Implementation of Synchronous/Asynchronous Interprofessional Internet Consultations in a U.S. Hospital-based Wound Clinic, Leveraging a Wound Care Specific Telemedicine Solution

Abstract Body: Background:  As wound care moves toward more comprehensive patient-centered care management, frequent consultation with multiple specialists is necessary. For patients, this often means separate visits that are costly/inconvenient. Interprofessional internet consultations (IICs) between treating practitioners and consulting specialists provide convenient and cost-effective alternatives.(1) In 2019, the Centers for Medicare and Medicaid Services (CMS) approved payments for 6 IICs CPT codes (99446-49/99451/99452).(1) However, to benefit from IICs, wound clinics need to overcome reimbursement complexities and/or burdensome technological requirements.(2) We aimed to implement IICs in a hospital-based wound clinic (HBWC) leveraging an easy-to-use, wound care-specific telemedicine software. Methods:  Using the Design Thinking methodology(3), the software* was developed as a module within a clinical/reimbursement decision support web-application** for wound care/hyperbaric clinicians: •Clinicians’ needs and CMS guidelines/requirements were identified •Module was developed with robust programming language_/library_/framework_ •Module was implemented at a HBWC: •Use cases were prioritized; workflows were designed •Wound care-specific documentation templates of the module were reproduced within the facility’s EHR to ensure workflow integration •Facility chargemaster was updated •Implementation playbook was created; billers/providers were trained Results:  The module is a cloud-based, mobile-responsive, HIPAA-compliant solution that allows wound care providers to meet clinical needs/CMS reimbursement requirements for IICs through built-in features/documentation templates. IICs were initially implemented in the wound clinic and the infectious disease department, to document/bill for interdepartmental consultations that already occurred on an informal basis. The EHR-agnostic module allowed for seamless workflow integration with the facility’s EHR. IICs enable wound clinicians to accurately diagnose infectious conditions/comorbidities and promptly initiate treatment.Future plans include IIC expansion to other departments (e.g. family medicine) and external services (e.g. post-acute facilities). Conclusions:  IICs were implemented at a HBWC, leveraging an easy-to-use, wound care-specific telemedicine software. Besides improving patient satisfaction, IICs may increase revenue through additional reimbursable services and more accurate ICD-coding.