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ePoster Presentations

EP-104 - Cleveland Clinic's Path to Quality Improvement for Telemedicine Visits

Monday, April 30
9:55 AM - 10:10 AM
Location: Education Zone, Booth 2416, Screen 1

Cleveland Clinic's Path to Quality Improvement for Telemedicine Visits

Ava George, DO; Kari Gali DNP, CNP; Matthew Faiman, MD, MBA, FACP; Mark Rood, MD; Jeffrey Arnovitz MSN, CNP; Andrea Marek, CNP

Background: Telemedicine improves provider access, engages patients and has great potential to improve clinical outcomes. Consequently, numerous health systems adapted telemedicine programs. Despite growth in telemedicine, many centers do not have clinical practice guidelines or quality review processes to support this new technology. The Cleveland Clinic Distance Health team began meeting weekly to create practice guidelines for common ailments seen on our on demand urgent care telemedicine platform "Express Care Online" and in the primary care setting. These guidelines are built using best practices and are internally vetted among subject matter experts to gain consensus. Once approved, the guidelines are shared electronically with all Cleveland Clinic providers via an enterprise wide policy repository. The team is now improving its quality monitoring program by developing practice guidelines for the institution, creating a more efficient chart review process utilizing smart-text and automated data pulls and focusing on performance improvement.

Objective: To standardize and enhance telemedicine process guidelines and the quality review process of telemedicine visits at Cleveland Clinic

Methods: The Distance Health team created templates for common ailments to facilitate standardized documentation. Smart data elements in these templates help with tracking data for quality review purposes. The team is working on an automated data pull from charts based on certain keywords, ICD and NDC codes, and demographics for quality review purposes regardless if a template is used. This automated data pull supports a large number of patient encounters being reviewed and limits what is needed for a manual review. Both the automated and manual review process ensure that either guidelines were followed or that proper clinical decision making documentation is provided in the chart to allow for deviation. Providers are then given feedback for performance improvement if necessary based on the chart audits.

Results: Process guidelines are simplified with the utilization of smart templates. While our analysis is pending, we hypothesize an improvement in quality monitoring and chart review process with the automated and manual data extraction and review.

Conclusion: The Distance Health team recognizes that as we modernize our delivery of care nationwide through newer methods such as telemedicine, an evolving, yet structured quality monitoring program is important in our efforts to deliver superior care.

Learning Objectives:

Ava George

Family Physician
Cleveland Clinic

Ava George D.O. is a family physician at Cleveland Clinic Foundation splitting her time seeing patients for virtual visits and seeing patients in the brick and mortar setting. She completed medical school at Lake Erie College of Osteopathic medicine and her family medicine residency at Cleveland Clinic-Fairview Hospital in 2013.

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