Chapter Advocacy Roundtable (CAR) Monthly Call Pam Varhol CAR - - PowerPoint PPT Presentation

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Chapter Advocacy Roundtable (CAR) Monthly Call

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Pam Varhol CAR Chair New England Chapter

April 17, 2020

Agenda

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• U.S. Federal & State Actions:

COVID

• 19
• Announcements
• Open Discussion on COVID
• 19

3

Coronavirus Aid, Relief, and Economic Security (CARES) Act

Key Health IT Provisions

3

David Gray

Se nio r Ma na g e r, G o v e rnme nt Re la tio ns & Co nne c te d He a lth Po lic y

Congressional Action to COVID-19

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COVID #1

• Coronavirus Preparedness and Response Supplemental Appropriations Act

COVID #2

• Families First Coronavirus Response Act

COVID #3

• Coronavirus Aid, Relief and Economic Security

(CARES) Act

• Sig ne d into la w Ma rc h 6, 2020
• Pro vide d $8.3 billio n in e me rg ency funding fo r fe de ra l a g e ncie s to re spo nd to COVID- 19 pa nde mic
• Gra nte d HHS Se c re ta ry wa ive r a utho rity o ve r 1834(m) o rig ina ting site re stric tio ns o n te le he a lth
• Allo we d rura l AND urba n site s, a nd be ne fic ia ry’s ho me , to se rve a s e lig ible o rig ina ting site s
• R

e quire d pro viders to ha ve a Me dic a re -esta blished re la tio nship with be ne fic ia r y in pre vio us 3 ye a rs

• Sig ne d into la w Ma rc h 18, 2020
• Fo c used o n pa id le a ve , fre e c o ro na virus te sting , pro te ctio n fo r public he a lth wo rke rs, a nd e xpa nde d

be ne fits fo r c hildre n a nd fa milie s

• Mo difie d “Qua lifie d Pro vider” la ng ua g e fo r Me dic a re te le hea lth se rvic es to a llo w re quire d pre existing

re la tio nship to be e sta blishe d o utside the Me dic a re pro g ram

• Sig ne d into la w Ma rc h 27, 2020
• Ove r $2 trillio n re lie f pa c ka g e fo c used o n he a lthc a re de live ry, sta te & lo c a l funding , busine ss a nd no n-profi

t re lie f, a nd o ve ra ll e c o nomic stimulus.

• Pro vide s fina nc ia l re lie f, a dva nced re imbursement pa yme nts, a nd e xpa nded te le hea lth fle xibility

COVID #4, 5, 6

• ???

Medicare Telehealth Takeaways (*limited to COVID-19 PHE)

• HRSA Gr

a nts (Se c . 3212): - Re a utho rize s HRSA’ s g ra nt pro g ra ms tha t pro mo te the use o f te le he a lth. T

he b ill a utho rize s $29 millio n a nnua lly thro ug h F Y 2025, with a t le a st 50% o f the funds a wa rde d fo r pro je c ts in rura l a re a s

• *HSAs for

T e le he a lth Se r vic e s (Se c . 3701) - Allo ws fo r Hig h De duc tib le He a lth Pla ns (HDHP) with a He a lth Sa v ing

Ac c o unt (HSA) to c o v e r te le he a lth se rv ic e s prio r to a pa tie nt re a c hing the de duc tib le .

• *Me dic a r

e T e le he a lth F le xibilitie s (Se c . 3703) - Re mo v e s the re q uire me nt tha t a pro v ide r must ha v e tre a te d the

pa tie nt in the pa st thre e ye a rs. F urthe r, the se c tio n e xpa nds the Se c re ta ry’ s wa iv e r a utho rity o v e r a ll 1834(m) sta tuto ry re stric tio ns.

• *T

e le he a lth Dista nc e Site s (Se c . 3704) - Allo ws F

e de ra lly Q ua lifie d He a lth Ce nte rs a nd Rura l He a lth Clinic s to se rv e a s a dista nt site fo r te le he a lth se rv ic e s during the CO VID-19 e me rg e nc y.

• *Home Dia lysis Pa tie nts Wa ive r

(Se c . 3705) - E

limina te s the re q uire me nt tha t a ne phro lo g ist c o nduc t so me o f the pe rio dic e v a lua tio ns o f a pa tie nt o n ho me dia lysis fa c e -to -fa c e during the CO VID-19 e me rg e nc y pe rio d.

• *Hospic e Ca r

e T e le he a lth Wa ive r(Se c . 3706) - Allo ws q ua lifie d pro v ide rs to use te le he a lth to fulfill the ho spic e

fa c e -to -fa c e re c e rtific a tio n re q uire me nt during the CO VID-19 e me rg e nc y pe rio d.

• *T

e le c ommunic a tions, Re mote Pa tie nt Monitor ing a nd T e le he a lth Wa ive r s (Se c . 3707) - Dire c ts HHS to issue

g uida nc e e nc o ura g ing the use o f te le c o m syste ms, inc luding RPM, to furnish ho me he a lth se rv ic e s during the CO VID-19 e me rg e nc y.

• F

e de r a l Communic a tions Commission - Pro v ide s $200 millio n fo r the F

CC to suppo rt the e ffo rts o f pro v ide rs b y pro v iding te le c o mmunic a tio ns se rv ic e s, info rma tio n se rv ic e s, a nd de v ic e s ne c e ssa ry to e na b le the pro v isio n o f te le he a lth se rv ic e s.

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Additional Key Health and Health IT Provisions

• CDC Public Hea lth Da ta Moder

niza tion - Autho rize s $500 millio n fo r pub lic he a lth da ta surve illa nc e a nd infra struc ture

mo de rniza tio n e ffo rts a t the CDC, sta te , a nd lo c a l he a lth de pa rtme nts

• Public Hea lth a nd Soc ia l Ser

vic es E m er g enc y Fund – Pro vide s $100 b illio n fo r o ur he a lth syste m to pre ve nt, pre pa re fo r, a nd

re spo nd to c o ro na virus, do me stic a lly o r inte rna tio na lly.

• 42 CFR

Pa r t 2 Cha ng es

• Ame nds re g ula tio ns g o ve rning the c o nfide ntia lity a nd disc lo sure o f sub sta nc e use diso rde r re c o rds, inc luding a llo wing c e rta in

re -disc lo sure s to c o ve re d e ntitie s, b usine ss a sso c ia te s, o r o the r pro g ra ms sub je c t to HIPAA a fte r o b ta ining the pa tie nt’ s prio r writte n c o nse nt.

• HHS Se c re ta ry sha ll issue g uida nc e within 180 da ys o n the sha ring o f pa tie nts’ pro te c te d he a lth info rma tio n re la te d to COVID-

19, inc luding g uida nc e o n c o mplia nc e with HIPAA re g ula tio ns a nd a pplic a b le po lic ie s.

• Com m unity Hea lth Center

s a nd Com m unity Menta l Hea lth Ser vic es Dem onstr a tion – e xte nds funding fo r the se pro g ra ms (a nd

• the rs) thro ug h No ve mb e r 30, 2020
• Cor
• na vir

us R elief Fund - Pro vide s $150 b illio n to Sta te s, Te rrito rie s, a nd Trib a l g o ve rnme nts to use fo r e xpe nditure s inc urre d due to

the pub lic he a lth e me rg e nc y with re spe c t to COVID-19 in the fa c e o f re ve nue de c line s,

• I

nc r ea sed R eim bur sem ent a nd Additiona l Wa iver s a nd Flexibilities:

• Te mpo ra rily suspe nds 2% Me dic a re se q ue stra tio n fo r the pe rio d Ma y 1, 2020 thro ug h De c e mb e r 31, 2020
• Me dic a re a dd-o n pa yme nts fo r inpa tie nt ho spita l COVID-19 pa tie nts, inc re a sing the pa yme nt tha t wo uld o the rwise b e ma de

to a ho spita l fo r tre a ting the se c o mple x pa tie nts b y 20 pe rc e nt.

• Give s a c ute c a re ho spita ls fle xib ility during the COVID-19 e me rg e nc y pe rio d to tra nsfe r pa tie nts o ut o f the ir fa c ilitie s a nd into

a lte rna tive c a re se tting s (suc h a s po st-a c ute c a re ) in o rde r to prio ritize re so urc e s ne e de d to tre a t COVID-19 c a se s

• Pr
• vides a dditiona l funding to a ddr

ess issues a r

• und Sm a r

t Com m unities, SDOH, Pr ec ision Medic ine

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HIMSS CARES Act Summary of Key Provisions

https:/ / www.himss.or

g / ne ws/ c a r e s-a c t-pr

• visions-he a lthc a r

e -a nd-he a lth-it

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US Federal Policy Responses to COVID

• 19 Pandemic

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April 17, 2020

CMS Relaxes Telehealth Requirements

• In- Sta te T

e le he a lth L ic e nsure R e quire me nts

• I

n g e ne ra l, a pro vide r must b e lic e nse d in the sta te whe re the pa tie nt is lo c a te d a t the time o f tre a tme nt

• CMS ha s wa ive d this re q uire me nt fo r Me dic a re pa tie nts
• Sta te s c a n re q ue st a Me dic a id wa ive r fro m CMS
• Ac c ording to the F

e de ra tion of Sta te Me dic a l Boa rds, 44 sta te s ha ve wa ive rs in pla c e for the ir Me dic a id prog ra ms for this purpose

• CMS Inte rim CMS F

ina l R e g ula tion pe rmits 80 a dditiona l te le he a lth se rvic e s

• Aud io -o nly visits
• Inpatie nt re habilitatio n, ho spic e , and ho me he alth fac ilitie s
• Re mo te patie nt mo nito ring
• Prio r pro vid e r-patie nt re latio nship no lo ng e r ne e d e d

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Other CMS Actions Granting More Flexibility

• Physic ian Se lf- R

e fer r al R ule s

• On Marc h 30, CMS issue d b lanke t waivers o f sa nc tions und e r the p hysic ia n se lf-re ferral law fo r

COVID-19 p urp o ses, p ro viding vital fle xibility fo r p hysic ians a nd p ro vid e r s

• T

he wa ive rs a re e ffe c tive Marc h 1, 2020, a nd ma y b e use d witho ut no tifying CMS

• Quality Payme nt Pr
• gr

am and Quality R e por ting Pr

• gr

am/ Value -Based Pur c hasing

• De a d line fo r 2019 sub missio n e xte nd e d until Ap ril 30, 2020
• COVID-19 ha s trigge re d implementatio n o f the MIPS Auto ma tic E

xtre me a nd Unc o ntr

• llable

Circ umsta nc e s (E &UC) p o lic y

• Clinic ians who d o n’ t sub mit d a ta will a uto ma tic ally re c e ive a ne utra l p a yment a d justment in

2021

• T

he a uto ma tic p o lic y d o e s no t a p p ly to gro up s o r vir tual gro up s

• Re q uired to c o mp lete a n a p p lic atio n if d a ta ha s a lre ad y b e e n sub mitted
• Gra nting e xc e p tio ns fro m re p o rting re q uir

e me nts a nd e xte nsio ns fo r c linic ians a nd p ro vide r s p a rtic ipating in Me dic are q ua lity re p o rting p ro gra ms fo r up c o ming me a sure re po rting a nd d a ta sub missio n

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CMS Expands Accelerated and Advance Payment Program

• T
• inc r

e ase c ash flow to pr

• vide r

s of se r vic e s and supplie r s e xpande d the pr

• gr

am to a br

• ade r

gr

• up of

Par t A pr

• vide r

s and Par t B supplie r s

• Only fo r the d ura ti
• n o f the p ub li

c he a lth e me rge nc y

• Inte nd e d to p ro vi

d e ne c e ssa ry fund s w he n the re i s a d i srup ti

• n i

n c la i ms sub mi ssi

• n a nd / o r c la i

ms p ro c e ssi ng

• Can pr
• vide ac c e le r

ate d or advanc e payme nts to any Me dic ar e pr

• vide r

/ supplie r who submits a r e que st to the appr

• pr

iate Me dic ar e Administr ative Contr ac tor

• T
• qualify for

advanc e / ac c e le r ate d payme nts

• Ha ve b i

lle d Me d i c a re fo r c la i ms w i thi n 180 d a ys i mme d i a te ly p ri

• r to the d a te o f si

gna ture o n the p ro vi d e r’ s/ sup p li e r’ s re q ue st fo rm

• No t b e i

n b a nkrup tc y

• No t b e und e r a c ti

ve me d i c a l re vi e w o r p ro gra m i nte gri ty i nve sti ga ti

• n
• No t ha ve a ny o utsta nd i

ng d e li nq ue nt Me d i c a re o ve rp a yme nts

• Qualifie d pr
• vide r

s/ supplie r s will be aske d to r e que st a spe c ific amount

• Mo st pro v ide rs a nd supplie rs will b e a b le to re q ue st up to 100% o f the Me dic a re pa yme nt a mo unt fo r a thre e -

mo nth pe rio d

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Additional Regulatory Actions Across HHS

• HHS Offic e of Civil Rig hts a nd HIPAA Re quir

e me nts

• OCR will e xe rc ise e nfo rc e me nt d isc r

e tio n a nd wa ive p e nalties fo r HIPAA vio latio ns a gainst he a lth c a re p ro vid ers

• Must se rve p a ti

e nts i n go o d fa i th thro ugh e ve ryd a y c o mmuni c a ti

• ns te c hno lo gi

e s, suc h a s Fa c e T i me o r Skyp e , d uri ng the p ub li c he a lth e me rge nc y

• E

nfo rc e me nt d isc re tion fo r viola tio ns o f c e rta in p rovisions o f the HIPAA Privac y Rule

• Re fe rs to c o ve re d e nti

ti e s a nd b usi ne ss a sso c i a te s fo r use s a nd d i sc lo sure s o f p ro te c te d he a lth i nfo rma ti

• n fo r p ub li

c he a lth a nd he a lth o ve rsi ght a c ti vi ti e s d uri ng the PHE

• Co ve re d e ntitie s ma y d isc lo se PHI

(suc h a s the na me o r o the r id e ntifying info rma tion a b o ut ind ivid uals) to first re sp o nd e rs without the ir HI PAA a utho r izatio n

• He a lth c a re p ro vide rs c an sha re info rmatio n with CDC, fa mily me mb ers o f p a tients, a nd
• the rs, to he lp a d d re ss the COVI

D-19 e me rge nc y

• HHS Offic e of Inspe c tor

Ge ne r a l

• No tifie d p hysic ians tha t the y will no t b e sub je c t to a d ministrative sa nc tions fo r re d uc ing o r

wa iving a ny c o st sha ring o b liga tio ns fe d e ra l he a lth c a re p ro gra m b e ne fic iar ie s ma y o we fo r te le he alth se rvic e s furnishe d

• Co ve rs va ri
• us mo d a li

ti e s, i nc lud i ng te le he a lth vi si ts, vi rtua l c he c k-i n se rvi c e s, e -vi si ts, mo nthly re mo te c a re ma na ge me nt, a nd mo nthly re mo te p a ti e nt mo ni to ri ng

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What’s Next on the Agenda

• F

ur the r r e g ula tor y c ha ng e s a nd fle xibilitie s a c r

• ss HHS to he lp a ddr

e ss the pa nde mic

• Whe n will F

ina l ONC a nd CMS Inte r

• pe r

a bility Re g ula tions be for ma lly publishe d?

• E

ffe c tive d a te fo r the c e rtific atio n p o r tion is ge ne ra lly 60 d a ys a fter p ub lic a tion

• Co mp lia nc e fo r o the r c o mp o ne nts o f ONC’ s Re gula tio n o c c ur six mo nths fro m its p ub lic atio n
• CMS Re gula ti
• n i

mp le me nta ti

• n d a te s a re ge ne ra lly Ja nua ry 1, 2021 o r Ja nua ry 1, 2022
• F
• r a c to rs re gula te d b y the info rma tio n blo c king p ro vision, e nfo rc e ment o f info rmatio n

b lo c king c ivil mo ne tary p e na ltie s (CMP) will no t b e gin until OI G e nga ge s in a no tic e a nd c o mme nt p e r io d

• He a lth IT

d e velo pe rs a nd HIN/ HI E s will no t b e sub je c t to p e na ltie s until OIG’ s CMP Re gulatio ns a re fina l

• ONC a nd OIG must sti

ll d e fi ne the a p p ro p ri a te d i si nc e nti ve s fo r p ro vi d e rs und e r i nfo rma ti

• n b lo c ki

ng

• T

he time frame fo r e nfo rc e me nt wo uld no t b e gin so o ne r tha n the c o mp lia nc e d a te a nd will d e p e nd o n whe n the CMP Re gulatio ns a re fina lize d

• ONC a nd OIG a re e mp ha sizing tha t the y a re e xhibiting d isc retion o n c o nd uc t tha t o c c urs

b e fo re tha t time a nd a ny q ue stio na ble a c tions will no t b e sub je c t to info rmation b lo c king CMPs

• Ho w e ve r, the a c to rs tha t a re sub je c t to the i

nfo rma ti

• n b lo c ki

ng re gula ti

• ns must c o mp ly a s o f the

c o mp li a nc e d a te

13

Questions?

14

15

US State Policy Responses to COVID

• 19 Pandemic

U.S. State Actions Telehealth

16

• L

ic e nsur e r e quir e me nts and r e ne wal waive r s

• Ove r

32 sa te s a re te mp o ra r ily waiving in-state lic e nsing re q uire ments fo r q ua lifie d me d ic al p e rso nne l o ve rall a nd sp e c ific ally fo r d e live r ing te le he alth fo r p ro vid ers o utsid e o f sta te lines.

• Me dic aid c ove r

age

• Ove r

28 sta te s a re e xp a nd ing a c c e ss to te le he alth fo r Me dic aid re c ipie nts.

• Comme r

c ial/ Pr ivate Insur anc e Cove r age

• Ove r

19 sta te s a re ma nd a ting tha t c o mme rc ial insur a nc e c a rriers c o ver te le health L e a rn mo re he re : http s:/ / www.himss.o rg/ news/ sta te s-c ovid -19-info rmatio n-tec hno logy

Data Surveillance and E-Case Reporting

• Be side s te le he a lth, sta te s a re b e g inning to a ppro pria te funds fo r surve illa nc e

to de te c t a nd ma na g e the o utb re a k a nd re q uire e le c tro nic c a se re po rting to pub lic he a lth e ntitie s.

• Ma ny o ppo rtunitie s he re to e xpa nd the se c a pa c itie s.

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L e ar n mor e he r e : http s:/ / www.himss.org/ news/ sta te s-c ovid-19-info rmatio n-te c hnolo gy

In Times of Crisis, HIEs are Front and Center

• He a lth info rma tio n e xc ha ng e (HIE) o rg a niza tio ns play an e sse ntial ro le in ag g re g ating and disse minating data to g ive lo c al

ho spita ls, pub lic he a lth o ffic ia ls a nd pro vide rs a b e tte r unde rsta nding o f the virus’ spre a d a nd the pa tie nts b e ing te ste d a nd tre a te d.

• Se ve ra l sta te a nd re g io na l HIEs a nd he a lth info rma tio n ne two rks a re le a ding e ffo rts to re spo nd to COVID-19, sinc e the y ha ve

the c a pa b ility to sha re va lua b le pa tie nt da ta . The le ve l o f infra struc ture o f e a c h HIE va rie s b y sta te

• The fo llo wing a re e xa mple s o f ho w HIEs ha ve prio ritize d in the ir re spo nse e ffo rts:
• T

est R esults Ag g r eg a tion a nd Aler ting : HIEs a re c o o rdina ting dire c tly with pub lic he a lth o ffic ia ls, pro vide rs a nd la b s to

inc re a se a wa re ne ss o f c a se s a nd c o mmunity tra nsmissio n, a nd to b e tte r pre pa re pro vide rs fo r inte rve ntio ns with infe c te d pa tie nts.

• Popula tion Hea lth Sur

veilla nc e a nd Ana lytic s: Be c a use o f the ir ro le a s da ta a g g re g a to rs, ma ny HIEs a re imple me nting to o ls

to a sse ss tre nds a nd info rm de c isio n ma king a ro und re g io na l re spo nse s.

• Br
• a der

Coor dina tion a c r

• ss Com m unities: Ma ny HIEs pa rtne r with c linic a l a nd so c ia l o rg a niza tio ns within a c o mmunity a nd

le ve ra g e the ir e xisting infra struc ture s to o ffe r b ro a de r suppo rt a nd e xpa nde d a c c e ss to no n-HIE pa rtic ipa nts.

• L

ea r n m or e about HIE use c ases, spec ific example and c onsider ations for HIE s and r elevant stakeholder s to r espond to COVID

18

HIMSS Supports Global Health IT Preparedness & Response Efforts for the COVID-19 Outbreak

• HIMSS c o ntinue s to mo nito r c urre nt CDC re c o mme nda tio ns fin re spo nse to CO VID-19 a nd c linic a l b e st pra c tic e s

a nd ide ntifying mo de l pra c tic e s fo r tre a tme nt

• HIMSS e ng a g e d the O NC a nd E

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

• HIMSS China T

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

• T

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

• Wo rking to c o mb ine o the r so urc e s o f da ta , c o uld he lp tra c k do wn a nd ma na g e the hig h-risk po pula tio n with

pre c isio n

• T

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

• HIMSS wa s suc c e ssful in he lping to se c ure $50 millio n fo r the first ye a r o f a multi-ye a r e ffo rt to suppo rt the

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.

• E

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? .

19

Immediate State & Local Strategies to Combat the COVID

• 19

Pandemic

20

• All states should immediately scale-up telehealth services to reduce the number of

individuals using health care facilities while at the same time preserving and improving

• health. The Trump Administration has issued flexible and constructive guidelines for

Medicaid, and states can use those flexibilities to help account for the uninsured population or those outside of the safety net.

• Whi

le o ve r 40 state s have “ pari ty” laws i n plac e fo r te le he alth se r vi c e s, HI MSS stro ng ly e nc o ura g e s state s to inc lude or expa nd provisions for both c overa g e a nd pa yment pa rity for a ll pla ns

• Sta te s a re e nc o urag e d to require priva te insura nc e c a rriers to reimburse for telehea lth in the

sa me wa y a s a n in- person visit.

Paym e nts to pro vide rs sho uld be the sam e as an i n-pe rso n vi si t and sho uld: (1) extend to post- CO VID- 19 enc ounters; (2) extend a c ro ss a ll Hea lth Pla ns in a

sta te’s jurisd ic tion (Me d i

c are , Me d i c a re Advantag e , Co m m e rc i al, Me di c ai d F e e -fo r-Se rvi c e , Manag e d Me di c ai d,); and (3) a pply to non- CO VID- 19 rela ted visits, whi c h is e sse nti al i n suppo rti ng vulne rable po pulati

• ns,

i nc lud i ng p ati e nts w i th c hro ni c i llne sse s and wi ll li ke ly re duc e the burde n o f pro vi de rs no w and po st COVI D-19 alo ng wi th i m pro vi ng po pulati

• n he alth.

21

• HI

MSS also e nc o ur a ge s sta te s to maintain the COVID- 19 telehe alth expansions for ongoing

tr e atme nt and r emote patie nt monitor ing for pe r sons with c hr

• nic

conditions and c ompr

• mise d immune systems. It ha s b ee n d o c ume nte d tha t virtual c a r

e d eliver y mod els supp o r t the q ua druple aim by improving ac c e ss, c a re c o ordina tio n, c linic al o utc o me s, a nd supp o r ts pa tie nt e nga geme nt. HHS c rea ted funding mec ha nisms thro ugh the CMS, CDC, HRSA a nd the F CC by whic h state s c a n p e r ma nently retain the vir tual life -saving c o nnec ted c a r e mo dels a nd inc r e a se disea se p r eventio n a nd trea tme nt mea sure s tha t a re esse ntial to c o mb a t COVID-19 a nd future c hro nic a nd c o mmunic able d ise ase thre ats.

• Sta te le gisla ture s sho uld move q uic kly to

e xpand lic ense por tability, (i.e . the Inte rstate

Medic al L ic e nsure Compa c t,) to make it e a sie r fo r p rovide r s to a c q uire lic e nses to p r a c tic e in multiple sta te susing te le he alth in re sp o nse to the Co ro navirus p ande mic .

• HI

MSS also e nc our a ge s sta te s to allow he althc ar

e pr

• vide r

s to engage in asynchr

• nous

te lehe alth se r vice s, suc h as stor e- and- for war d, provide d

tha t a ny a nd all tele health p r a c tic e s are c linic ally ap prop r iate , p r

• pe r

ly do c ume nte d , and o the r wise c omply with p ro p e rsta nd a rdso f c a re .

22

• State s sho uld c o nsi

de r perma nently inc luding the orig ina ting site (the loc a tion of the Pa tient) to

inc lude the Pa tient's Home to boost remote pa tient monitoring (R PM) during the CO VID- 19 c risis a nd these efforts should be extended beyond the next 12- 24 months a fter the CO VID- 19 c risis is expec ted to end as a le ve r to de li

ve r quali ty c are fo r pati e nts wi th c hro ni c c o ndi ti

• ns,

re duc i ng the i r ne e d to vi si t the e m e rg e nc y de partm e nt o r be adm i tte d to the ho spi tal as an i npati e nt.

• HI

MSS stro ng ly e nc o urag e s state s to ma ximize their pa rtic ipa tion in federa l funding prog ra ms

for hea lthc a re telehea lth network infra struc ture a nd c onnec tivity o ffe re d thro ug h the F

e de ral Co m m uni c ati

• ns Co m m i

ssi

• n (F

CC), U S De partm e nt o f Ag ri c ulture , and o the r ag e nc i e s, wi th the c o nsi de rati

• n pro vi

di ng a state fundi ng m atc h i s ali g ne d wi th fe de ral fundi ng .

• Gi

ve n the dynam i c nature o f the c o ro navi rus o utbre ak, state s sho uld e nsure that pro vi de rs who are no t able to m ake si g ni fi c ant i nve stm e nts i n m o de rn te le he alth te c hno lo g y have a m e c hani sm to re ac h the i r pati e nts. HI MSS also e nc o urag e s state s to support telehea lth

networks tha t build on peer- to- peer c onsulting tha t bring spec ia lty expertise to sma ll or rura l providers throug h Projec t E CHO or simila r prog ra ms. Mo re o ve r, the HHS Offi

c e fo r Ci vi l Ri g hts has m ade allo wanc e s fo r pro vi de rs to re ac h the m o st vulne rable po pulati

• ns.
• F

urthe r, HI MSS e nc o urag e s state s to embra c e mobile hea lth solutions tha t

support the tra nsmission of pa tient hea lth informa tion using sma rtphones or ta blets thro ug h se c ure appli

c ati

• ns whi

le pro te c ti ng pati e nt pri vac y.

23

24

• Mandate by public statute or regulation routine public health

Mandate by public statute or regulation routine public health data submission and query by leveraging relief funding that data submission and query by leveraging relief funding that supports supports electronic case reporting electronic case reporting (eCR), and that enables (eCR), and that enables cross cross-jurisdiction sharing of notifiable condition reports. jurisdiction sharing of notifiable condition reports.

• Given c ur

re nt COVI D-19 da ta c ollec tio n and a ggr e gation e ffo rts taking pla c e , sta te s sho uld lever a ge ea sily sc alable solutio ns like the CDC F

• unda tio n-supp o r

ted Digital Br id ge or E HR-lite mec hanisms to e nsur

e c onsiste nt quality data r epor ting to the state he alth de par tments and to the CDC. T

his strate gy is vital to ensur ing tha t unde rser ved a nd rura lc o mmunitiesa re a b le to re sp o nd to the COVI D-19 c risis.

• Sta tes sho uld also c o nsid e r as a pr

ior ity, the e stablishme nt or e xpansion of r

e por ting on additional data e lements dur ing e me r ge nc y dec lar ations such as be d c apac ity, wor kfor ce , pe r sonal pr

• tec tive

equipment (PP E ), e tc .,

where a ssessme nt and c o o rd ina tio n to ha nd le syste m surge is sup p o rte d b y d a ta .

• Moreover, state s sho uld mandate that demogr

aphic data is c aptur e d and shar e d with state and loc al public he alth author itie s to sup po rt c o ntac t trac ing, ho t-spo tting, and

info r me d polic y d ec ision making. T his a c tivity is e sp e c ially imp orta nt a s p r

• vide rs

le verage p o int o f c a re te sts.

25

Recent COVID

• 19 Headlines State & Local Governments Track

Cell Phone Data

26

Strengthen the public health and health data infrastructure by using current Strengthen the public health and health data infrastructure by using current relief funding to prioritize syndromic surveillance, emergency response, and relief funding to prioritize syndromic surveillance, emergency response, and environmental data with clinical care documentation using standards environmental data with clinical care documentation using standards

• based

based platforms (e.g. FHIR, etc.). platforms (e.g. FHIR, etc.).

• HI

MSS re c ommend s that state s utilize the De par

tme nt of Home land Secur ity (DHS) F usion Model to make available a se t of pr

• tocols, me thodologie s, and tools that suppor

t standar ds- base d inte r

• pe r

ability and infor mation shar ing dur ing c r ise s. T

his app roa c h will allow c ommunity p artne rs to levera ge ne e de d da ta so urc es that may no t be c urr e ntly available to the m. T he DHS p ro to c ols c o uld help he althc are lea d ers und ersta nd da ta

• wne rship a nd d a ta sha ring p o lic ie sb e fo re a c risista ke sp lac e.
• Sta tes sho uld c o nsid e r the use o f smar

t he alth te chnologies suc h as ar tific ial inte lligence and mac hine le ar ning to pr

• vide pr

e dic tive analytic s with ho ur

ly de tec tio n a s well a s c o ntinuo us mo nitor ing fo r po tential outb reaks leading to grea te r situatio nal awa r e ness a nd timelie rinter ventio ns.

• Public he alth c ommunic ations infr

a struc tur e is similar ly imp o r tant, and sta tes should take

advantage of the gr

• wing availability of mobile phones and inte r

ne t- base d r e por ting tools that may infor m

• utbr

e ak and diagnostic r e por ting,

pa rtic ula r ly whe re traditional surveillanc e systemsa re o utd a te d .

27

• Leverage

Leverage Health Health Information Information Exchanges Exchanges (HIEs) (HIEs) or

• r cross

cross-sector sector health health data data sharing sharing platforms platforms to to collect collect data data across across sectors sectors including including electronic electronic health health record record data, data, emergency emergency room room (EMR) (EMR) encounters, encounters, emergency emergency medical medical services services (EMS) (EMS)data, data, public public health health surveillance surveillance data, data, etc etc.

• Sta tes ha ve the a uthority to de c la re a nd deputize a n HIE to c ollec t c orona virus informa tion and

sho uld c o nsi de r the ro le HI E s m ay play i n e na bli ng auto m ati c subm i ssi

• n o f syndro m i

c surve i llanc e i nfo rm ati

• n to the state he alth de p artm e nt, and the c o lle c ti
• n o f COVI

D-19 te st data fro m ho sp i tals, publi c he alth labs, E MS syste m s, and c o m muni ty te st si te s (e .g . c hurc he s, drug sto re s, o the r re ta i le rs). Suc h a p ro c e ss c o uld re duc e the da ta re po rti ng o bli g a ti

• ns o f

pro vi de rs.

• Sta te s m ay also

e ng ag e

HIE s a nd loc a l a nd sta te epid emiolog ists to c rea te CO VID- 19 da shboa rds that le ve rag e

ag g re g ate d and ano nym i ze d lo c ati

• n data fro m so c ial m e di

a so urc e s and sup po rt the c re ati

• n o f d i

se a se p re ve nti

• n m aps. Co nc re te e xam ple s o f this c an

be fo und i n the state s o f Washi ng to n and I ndi ana.

• Mo re o ve r, g i

ve n the so c i

• -e c o no m i

c i m pac ts o f COVI D-19, state s sho uld c onsid er how HIE

s c a n supp ort c linic a l a nd public hea lth workforc e need s, c a re c o ordina tion, a nd in the ma na g ement of da ta rela te d to the So c ia l De termina nts O f Hea lth (SDO H), whi

c h are c ruc i al to the de li ve ry o f c are to vulne rable po pulati

• ns.

28

29

• Pe r

spe c tive s on r e str ic te d pe r sonal fr e e doms, inc luding pr ivac y and othe r human r ights give n the outgr

• wth of sur

ve illanc e , pote ntial data e xploitation, and misinfor mation ar e be ing te ste d ac r

• ss the wor

ld.

• L

e gac y te c hnology and le gac y polic ie s (e .g. r e mote wor king, issuing de vic e s)

• Digitization of se r

vic e s (c onve nie nc e r e fr ame d as e sse ntial se r vic e s)

• A lot of band aids ac r
• ss age nc ie s taking a

siloe d appr

• ac h to mode r

nization of se r vic e s – vir tual se r vic e s

• State s will ne e d to r

e alize an e nte r pr ise str ate gy

• How many c r

itic al he alth syste ms ar e on

• utdate d IT

syste ms?

• Anti

c i p a te mo d e rni ze d syste ms o r i nfra struc ture p a c ka ge d i n the 4th Ai d Pa c ka ge

• Also mo d e rni

zi ng the b usi ne ss p ro c e sse s tha t w e re re li a nt o n p a p e r p ro c e sse s

Future Forward – State Health IT & Emergency Response Planning

HIMSS Policy Resources

COVID- 19

• CAR

E S Ac t (PL 116- 136) He a lth Pro visio ns

• CAR

E S Ac t- Suppo rt fo rDa ta E le me nta l to He a lth Ca mpa ig n

• T

e le he alth in the COVID- 19 Spo tlig ht(Fe de ra l Ac tio ns)

• R

e mo te Pa tie nt Mo nito ring : COVID- 19 Applic a tio ns a nd Po lic y Cha lle ng e s

• Sta te s T

a c kling COVID- 19 Using Info rma tio n a nd T e c hnolog y

• In T

ime s o f Crisis, HIE s a re Fro nt a nd Ce nte r

30

ONC & CMS Inte r

• pe r

ability F inal R ule s

• Fina l ONC Inte ro pera bility R

e g ula tio n: Wha t Yo u Ne e d to Kno w

• Fina l CMS Inte ro pe r

a bility R e g ula tio n: Wha t Yo u Ne e d to Kno w

• CMS Inte ro pe r

a bility R e g ula tio n: Co nditio ns o f Pa rtic ipa tio n Fa c t She e t

• ONC Inte ro pe r

a bility R e g ula tio n: Pro visio ns R e la te d to Qua lity Pro g ra m R e po rting fo r Ce rtifie d E HR T e c hnolo gy

R e c e ntly Submitte d Public Comme nt L e tte r s

• HIMSS a nd PCHAllia nc e Co mment o n Fe de r

a l He a lth IT Stra te g ic Pla n

Announcements

31

Alana Lerer

Ma na g e r, G o v e rnme nt Re la tio ns

HIMSS20 Digital

• E

xplo re e xpe rt-le d se ssio ns a c ro ss 17 he a lth info rma tio n a nd te c hno lo g y to pic s.

• E

a rn c o ntinuing e duc a tio n c re dits to wa rds CAHI MS, CPHI MS a nd e nduring c re dits (ACPE , CME , PDU, CNE a nd L L SA.)

• Hig hlig hte d se ssion: He a r fro m ONC Na tio na l Co o rdina to r, Dr. Ruc ke r, a nd

HI MSS Pre side nt & CE O, Ha l Wo lf, o n the ne e d fo r inte ro pe ra b ility to a ddre ss COVI D-19. Re g iste r he re .

Explore HIMSS20 Dig ita l he re .

32

Explore a nd submit to the HIMSS COVID- 19 dig ita l think ta nk

T he HIMSS COVID-19 Digital T hink T a nk is a va lua ble re so urc e fo r yo u a nd yo ur p e e rs a s yo u le a d yo ur fa c ility, te a m a nd p a tie nts thro ugh the c risis. Sha re wha t yo u kno w, se e wha t’ s wo rking fo r o the rs, a nd b ring le sso ns b a c k to yo ur c o mmunity.

Shar e . Ha ve a COVI

D-19 re lated p ro c e ss o r so lutio n tha t's wo rking we ll in yo ur

• rga nizatio n? Sub mit it.

L e ar

• n. L
• o king fo r wa ys to b e tte r ma na ge COVID-19? E

xp lo r e so lutio ns fro m fe llo w he a lthc a r e p ro fe ssionals.

• Ask. Ha ve q ue stio ns a b o ut a so lution? Co mme nt o n it a nd e nga ge in the d isc ussio n.

Ge t Sta rte d

33

COVID

• 19 Maker Challenge
• Ca lling All Ma ke r

s! Jo in Challe ng e Ame r ic a and the Ve te r ans He alth Administr atio n Inno vatio n E c o sy ste m in the fig ht ag ainst COVID-19.

• We ar

e se e king c halle ng e s ar ising fr

• m the fr
• ntline e ffo r

ts to c o mb at COVID- 19 https:/ / www.c ovid19ma ke r c ha lle ng e .c om/

34

Chapter Leader Webinars

Cha pte r E le c tion a nd Boa r d T r a nsition We dne sda y, Apr il 22, 2020 12:00 pm CT Re g iste r

35

State Spotlights

• Nic k Chr

istia no (Ne w Yor k)

• Ma r

c ine F

• r

r e tte (South Da kota )

• L

e e L a ve r g ne (T e xa s)

• Cha d Hine r (Wa shing ton Sta te )

36

Open Discussion

Que stio ns fo r yo u a nd yo ur o rg a niza tio ns/ Cha pte rs:

• Wha t a re the c ha lle ng es, ro a dblo cks, a nd frustra tio ns (po lic y, te c hnica l, wo rkfo r

c e, e tc .) tha t yo u ha ve e xpe rie nc ed in yo ur COVID- 19 re spo nse?

• Wha t ha ve yo u se e n fro m yo ur sta te / lo c a l g o ve rnme nt’s re sponse to the se c ha lle ng es a nd wha t a re the re la te d
• ppo rtunitie s a nd insig hts fo r the he a lth IT

c o mmunity?

• Wha t a re the mo st impo rta nt o ppo r

tunitie s, le sso ns le a rned, be st pra c tic es, insig hts, yo u ha ve e xpe rie nce d with yo ur COVID- 19 re spo nse?

• If yo u a re utilizing te le he a lth, wha t ha ve be e n so me o f the ro llo ut c ha lle ng es o r o bsta c le s? Wha t ha ve be e n yo ur

big g e st suc c e sses? Ha ve yo u be e n a ble to c a pture a ny da ta / ho w a re yo u me a suring suc ce ss o r re sults?

• Wha t a re the te c hno lo gy o bsta c les/ limita tio ns yo u ha ve e nc o untered? Ha ve yo u be e n a ble to a ddre ss the m ye t?
• Ho w ha s yo ur a dvo c a cy ta c tic s a nd fo c us a re a s c ha nged be c ause o f COVID- 19?

Spe c ific to HIMSS a nd the GR te a m:

• Wha t re so urces o r to o ls do yo u wish we re o ut the re tha t yo u do no t ha ve / se e e lse whe r

e?

• R

e g a rding o pportunitie s to e duc a te c o ngressio na l, sta te a nd fe de ra l sta ff fo r future le g isla tio n/ a g ency a c tio n, wha t issue s sho uld we be fo c using o n? Ho w c a n we ta ke yo ur e xpe rie nce s a nd bring the m to the se sta ke ho lders?

• Ho w c a n HIMSS he lp yo u ma ke c o nne ctio ns, do mestica lly o r g lo ba lly, with fe de ra l o r priva te se c to r c o nta c ts?

37

38

• Sug g e ste d monthly ta sks:
• T

a ke c a re o f yo urse lf a nd yo ur c o mmunity!

• E

ma il HI MSS a b o ut yo ur a d vo c a c y p ro gre ssa nd q ue stio ns.

• Sha re yo ur COVID-19 Sto ry
• Re vie w CAR c a ll slide s a nd r

e c or ding s poste d on the CL

• RA. (Ge t I

nvo lve d  CAR Ca lls)

• Ne xt monthly c a ll: Ma y 15t

h a t 12pm E

T

Thank you!