of rapid change, normal rules and regulations are relaxed to increase accessible care. The Centers for Medicare & Medicaid Services (CMS) recently adjusted its policies so more practitioners can use telehealth during the COVID-19 outbreak. 

How CMS is Responding to COVID-19

Public health emergencies, such as the COVID-19 pandemic, require the U.S. healthcare system work quickly to make sure people are receiving necessary care. As the largest health insurer in the nation, CMS plays a critical role in enforcing new safety and billing guidance during these uncertain times. CMS has implemented temporary changes during our country’s state of emergency. Here is a quick summary of the timeline so far:

Timeline: 

March 13 – The United States declares COVID-19 as a national emergency. CMS publishes an initial emergency declaration fact sheet for healthcare providers.

March 17 – CMS announces an expansion of telehealth services covered for Medicare beneficiaries. CMS also approves the first state request for 1135 Medicaid waiver in Florida.

March 27 – 34 states officially approved for a Medicaid waiver under Section 1135 (see the CMS Newsroom for updated numbers).

March 30 – 80 additional telehealth services added under Medicare coverage.1  

These dates are only a few noteworthy occasions of the many changes made in the past month by our country. CMS reports that Medicaid waiver requests are being approved in historic turnaround times. Fulfilling waiver requests quickly grants states ample flexibility to serve individuals on Medicaid, who are often underserved in communities. CMS reports, “Other types of Medicaid waivers can require months of negotiation, but in light of the urgent and evolving needs of states during COVID-19 CMS developed a streamlined template for facilitate expedited application and approval of Medicaid 1135 waivers.”2  

What does a Section 1135 waiver mean?

The Medicaid-specific waivers approved to many states are under Section 1135 of the Social Security Act. These waivers specifically provide the healthcare system greater flexibility for providing care to individuals. Some of the temporary flexibilities include:

  • Waiving requirements in the authorization for fee-for-service program
  • Out-of-state providers can provide care to another state’s Medicaid population if they have been impacted by the national emergency
  • Waiving requirements that providers be licensed in the specific state they are providing care in (as long as they have equivalent licensure in another state)
  • Suspending requirements relating to pre-admission or annual screenings (specific to nursing homes)

CMS changes are evolving each day. It is important now more than ever to stay up to date with the facts. Regulations differ on a state and local level. As always, follow the guidance of your local health authorities. For further details on the Section 1135 waivers (specific to state Medicaid), please visit Medicaid.gov or trust reliable news sources, such as the CMS Newsroom. Furthermore, CMS is regularly updating this webpage to keep beneficiaries and healthcare professionals up to date.

Further Expansion for Telehealth

Telehealth is continually seeing an expansion during the COVID-19 pandemic. CMS is now allowing 80 additional services to be provided through telehealth, specifically for Medicare patients. Covered healthcare professionals may use any non-public facing product, such as FaceTime, Skype and Facebook Messenger to provide telehealth during this public health emergency. Penalties won’t be imposed on covered providers who have not entered into a HIPAA BAA with these vendors.

Billing has also been adjusted, allowing healthcare professionals to bill telehealth visits at the same rate as in-person visits. New and existing patients can now be at home while receiving various forms of healthcare.

As always, see CMS.gov for more information on the temporary regulatory changes and other changes that might be implemented. 

Patagonia Health is Here for You

There is so much information out there about COVID-19. Patagonia Health is here for you as a resource. We are regularly updating resource pages to specifically help you sift through the noise. 

State-Specific Telehealth Coding and Billing Cheat Sheets and other Educational Resources

COVID-19 Resources for Public & Behavioral Health

As a trusted Public and Behavioral Health EHR, practice management, and billing solution, we understand the importance of combating the ongoing pandemic of COVID-19. Our team is currently collaborating with customers to develop a fully integrated telehealth solution. If we can be a service or resource for you, please contact us today. 

References:

1 https://www.beckershospitalreview.com/telehealth/cms-adds-85-more-medicare-services-covered-under-telehealth.html

2 https://www.cms.gov/newsroom/press-releases/trump-administration-approves-34th-state-request-medicaid-emergency-waivers

Additional Resources:

The National Council’s COVID-19 Resources

CMS Emergency Information on COVID-19

Medicare Telemedicine Health Care Fact Sheet

Historic Expansion of Telehealth Announcement from HHS

Why Health Information Exchange is Important for EHR Use

Health Information Exchange is Important for EHR Use

Electronic Health Records (EHRs) are an integral part of today’s healthcare system. Despite initial hesitation to switch to an EHR, an overwhelming majority of organizations that have made the change cannot imagine going back to paper. EHRs improve efficiency and increase reimbursements while improving patient care. As providers become more fluent with the technology, EHRs help them with decision making and influence the way a client is treated. Additionally, EHRs enable connectivity, or to use the current buzzword, interoperability.

Interoperability refers to health information technology that enables electronic health information to be easily exchanged. It lets authorized professionals access, exchange and use the health information. In our journey to transform healthcare, Health Information Exchanges (HIEs) have been established. Connecting an EHR to an HIE allows health information to flow seamlessly to the right people at the right place at the right time.

What is an HIE?

But what exactly is an HIE? Historically, when a patient visited a healthcare facility, the provider had two paths to understand the medical history of the patient:

  • Check the facility’s own EHR system for prior visit information, such as allergies, medications, procedures, etc.
  • Ask the patient to fill in any missing information not already documented.

As you know, there are several problems with this process. Not only do patients rarely remember information from prior visits, but they are seen in multiple facilities using various EHR systems, as well. Also, consider a patient who comes into the ER and is unresponsive. How would a provider find out about his or her missing information?

A Health Information Exchange addresses this issue. An HIE is a secure central repository of patient data aggregated across multiple facilities and EHR systems in the same region. The goal is to provide a holistic view of the patient’s electronic health record through a secure, standardized system. EHRs connected to an HIE can share information via the federally defined standards of CCR (Continuity of Care Record) and CCD (Continuity of Care Document). This is the standard all federally-certified EHRs must follow.

Any federally-certified EHR connected to an HIE can (if permitted) send and/or receive information between the EHR and the HIE. Thus, the provider can send and receive electronic information with any community provider also connected to the HIE.

Benefits of Health Information Exchange

Benefits of Using an EHR for Health Information Exchange

Using an HIE streamlines information and connects a practitioner to all aspects of a client’s medical history. Practitioners can receive health information from the HIE, such as a patient discharge summary from a community hospital. This information can be brought into a patient’s chart as electronic health data after it has been reviewed. Using an HIE helps facilitate coordinated patient care, enabling an organization to:

  • Save time by minimizing readmissions
  • Increase efficiency by moving away from paper and fax machines
  • Save money by avoiding duplicate testing
  • Provide clinical decision support tools to improve care and treatment
  • Minimize medication and medical errors
  • Engage consumers about their own personal health information
  • Improve healthcare quality and outcomes.

HIEs reduce the amount of time patients spend completing paperwork and briefing their providers on their medical history. This frees up more time for discussions about health concerns and treatments between the patient and provider. By saving time for patients and providers along the continuum of healthcare delivery, HIEs have the potential to both reduce costs and improve health outcomes.

Health Information Exchange Challenges

The push for nationwide interoperability and improved health data exchange have increased HIE and EHR use. In some cases, organizations have been mandated to make the adoption. But, that doesn’t mean HIE connectivity doesn’t come without challenges.

HIE and Data Security

One of the biggest concerns with HIEs is ensuring health data privacy and security are maintained throughout the entire data exchange process. Participating organizations must follow all federal and state requirements related to data security, but they still need to allow information to be exchanged freely for patient care. While information exchange between EHR systems and HIEs is HIPAA compliant, the growing number of cybersecurity attacks have piqued concern about health data security.

A 2017 Black Book survey confirmed these fears extend to patients. Patients surveyed were nervous their digital health information might be shared beyond their physician and hospital. Furthermore, they are not confident their physician will be able to keep their personal information secure. 69% felt their primary care physician “does not demonstrate enough technology prowess” to reassure them that their data is safe.

Physician Burnout

Another major challenge HIE connectivity brings to the forefront is information overload. Physicians are already experiencing burnout. Providers are further burdened with copious amounts of data flooding them, which can lead to less effective care.

While the Patients Over Paperwork initiative is promising to reduce administrative burden and physician burnout, it doesn’t fully account for the volume of data providers will be faced with.

Many providers have lamented that their EHR system is not built with an easy to use clinical workflow. Adding another step to incorporate data from an HIE is just that – another step.

Regardless of the challenges, EHRs and HIEs aren’t going away. They are a major part of the digitization of healthcare and the shift toward value based care. Learning to utilize these tools effectively will help your organization provide more streamlined, effective patient care. And, of course, we recommend working with an EHR vendor who will help you navigate this process with training, support and best practices!

https://www.healthit.gov/faq/what-are-benefits-health-information-exchange

https://ehrintelligence.com/news/what-are-potential-benefits-challenges-of-hie-use

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