Weaving Zoom into workflow and updating EHR saves clinic during COVID-19

As a result of a rapid response plan, COPE Community Services continued to deliver healthcare at a pre-pandemic rate, and patients were seen with little disruption.
By Bill Siwicki
11:06 AM
COPE Community Services, Tucson, Arizona

COPE Community Services in Tucson, Arizona.

At the onset of COVID-19, COPE Community Services, a Tucson, Arizona-based nonprofit behavioral and physical healthcare organization serving more than 15,000 clients in Pima County, was unprepared to have its staff work remotely.


COPE needed to react quickly to the sudden change in the healthcare service delivery model and minimize any negative impact from these changes. Medicaid instituted new guidelines and procedure codes to address this new reality, but the turnaround time to implement these changes was very short.

These obstacles had the potential to negatively affect COPE’s service delivery and balance sheet, so they needed to be addressed immediately. What COPE was experiencing had become a common setback with sobering consequences.

In April 2020, the National Council for Behavioral Health discovered through its survey of 880 U.S. healthcare organizations that nearly two-thirds of respondents reported being unable to survive for longer than three months under COVID-19 conditions. Additionally, almost half of all behavioral healthcare organizations already had cut staff.

Because the prognosis was so grim, COPE knew it needed to act fast to minimize damage to the organization.


To keep staff operational, meet remotely with patients and maintain the functionality of the organization, COPE turned to Health Information Management Systems (HiMS, no relation to HIMSS, parent company of Healthcare IT News) for a rapid-response solution that included both hardware and software implementation.

COPE CEO Rod Cook met with Khalid Al-Maskari, the CEO of HiMS, to create an add-on to COPE’s existing business continuity plan. As a longtime client of HiMS, COPE knew it could rely on the company to deliver the right solution to its 450 staff members and 15,000 patients, Cook said.

"The value of disaster-preparedness, coupled with and an in-depth business continuity plan, should not be understated for integrated healthcare organizations."

Rod Cook, COPE Community Services

Together, they developed a plan to address three areas: remote workforce, revenue cycle management continuity and a new telemedicine solution. To deliver a solution on such a tight turnaround would be difficult, Cook said, but COPE and HiMS knew that moving quickly would be the difference between struggling and thriving during a time of crisis.

“Instead of having COPE use desktop computers, HiMS suggested laptops and VPN access to see patients at home,” Cook explained. “HiMS had a few laptops in stock, but the company needed to purchase 50 laptops to meet COPE’s needs. During a time when supply chains were disrupted, HiMS leveraged its close relationship with one of its vendors.

“In just three days, the company had 50 laptops delivered to COPE,” he added. “Because HiMS already had the software in place to make device deployment easy, it took just three days total for shipping, inventory, software downloads, creating VPN access and deploying to staff.”


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First, HiMS’s AXiOM EHR software needed to be updated with the latest HCPCS codes for certain COVID-19 diagnostic tests, as well as CPT codes for testing purposes.

COPE also needed a way to bill for services that weren’t provided via telehealth. Because AXiOM is entirely cloud-based, it was able to update COPE’s code modifiers remotely without issue, Cook said.

“Within two days, AXiOM was updated with the codes that met state and federal requirements, and it was configured to easily work for remote staff without placing the burden of setup, connection and configuration on clinical teams,” Cook noted. “Zoom was then integrated into the software platform, allowing patients and clinicians to communicate with very little disruption.”

HiMS’ IT department also conducted Zoom tutorials with clinicians to eliminate any possible learning curves, in addition to implementing additional security protocols to prevent Zoom hacking, he added.

“COPE also benefited from its longstanding partnership with HiMS,” Cook said. “The clinics’ use of all of HiMS’ services made its transition to a virtual care model significantly faster than it would’ve been using multiple technology providers. The reason for this is HiMS’ prioritization of interoperability.”

Through AXiOM, all of COPE’s technologies, including telehealth and revenue cycle management (RCM), can communicate with each other. When a telehealth appointment ends, AXiOM enables COPE to collect that patient data and bill automatically without the risk of human error. This feature allowed COPE not to experience a revenue decrease during the pandemic, Cook noted.

“HiMS also created a new website to accept online enrollments for COPE,” he said. “This solution ensured continuity and helped alleviate the pandemic-related stress staff members were experiencing. Because AXiOM made it easy to connect, clinical teams were able to focus on quality of care.”


As a result of the rapid response plan, services continued to be provided at a pre-pandemic rate, and patients were seen with little disruption, Cook reported.

“The online enrollment website also helped many clients connect directly with COPE for intake and evaluation,” he said. “COPE even experienced a greater influx of clients in 2020 than it had before COVID-19. Due to increased enrollment levels, COPE maintained a favorable financial position when several others were hemorrhaging patients and closing their doors.”

Another success metric was the lack of learning curve for COPE’s staff, he added. All staff members had complete access to their files at home through VPN access, and no data was lost in the migration. Having e-mail, Zoom and everything else preconfigured alleviated the transition burden.

The only true difference from an IT perspective was the use of laptops instead of desktops. Everything clinical staff had pre-pandemic was seamlessly transitioned from their in-person desktop to their work-from-home laptops.


“The value of disaster-preparedness, coupled with an in-depth business continuity plan, should not be understated for integrated healthcare organizations,” Cook advised. “Organizations should also look for an EHR that keeps the focus on its customers and understands the value of putting patients first. For those considering newer EHRs or other health-tech solutions for remote treatment and billing, interoperability should be a key consideration.”

Data silos from incompatible software solutions can lead to major issues down the line, including data loss, slower revenue cycles and patient mismanagement, he added.

“When providers choose solutions that are both interoperable with existing systems and user friendly for their staff, clinical team members can access relevant data from any of its systems without compromising accuracy,” he said.

“In addition, administrators or clinical team members only need to input data once, making it easier for staff to communicate with each other and with their patients. Interoperable systems with artificial intelligence can also ensure billing codes are entered properly, which helps to reduce the rate of claims denials.”

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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