CMS TEAM is coming: Why CIOs must act now on EHR optimization

As someone who has helped health systems implement value-based care technology for over a decade, I can attest to the complexities of EHR optimization efforts, and the long runway needed for maximum success. We’re a little less than a year away from the launch of the Centers for Medicare & Medicaid Services’ (CMS) Transforming Episode Accountability Model (TEAM) and my unequivocal advice to healthcare chief information officers (CIOs) is to immediately start preparing your EHRs for the significant changes on the horizon.   

3 reasons for CMS TEAM urgency  

TEAM represents more than just another CMS program – it's a fundamental shift in how hospitals will be reimbursed for surgical care. With approximately 15% of Medicare revenue at risk, the stakes are too high for delayed action. Here's why CIOs need to start their EHR optimization now: 

Complex integration requirements

TEAM demands seamless data flow across the entire episode of care. This means your EHR must effectively integrate the following: 

• Pre-operative risk assessment and planning tools 

• Surgical documentation and order sets 

• Post-acute care coordination systems 

• Quality measurement and reporting capabilities 

• Financial tracking and reconciliation tools 

These integrations take time to design, test, and implement properly, and require leadership and collaboration from hospitals and health systems, clinicians, care managers and coordinators, quality and compliance leaders, and revenue cycle leaders. Waiting to begin this work puts your organization at significant risk. 

Critical workflow redesigns

TEAM success requires fundamental changes to clinical and operational workflows. Your EHR must support: 

• Standardized care pathways for each of the five surgical episode categories: lower extremity joint replacement, surgical femur and fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedure 

• Risk stratification and patient monitoring 

• Care coordination across settings 

• Quality measure capture and reporting 

• Cost tracking and analysis 

These workflow changes must be carefully designed, tested with end users, and refined through multiple iterations. This isn't a three-month project – it's a sustained transformation effort. 

Significant data infrastructure needs

Ensuring compliance with the TEAM program, and thus its overall success, hinges on robust data analytics capabilities. You'll need: 

• Real-time cost and quality dashboards 

• Risk adjustment factor capture 

• Post-acute care utilization tracking 

• Provider performance analytics 

• Financial reconciliation tools 

Building this data infrastructure requires significant planning, development, and validation time. Starting now gives you the runway needed to get it right. 

Priority actions for CIOs 

Here's what you should do now to prepare:  

• Assessment and planning
  
  • Inventory current EMR capabilities against TEAM requirements
  • Identify gaps in functionality and integration
  • Develop a comprehensive roadmap for EMR optimization
  • Establish governance structure for TEAM technology initiatives

• Early implementation priorities
  • Begin standardizing surgical documentation templates
  • Implement pre-operative risk assessment tools
  • Develop care coordination workflows
  • Build quality measure capabilities
  • Design episode cost-tracking mechanisms

• Data strategy development
  
  • Assess current analytics capabilities
  • Plan for enhanced data integration needs
  • Design performance dashboards
  • Develop reporting frameworks

Common EHR optimization pitfalls to avoid 

1. Underestimating complexity: TEAM isn't just about surgery – it's about managing care across a 30-day episode. Your EHR needs to support this extended care period effectively. 
2. Focusing only on technology: While EHR tools are crucial, success requires alignment with clinical and operational workflows. Engage stakeholders early and often. 
3. Neglecting change management: New tools require new ways of working. Build in time for training, adaptation, and workflow refinement. A commitment to change management becomes especially important as you address the continuum of care, not just a single department or practice. 
4. Insufficient testing: Rush implementations often lead to poor adoption and suboptimal results. Give yourself time for thorough testing and refinement. 

The cost of delay 

Waiting to begin EHR optimization for TEAM creates several risks: 

1. Financial risk: Inadequate systems could lead to poor performance and significant financial penalties under TEAM. 
2. Operational disruption: Rush implementations close to the go-live date can create chaos and resistance from end users. 
3. Missed opportunities: Early preparation allows you to identify and capitalize on improvement opportunities before they impact performance. 
4. Competitive disadvantage: Organizations that prepare early will not only avoid risks, but also have a significant advantage in managing TEAM episodes effectively, positioning them as leaders in the evolving healthcare landscape. 

Next steps for CIOs

Start by forming a TEAM steering committee that includes: 

• Clinical leadership 

• IT team members 

• Quality improvement staff 

• Financial representatives 

• Operational leaders 

This group should begin meeting regularly to: 

1. Assess current state capabilities and related technology tools (EHR and others). 
2. Identify priority gaps. 
3. Develop implementation timelines. 
4. Allocate resources. 
5. Monitor progress. 

Conclusion 

With less than a year left before TEAM implementation, the urgent need to prepare now can’t be overstated.  

Organizations that thrive under TEAM will use this preparation period effectively to build comprehensive, well-tested systems that support efficient care delivery across the entire episode of care. Don't wait – the time to act is now. 

Need help preparing your organization for TEAM? Contact Nordic today to discuss comprehensive strategies with one of our talented consultants.