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Chapter Advocacy Roundtable (CAR) Monthly Call
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Pam Varhol CAR Chair New England Chapter
Ma rc h 20, 2020
Chapter Advocacy Roundtable (CAR) Monthly Call Pam Varhol CAR - - PowerPoint PPT Presentation
Chapter Advocacy Roundtable (CAR) Monthly Call Pam Varhol CAR Chair New England Chapter Ma rc h 20, 2020 1 1 Agenda U.S. Federal & State Actions: COVID -19 CAR Round Robin Federal Updates: CMS & ONC Final Rules
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Pam Varhol CAR Chair New England Chapter
Ma rc h 20, 2020
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Round Robin
Cha p te r Ad v o c a c y Ro und ta b le Mo nthly Ca ll
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e you wor king dir e c tly with your sta te to pr
solutions to the
e a k?
e the pr ima r y a r e a s of the COVID-19 r e sponse r e quir ing sta te he a lth IT suppor t?
ma tion would you like to se e on the HIMSS COVID-19 Re sour c e Pa g e ?
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5 Source: World Health Organization
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U.S. Cases of COVID-19: 14,631 Total deaths: 210
Source: https://coronavirus.jhu.edu/map.html As of 3/20/20
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me d c a se s
Sour c e : Wor ld He a lth Or g a niza tion (a s of Ma r c h 19, 2020)
c re stri c ti
ve d fo r all urban and rural are as and the pati e nts ho m e was i nc lude d as an e li g i ble o ri g i nati ng si te
ll no t e nfo rc e any re qui re m e nt fo r an e stabli she d re lati
p, whi c h i s c ri ti c ally i m po rtant, de spi te the statuto ry re qui re m e nt that a pati e nt m ust have a re lati
p wi th the i r pro vi de r wi thi n the last thre e ye ars
he se ne w wai ve rs o n te le he alth se rvi c e s wi ll no t be li m i te d to pati e nts wi th COVI D-19, and i nste ad wi ll bro ade n thi s fle xi bi li ty wi tho ut re g ard to the di ag no si s o f the Me di c are be ne fi c i ary
c are m ust e nsure pro vi de rs are able to use re m o te physi
c al m o ni to ri ng to tre at pati e nts and fre e up valuable re so urc e s fo r ho spi tals to tre at m o st at-ri sk pati e nts
de rs wo rki ng i n F QHCs and RHCs are sti ll no t e li g i ble to pro vi de te le he alth se rvi c e s. T he y c an o nly se rve as di stant si te s, no t o ri g i nati ng . T hi s sho uld be update d to i nc lude the i r e li g i bi li ty.
L ea rn more: https:/ / www.himss.or g / news/ telehea lth-c ovid-19-spotlig ht
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F
up da te s a t https://www.hi mss.org/ ne ws/c o ronavirus
e tar y's T r ansfe r , CDC will:
ha ve b o rne the la rge st b urd e n o f re sp o nse a nd p re p a red ness a c tivitie s to d a te . T his is a n initial a ward fo r tho se jurisd ic tio ns who re q uire immedia te a ssistanc e fo r a c tivitie s suc h a s mo nitoring o f tra vele rs, d a ta ma na ge me nt, la b e q uipme nt, infe c tio n c o ntrol, a nd surge sta ffing. Onc e sup p le me ntal fund ing is p ro vid ed , sup p o rt will b e p ro vid ed to a ll sta te s a nd lo c a l jurisdic tio ns fo r a variety o f c ritic al p ub lic he a lth a c tivitie s.
d an initial $10 million c ooper ative agr e eme nt to state and loc al jur isdic tions to be gin imple me ntation of c or
us sur ve illanc e ac r
ac tivities and othe r sur ve illance syste ms.
T his initial a ward is fo r a limite d numb e r o f jurisdic tions. Onc e sup p le mental fund ing is p ro vide d, a d d itio nal sup p o rt will b e p ro vid e d to a ll sta te s a nd lo c a l jurisdic tio ns to e nha nc ing te sting a nd surveilla nc e.
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a nd ide ntifying mo de l pra c tic e s fo r tre a tme nt
HRA to de te rmine ho w to impro v e o utb re a k ma na g e me nt func tio ning (like e le c tro nic c o nta c t tra c ing ) within c o mme rc ia l a nd CDC G O T S (NE DSS Ba se Syste m) surv e illa nc e syste ms
e a m is mo nito ring the re sp o nse o f this issue o n the g ro und a nd d o c ume nting le sso ns le a rne d a ro und v ita l stra te g ie s
he te a m is le v e ra g ing b ig da ta fo r sc re e ning lo w-risk g ro ups with a po ssib le c o nta c t histo ry a nd is a lso c o nside ring ho w inte rne t b a se d a pps a nd pla tfo rms c a n b e e mplo ye d to de liv e r c o st-e ffe c tiv e o nline sc re e ning a nd c o nsulta tio n to a la rg e r lo w-risk po pula tio n
pre c isio n
he te a m re le a se d a re c e nt a rtic le a b o ut c urre nt e ffo rts using b ig da ta a nd sc re e ning to o ls tha t c a n b e fo und a t https:/ / mp.we ixin.q q .c o m/ s/ N36WQ DJf3Mq hjCWuuHK v 8Q
mo de rniza tio n o f pub lic he a lth da ta surv e illa nc e a nd a na lytic s a t CDC a nd sta te a nd lo c a l le v e l.
xplo re with HIMSS PPC o n the b e st use o f the se funds to a ddre ss imme dia te thre a ts inc luding CO VID-19 a nd tha t suppo rt fo unda tio na l infra struc ture tha t he lps a ll c o nditio ns/ ha za rds? .
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11 COVI D- 19 Data Challe nge Public He alth Data Mode rnization Solution Core Public He alth Data Syste m for I nve stme nt Data on COVI D- 19 c ase s is c olle c te d and transmitte d by pe n and pape r, spre adshe e ts, phone c alls, and e mails; data is ofte n re - ke ye d to re port c ritic al de tails from state s to the CDC; manual e fforts are so time c onsuming data may not be re porte d for days de spite it be ing store d in an e le c tronic syste m
Auto ma te d e le c tr
e inte r
a b le a nd e xc ha nge b e tw e e n sta te he a lth d e p a r tme nts a nd CDC in r e a l-time Na tio na l No tifia b le Dise a se Sur v e illa nc e Syste m
Basic c linic al data of COVI D- 19 patie nts (symptoms, pre gnanc y status, hospitalization, I CU status) store d in e le c tronic he alth re c ords c annot be se amle ssly transmitte d to public he alth de partme nts
Re a l-time , se c ur e , a nd a uto ma te d r e p o r ting fr
he a lth r e c o r d s to p ub lic he a lth d e p a r tme nts; institute a na tio na l sc a le -up Ele c tr
e p o r ting
Patie nts pre se nting with re spiratory illne ss in e me rge nc y de partme nts are not flagge d to public he alth as pote ntial c ase s, c luste rs or outbre aks as 30% of e me rge nc y de partme nts don’t submit any data; urge nt c are data is almost e ntire ly abse nt
Pr e d ic tiv e a na lytic s a nd a r tific ia l inte llige nc e p r
ly d e te c tio n a nd c o ntinuo us mo nito r ing fo r p o te ntia l o utb r e a ks Synd r
v e illa nc e
Public He alth Infr astr uc tur e inve stment c ampaig n –T he Data C ampaig n L e tter to the Ho use and Se nate A ppr
iator s c alling fo r an inc r e ase o f $950 millio n in appr
iatio ns fo r PH Infr astr uc tur e as par t o f the late st C O VI D-19 Supple mental A ppr
iatio ns.
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De aths c ause d by CO VID- 19 ar e not linke d to c linic al data or m e dic al e xam ine r / c or
data syste m s, or c ase r e por ting syste m s Inte r
able and r e al- tim e r e por ting of de ath data fr
c e s E le c tr
e c or ds syste m s CO VID- 19 labor ator y te sts ar e or de r e d by phone and via pape r r e que sts; spe c im e ns ar e ofte n se nt to m ultiple r e fe r e nc e labs and slow data de lays te st r e sults, whic h m ust be shar e d by phone or
e adshe e ts CO VID- 19 te st r e sults sit in c linic al L abor ator y Infor m ation Manage m e nt Syste m s, stagnating and ar e ne ve r se nt to state / loc al public he alth de par tm e nts to initiate c ase inve stigations and c ontac t tr ac ing
We b p o rta ls fo r a ll he a lth c a re p ro vide rs to e nte r a nd tra c k COVI D-19 sp e c ime n sub missio n to p ub lic he a lth la bo ra to rie s Auto ma te d re p o rting o f re sults to p ub lic he a lth e p id e mio l
a s so o n a s the y a re a va ila ble L a b o ra to ry info rma tio n ma na ge me nt syste ms (L I MS) a nd Ele c tro nic la b o ra to ry re p o rting (EL R) o f te st re sults fro m c linic a l c a re to p ub li c he a lth a nd fro m CDC to sta te / lo c a l p ub lic he a lth
nc our age r
y (w he re ve r p o ssi
b le to re q ui re b y la w o r p o li c y) to e na b le a he a lth IT i nfra struc ture to b e b ui lt a nd ma i nta i ne d , so re so urc e s a re re a d i ly a va i la ble i n a n e me rge nc y. Inve stme nts sho uld c o nti nue i n ke y i ni ti a ti ve s, suc h a s e le c tro ni c c a se re p o rti ng, w hi c h w i ll e na b le c ro ss-juri sd i c ti
ng o f no ti fi a b le c o nd i ti
e ate c r
he alth data platfor ms or
tals to c olle c t data ac r
domains base d on Me dic aid c laims, e nvir
ve illanc e data, e missions data, e tc . T
hi s a p p ro a c h c a n b e use ful i n c re a ti ng ta rge te d i nte rve nti
ng to the o p i
d c ri se s, c o mmuni c a b le d i se a se s a nd o the r no n-he a lth d a ta suc h a s tra nsp o rta ti
sup p o rt he a lth i mp a c t a sse ssme nts tha t p o li c yma ke rs c a n le ve ra ge to ma ke i nfo rme d d e c i si
ng a ll ha za rd s.
nc our age the use of patie nt por tals as a me ans to addr e ss patie nt-le ve l issue s in a he alth e me r ge nc y
i f i nd i vi d ua ls a re e va c ua te d to a no the r c o mmuni ty o r i n a she lte r. T hi s w i ll sup p o rt HHS a ge nc i e s a nd p ro vi d e rs w i th kno w le d ge , me d i c a ti
a gno se s a nd o the r p a ti e nt ne e d s i f the y a re c o mp le te a fte r mo vi ng p a ti e nt d a ta thro ugh p o ssi b ly multi p le e xc ha nge s.
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nk so c i al m e di a strate g i e s at the state le ve l and the use of mobile hea lth tec hnolog y to
c onnec t with vulnera ble popula tions in c rises. I
n the e ve nt o f c ri si s, publi c he alth ag e nc i e s sho uld m ake so c i al m e di a data avai lable to he althc are ag e nc i e s, c o m m uni ty partne rs and the publi c so the y c an le ve rag e platfo rm s fo r c o nne c ti vi ty (and to e valuate re spo nse s).
Pla n tha t foc uses on prepa ra tion for c oordina ted surveilla nc e, detec tion, a nd response during hea lth emerg enc ies (a standalo ne plan o r a part o f a bro ade r
state he alth I T plan o r e m e rg e nc y re spo nse plan) and po li c ym aki ng re le vant to he alth c ri se s.
L ea rn more here: https:/ / www.himss.org / sites/ hde/ files/ d7/ u397813/ himss- innova tive- te c hnolog y- polic y- c hec klist.pdf
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ic e nsing wa ive r s for te le he a lth r e la ting to COVID-19 (Ar izona , Ca lifor nia , F lor ida , L
yla nd, Mississippi, Nor th Ca r
e nne sse e , a nd Wa shing ton)
a g e (Ca lifor nia , Conne c tic ut, Distr ic t of Columbia , L
yla nd, Ma ssa c huse tts, Mic hig a n, Missour i, Ne w Yor k, a nd We st Vir g inia )
c ia l/ Pr iva te Insur a nc e Cove r a g e (Ar izona , Color a do, Ma r yla nd, Ma ssa c huse tts, Mic hig a n, Minne sota , Ne w Yor k, Pe nnsylva nia , a nd T e xa s)
e xisting c ove r a g e (Ca lifor nia , Distr ic t of Columbia , Ne w Yor k)
T he Ce nte r fo r Co nne c te d He a lth Po lic y ha s a he lpful re so urc e fo r a dditio na l info rma tio n o n te le he a lth a t the sta te a nd fe de ra l le ve ls.
F
up da te s a t https://www.hi mss.org/ ne ws/c o ronavirus
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requires reporting c a ses, tra c king pa tients, a nd informa tion sha ring with releva nt pa rties.
mitig a te the CO VID- 19 outbrea k with g overnmenta l a nd nong overnmenta l pa rtners for the limited purposes of monitoring , investig a tion a nd c ontrol, a nd trea tment a nd c oordina tion of c a re.
c onta inment of the CO VID- 19
Depa rtment of Hea lth a nd Huma n Servic es within 24 hours.
xec utive order to implement surveilla nc e a nd c ontrol mea sures for individua ls who ha ve been dia g nosed with or a re risk of c ontra c ting CO VID- 19
up da te s a t https://www.hi mss.org/ ne ws/c o ronavirus
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Fo llo w HIMSS’ s COVID-19 upd ate s at https:/ / www.himss.o rg / ne ws/ c o ro navirus Ke y re so urc e s to trac k c o ro navirus: https:/ / www.he althc are itne ws.c o m/ ne ws/ ke y- re so urc e s-ke e p-trac k-c o ro navirus-pand e mic
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provide hea lth IT solutions to the outbrea k?
response requiring sta te hea lth IT support?
would you like to see on the HIMSS COVID-19 Resourc e Pa g e? Consider:
eg isla tive a nd polic y c ha ng es
lec tronic c a se reporting a nd telehea lth
ng a g ement with Hea lth Informa tion E xc ha ng es
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tic ipation
g e , and T r ansfe r Eve nt No tific atio ns
e me nt star ts 6 mo nths after public atio n o f r ule
ds base d A PI must use FHIR Re le ase 4.0.1
Dir e c tor y API
ting 1/ 1/ 2021
to Paye r Data E xc hange
dinate c ar e be twe e n payer s by e xc hanging , at a minimum, the data e le me nts spe c ifie d in the c ur r e nt c o nte nt and vo c abular y standar d finalize d by HHS in the O NC 21st C e ntur y C ur e s A c t final r ule
e quir e d to be par t o f a T r uste d Exc hang e Ne two r k
e ase the fr e que nc y of Fe de r al-State Data E xc hange s
tic ipate in daily e xc hang e o f buy-in data, whic h inc lude s bo th se nding data to C MS and r e c e iving r e spo nse s fr
ting and Infor mation Bloc king
e po r t tho se pr
s that atte ste d “no ” to info r mation blo c king pr
e po r t name s and NPIs o f tho se pr
s who do no t have dig ital c o ntac t info r matio n inc lude d in the Natio nal Plan and Pr
Enume r atio n System (NPPE S) system be g inning in the se c o nd half o f 2020 as pr
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di ti
nali ze s se ve ral c hang e s to the 2015 E di ti
pdate , i ntro duc i ng so m e ne w c e rti fi c ati
te ri a, re vi si ng e xi sti ng c e rti fi c ati
te ri a, and re m o vi ng c e rti fi c ati
te ri a
ONC Cures Ac t Fina l Reg ula tion
sta blishes spec ific API Conditions of Certific a tion
c e s de ve lo pe rs o f c e rti fi e d he alth I T sho uld e ng ag e i n, suc h as m i ni m i zi ng the “ spe c i al e ffo rt” ne c e ssary to ac c e ss, e xc hang e , and use E HI vi a c e rti fi e d API te c hno lo g y
N/ HI E De fi ni ti
s m e rg e d
n U SCDI v1 wi ll de fi ne E HI duri ng the i ni ti al 24-m o nth pe ri
m ple m e ntati
ig ht E xc eptions Defined for When a n Ac tor Would Not be Considered a n Informa tion Bloc ker
s the Co nte nt and Manne r E xc e ptio n
HI) o f a n a c to r’ s re spo nse to a re q ue st to a c c e ss, e xc ha ng e , o r use E HI, a s we ll a s the ma nne r in whic h the a c to r ma y fulfill the re q ue st
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ina l ONC Inte rope ra bility R e g ula tion: Wha t You Ne e d to Know
he ONC Inte ro pe rability and Info rmatio n Blo c king Final Re g ulatio n imple me nts ke y pro visio ns o f the 21st Ce ntury Cure s Ac t fo c use d o n ad vanc ing inte ro pe rability; suppo rting the ac c e ss, e xc hang e , and use o f e le c tro nic he alth info rmatio n (E HI); and , ad d re ssing o c c urre nc e s o f info rmatio n blo c king
ina l CMS Inte rope ra bility R e g ula tion: Wha t You Ne e d to Know
he CMSInte ro pe rability and Patie nt Ac c e ss Final Re g ulatio n is fo c use d o n libe rating patie nt c laims d ata so patie nts c an be mo re info rme d d e c isio n make rs le ad ing to be tte r-info rme d tre atme nt
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e ss Re le ase : https:/ /www.c ms.g ov/newsr
ess-r ele ases/ hhs-finalize s-histor ic -r ule s-pr
mo r e -c o ntr
ability-and-patie nt-ac c e ss-fac t-sheet
G uidanc e / G uidanc e/ I nte r
ability/ inde x
e xt: https:// www.c ms.g ov/file s/do c ume nt/ c ms-9115-f.pdf
e ss Re le ase : https:/ /www.hhs.g ov/ about/ ne ws/2020/ 03/ 09/ hhs-finalize s-histo r ic -r ule s-to-pr
mo r e -c o ntr
vie w Fac tshe et: https:// www.he althit.g ov/c er us/site s/c e r us/ file s/2020-03/ Cur esUpdate Over vie w.pdf
ime line (info g r aph): https:/ / www.he althit.g ov/ c e r us/ sites/ c er us/ file s/ 2020- 03/ Hig hlig hte dReg ulato r yDate s.pdf
iso n: https:/ / www.he althit.g ov/ c er us/ sites/ c er us/ file s/ 2020- 03/ NPRMvsFinalRule.pdf
tific atio n O ver vie w; A PI C e r t C r ite r ia; Info r matio n Blo c king Exc e ptio ns and A c tor s; USC DI ; Re g ulator y Date s): https:/ /www.he althit.g ov/c ur e sr ule/ r e sour c e s/ fac t-sheets
s: https:/ /www.he althit.g ov/c ur e sr ule/ r e sour c e s/ we binar s
e sr ule /
e xt: https:// www.he althit.g ov/c er us/site s/c e r us/ file s/2020-03/ ONC_Cur es_Ac t_F inal_Rule _03092020.pdf
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Co urte sy o f Dr. Wa lter Sua re z
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Alana Lerer
Ma na g e r, G o v e rnme nt Re la tio ns
s
ma il le tte rs to yo ur le g isla to rs
e le c te d o ffic ials at the L e g islative A c tio n C e nter he r e : http:/ / c qr c e ng ag e.c o m/ himss/home?0
al ac tio n c e nter c ampaig n sho r
s to e duc a te a nd e ng a ge yo ur me mbe r s. T
le a de rs o r c o mmitte e to do re se a rc h o n wha t is ha ppe ning in yo ur sta te o n c o ro na virus a nd he a lth IT a nd o the r issue s
e vie w ke y re so urces o n CAR Go o g le Drive
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F
MSS’ s COVI D-19 upda te s a t https:/ / www.himss.o rg / ne ws/ c o ro na virus Ke y re so urc e s to tra c k c o ro na virus: https:/ / www.he a lthc a re itne ws.c o m/ ne ws/ ke y- re so urc e s-ke e p-tra c k-c o ro na virus-pa nde mic Upc o ming we b ina r: I ta ly a nd Ge rma ny fa c e COVI D-19 https:/ / www.himssle a rn.o rg / ita ly-a nd-g e rma ny- fa c ing -c o vid-19? e ve nt-re g ite r-ta g =16187
you would like to se e virtua lly he re
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a ke c a re o f yo urse lf a nd yo ur c o mmunity!
ma il HI MSS a b o ut yo ur a d vo c a c y p ro gre ss.
e c or ding s poste d on the CL
nvo lve d CAR Ca lls)
il 17, 2020 a t 12pm E T