APP Key Messages | Oct. 28, 2021

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Oct. 28, 2021

In this issue

COVID-19 boosters and pediatric update
Flu shot deadline extended
Medicare and marketplace open enrollment
Epic Connect Program
CI Program Waiver

Booster update: Last week, the FDA and CDC expanded booster eligibility to allow for a single booster dose of the Moderna and Johnson & Johnson COVID-19 vaccines for certain individuals as well as the mix and matching of booster doses. We are working to have scheduling in place soon to allow eligible patients and team members to schedule Moderna and Johnson & Johnson boosters, while ensuring accuracy and safety in scheduling and administering as well as proper systems for documentation and billing. Currently, Advocate Aurora Health is administering booster doses of the Pfizer vaccine to eligible individuals who have received an mRNA series or the Johnson and Johnson vaccine. In addition, we continue to administer third doses of the mRNA vaccines to patients who meet the CDC's criteria for moderately and severely immunocompromised. Eligible patients and team members can schedule Pfizer boosters at Advocate Aurora’s patient vaccine clinic locations across Illinois and Wisconsin via the LiveWell app, at aah.org or by calling 866-443-2584.

COVID-19 pediatric vaccine update: This week, the FDA's advisory committee recommended a smaller dose of Pfizer's COVID-19 vaccine for children ages 5-11 for emergency use authorization. The FDA is expected to rule on this recommendation in the coming days, and next week, advisers to the CDC are meeting to weigh in on vaccines for this age group. We anticipate final approval from the FDA and CDC in early November and are quickly finalizing our plans so we can begin vaccinating this pediatric age group following their recommendations.

Asymptomatic testing update: On Nov. 1, we’re shifting to a scheduled model for asymptomatic COVID-19 testing in our immediate/urgent care centers and Walgreens clinics to better manage patient volumes and make it easier for those without symptoms to get a PCR test for travel, return to school/work or other needs. We’re promoting the LiveWell app and website as the primary tool for easy scheduling and the quickest way to get test results within 24-48 hours. Those with language or technology barriers may call the COVID-19 hotline to schedule. Patients with symptoms may continue to seek testing by first being evaluated via a Quick Care video visit, their PCP, scheduling at a Walgreens clinic or walking in to an immediate/urgent care center.

DEADLINE EXTENDED: Flu vaccine deadline now through Nov. 5. All APP aligned physicians on staff at Advocate Aurora Health hospitals are required to get a flu shot by Nov. 5. Flu shot clinics are now open at Advocate hospitals: View locations and schedule. If you receive your flu shot at any location outside of the team member flu shot clinics (including Advocate Medical Group offices, Advocate Clinics at Walgreens or Advocate immediate care centers) you MUST submit a verification form. If you receive the flu shot from a flu champion at an Advocate hospital site where you practice, the form is NOT required.

Open Enrollment Season

Medicare annual enrollment: Underway until Dec. 7, this is a time for eligible individuals to join or change Medicare coverage. View more information, including our partnership with Devoted Health to offer a Medicare Advantage (MA) HMO plan. We also remain in network with other major MA plans in Illinois. Learn more about MA.

Health insurance marketplace: On Nov.1, the marketplace opens for individuals and families to purchase health insurance coverage. View this guide for information, including our partnership with BCBS of Illinois to offer BlueCare Direct. Links are provided to see all plans including our network.

Clinical Integration Program

Program waiver

Due to the COVID-19 public health emergency, significant program changes and data collection issues:

We are waiving the minimum CI thresholds of 65% (board-certified physicians) and 70% (for those without board-certification). This means that all participating physicians will be incentive eligible, and none will be placed on probation or terminated from APP regardless of CI score for the 2021 performance year.

Physicians are not required to complete the CI-1 and CRA courses to maintain APP membership. However, you are highly encouraged to take these courses to obtain the CI credit and earn the associated dollars for completion. Note: The waiver does not apply to the Compliance training module as this a CMS, plan and APP membership requirement.

Additional CI updates

Performance: We continue to have significant opportunity for improvement with nine core adult measures that are more heavily weighted in the CI program, are reported on a rolling year basis and align with measures in most value-based agreements. View latest results and what you can do:
Access your CI scorecard to see if you are doing well or need to improve.
Consider your office workflows. Do they include evaluation and discussion of these care needs – with every patient, at every visit?
Engage patients who have care needs/gaps who are not scheduled for visits yet this year. Share safety measures your office has in place – or the option for a virtual visit.

Checklist: View the "End of Year" checklist for the five things you need to do.

Latest program update: View here.

Critical blood components shortages

Physicians can expect intermittent and chronic shortages of blood products for the rest of the year in Illinois, and likely into 2022. The American Red Cross anticipates these shortages will sometimes be severe and may limit their ability to meet adequate blood supplies. Read more.

Epic Transformation

Epic Connect update

Timeline: Our first six practices are now live. Our next five practices will go live in December followed by larger waves. Wave 1 practices have been notified and all other eligible practices will be notified on wave selection in the coming months.

Wave 1: Go Live April 2022
Wave 2: Go Live October 2022
Wave 3: Go Live April 2023
Wave 4: Go Live October 2023
Future waves to be determined if needed.

Learnings: We know learning and implementing new processes and technology can be challenging. We launched the program with small pilots to learn what works well and what can be improved before the larger waves. Despite expected hiccups in the road, implementing this platform has tremendous potential for our APP practices. Changes based on feedback from our first Go Live:

Adjustments to the Operational Assessment to capture more practice information prior to Go Live
Improvements to Operational Readiness meetings to focus on key changes; developed “workflow walkthrough” videos
Scheduling kick-off meetings with each practice’s IT vendor to be deliberate about the asks and timelines critical for success
Engage multiple teams to focus on billing and faxing workflow efficiencies

Additional Advocate Aurora Epic updates

Epic upgrade on track for Nov. 17: Please see this overview for additional safety and efficiency enhancements slated for this upgrade. Clinical end user education begins early November.

Daylight saving time in Epic: The fall daylight savings time event will occur Sunday, Nov. 7. This will be the first time the Epic platform will not be taken down during the daylight savings time transition period. The repetition of the 1 a.m. hour during fall daylight saving time can result in unique situations that Epic users accessing the system during that time should be prepared to manage. Education regarding impacted workflows can be found on Learning Home Dashboard. Epic end users should review these materials prior to Nov. 7. Read more.

Error message in Epic: Some users have been getting an error message when launching Epic. This is most likely to occur when end users forget to close Epic and/or log out of the computer before logging in to a different computer and trying to launch Epic. To prevent this, close Epic and log out before logging into another computer. See huddle sheet for more information.

Advance Care Planning

New Epic tools

Concurrent with the Epic upgrade on Nov. 17, new advance care planning (ACP) tools will go live. The Epic ACP Foundation tool set supports a team-based approach to ensure we have accurate documentation our patients’ goals, values and treatment preferences when the need for this information arises.

Key things to know:

The Advance Directives activity will be updated and called Advance Care Planning (ACP). You will continue to access the ACP activity from the patient storyboard and use this as a one-stop show for all ACP tools.
Tools include:
Simplified story board to reflect availability of ACP documentation
Inpatient triggers to case management / social work / Mission and Spiritual Care indicating patient desire to record ACP decisions
ACP Note type and .acpgoc smart text (currently available) for ACP documentation
Training on tools and workflows will be available on Nov. 1 in the Epic Learning Home Dashboards.

Code Status Policy

Work is underway on a new Advocate Aurora Health policy for discussing, entering, documenting, communicating and reviewing Code status orders to ensure we have a safe, consistent approach across Illinois and Wisconsin, and across the care continuum - planned to go live in early 2022. Register for the following webinars on Nov. 16 (Outpatient) & Nov. 17 (Inpatient). Sessions will also be recorded for on-demand viewing.

Supporting Your Practice

New Advocate Memory Center Program: A new Population Health Cognitive Impairment Search Program is available for the early identification of patients to allow quicker access to comprehensive assessment, treatment and support. The program leverages natural language processing to search medical records for indicators of cognitive impairment. Learn more and view Advocate Memory Center sell sheet.

Medication adherence tips: To improve medication adherence for patients with chronic conditions, please use these strategies when prescribing medications: 90-day supply / 1 year of refills / Mail order/auto-refill / Assess refills at every patient interaction. View results of recent outreach to understand barriers to our patients taking their medications as prescribed.

Universal Protocol Policy and Epic workflow now effective: The Universal Protocol Policy, which provides procedures to ensure patient safety, is now available at Advocate Aurora Health sites along with the workflow in Epic to support it. If you have a role in surgical service areas or are involved in invasive procedures, regardless of the location the procedures are performed, view these items: Educational material | Just in time resource | Checklist. In Epic, navigate to Learning Home “Tip Sheets and Updates” to find more materials.

Please “Read more” for additional important updates:

Population health patient outreach

Continuing Medical Education

National Acute Care for Elders Conference (ACE)

Friday, Nov. 5 | 9 a.m. – noon

The National Acute Care for Elders (ACE) Virtual Conference focuses on implementing best-practice models of care in our own communities and draws national attention towards the efforts to improve care for vulnerable, older adults. View speakers, schedule and topics.