Chapter Advocacy Roundtable (CAR) Monthly Call Pam Varhol CAR Chair New England Chapter Ma y 15, 2020 1 1
Agenda • Review of COVID -19 Discussions • State Telehealth Update • CAR Open Discussion • Announcements 2
COVID -19 Discussion Review Valerie Rogers, MPH Dire c to r, G o v e rnme nt Re la tio ns 3 3
Key Takeaways from CAR & Chapter Leader Discussions • Pe rm ane nt e xpansio n o f te le he alth (inc luding re m o te patie nt m o nito ring ) • Im pro ve d public he alth infrastruc ture inc luding the e xpansio n o f m o de rnize d public he alth surve illanc e and use o f m o bile and dig ital so lutio ns to suppo rt public he alth c o ntac t trac ing e ffo rts • Mo de rnizatio n o f privac y and se c urity laws, data e xc hang e po lic ie s and busine ss pro c e sse s ac ro ss and be twe e n g o ve rnme nts and the ir private he althc are partne rs • Addre ssing so c ial de te rm inants o f he alth and dise ase pre ve ntio n and c o ntro l thro ug h the e ng ag e m e nt o f affe c te d po pulatio ns using c o nne c te d he alth applic atio ns • Pro m o tio n o f the HIMSS Dig ital He alth Inde x and o the r m o de rnize d busine ss pro c e sse s to raise the visibility in the c o m munity, and inc re ase the pe rc e ive d value to the public , po lic ymake rs, funde rs, and o the r ke y stake ho lde rs. 4
Testing 5
Testing the most vulnerable populations Testing the most vulnerable populations • E xpand te sting c apac ity ac r oss state s and population c e nte r s Ke y sugge sti o ns fo r te sti ng e ve ry p e rso n d i a gno se d w i th p ne umo ni a He a lth c a re w o rke rs/ fi rst re sp o nd e rs Pe o p le i n nursi ng ho me s a nd o the r c o ngre ga te fa c i li ti e s, the i r sta ff a nd c o nta c ts Pe o p le i d e nti fi e d a s a p a rt o f a c luste r o f d i se a se tha t c o uld b e Co vi d -19 (e .g. fa c to ry w o rke rs) • Str e ngthe n public and pr ivate c ollabor ations Exp a nsi o n a nd c o o rd i na ti o n a c ro ss p ub li c la b o ra to ri e s, uni ve rsi ty la b a nd p ri va te fa c i li ti e s Co mmuni ty-b a se d te sti ng…d ri ve -thro ugh a nd w a lk-up te sti ng si te s Co st sha ri ng a nd c o o p e ra ti ve p urc ha si ng a nd d i stri b uti o n o f te st ki ts/ te sts • Standar dization ac r oss diffe r e nt type s of te sting Ne w te c hno lo gi e s fo r p o i nt-o f-c a re a nti ge n te sti ng a nd se lf-a d mi ni ste re d te sts Se ro lo gy (a nti b o d y) te sti ng E nsur ing public he alth r e por ting! https:/ / www.ng a .o rg / c e nte r/ public a tio ns/ he a lth/ ro a dma p-to -rec o ve r y / 6
Contact Tracing & Surveillance 7
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.). • Pr (e .g. a dmission, disc ha rge , a nd tr a nsfer (ADT ) ior itize Syndr omic Sur ve illanc e no tific a tio ns from all ho spitals. T his da ta c a n sup po rt e fforts to develop situational a wa re nessre late d to COVID-19 • Sta tes sho uld c onside r the use of smar t he alth tec hnologie s such as ar tific ial inte lligence ly detec tion as well a s and machine le ar ning to pr ovide pr e dic tive analytics with hour 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 state s should take advantage of the gr owing availability of mobile phones and inte r ne t- base d r e por ting tools ting , p artic ular ly whe r e that may infor m contac t tr ac ing, outbr e ak and diagnostic r e por tra d itio nalsurveilla nc e syste msa re o utd a te d . 8
Member Recommendations/ Evidence-based Strategies Cont’d • Wo rk with lo c a l to g lo b a l g o ve rnme nt o ffic ia ls to a ddre ss e xisting po lic y b a rrie rs tha t ma y pre ve nt the use o f I nte rne t-b a se d to o ls a nd mo b ile te c hno lo g ie s fo r c o nta c t tra c ing a nd pub lic he a lth surve illa nc e b y e sta b lishing c le a rly writte n po lic ie s a nd pro c e dure s fo r the a ppro pria te use o f I nte rne t-b a se d to o ls a nd mo b ile te c hno lo g ie s, inc luding sta nda rds to e nsure c o nfide ntia lity a nd c o mplia nc e with fe de ra l, sta te a nd lo c a l la ws. • De ve lo p a nd disse mina te fie ld-te ste d, e vide nc e -b a se d pra c tic e s, po lic ie s, a nd g uide line s fo r using I nte rne t-b a se d to o ls a nd mo b ile te c hno lo g ie s. Re f. https:/ / www.linke din.c o m/ po sts/ the -o nta rio -c ha pte r-o f-himss_mo b ile - ne two rk-o pe ra to rs-ro le -in-c o vid-19-a c tivity-6661228887231602689-iyn 9
Member Recommendations/Evidence-based Strategies Cont’d • E nc o ura g e s jo int lo c a l-sta te -fe de ra l de c isio n-ma king whe n pla nning a nd a llo c a ting the use o f fe de ra l, sta te , a nd lo c a l re so urc e s to e xpa nd o r e nha nc e he a lth info rma tio n te c hno lo g ie s fo r COVI D-19 a nd future dise a se o utb re a ks. • Also urg e e xpa nde d invo lve me nt o f he a lthc a re pa rtne rs (HI E s, ho spita l syste ms, F QHCs, te c hno lo g ists, e tc .) in the ro utine pla nning a nd de ve lo pme nt o f multi-ye a r e me rg e nc y pre pa re dne ss pla ns, sta te he a lth I T ro a dma ps o r o the r stra te g ic pla ns with a c o nc urre nc e pro c e ss b a se d o n the princ iple s o f c la rity, e q uity, tra nspa re nc y, a nd c o lla b o ra tio n a mo ng sta ke ho lde rs. 10
Ga ps in COVID-19 Na tio na l Da ta Co lle c tio n & Sha ring L a c k o f Inte ro pe r a bility o f Ne e d to Stre ng the n the L imite d Public R e po rting o n Multiple Spre a dshe ets & Syste ms Public He a lth Info rma tic s R a c e / E thnic ity Da ta T o o ls Infra struc ture Ne e d me c ha nisms tha t a llo w e xc hange Ne e d to a d d re ss ra c ia l d isp a ritie s Multip le silo e d e ffo rts und e rwa y to o f he a lth info rma tio n a c ro ss re la te d to a c c e ss to Susta ina b l e funding to sup p o rt a c c o mp lish simila r wo rk - ta xing ge o gra p hic a l/ p ub l ic / private d a ta he a lthc a re / testing, id e nti fying inte ro p e ra b ili ty initi a ti ve s that a lre a d y inund ated p ub li c he a lth b o und a rie s, imp ro ved d ata a na l ytic s, imp lic it b ia s in me d ic a l c a re , c o nne c t syste ms a nd fo r whic h a nd he a lth c a re p ro vi d e rs to sp e nd a nd b o lste r c a p a bilitie s fo r mo re re a l- p ro vid ing ta ilo re d p re ve ntio n a ggre ga te d d e -id e nti fie d d ata c a n a d d itio nal time -sha ring simila r time info rma tio n o n COVI D19 thro ugh me ssa ging, a nd p a inti ng a mo re b e ma d e wid e ly a vailab l e (o p e n info rma tio n to d iffe re nt e ntitie s e ffic ie nt, no n-b urde nso me re p o rting & a c c ura te ima ge o f ga p s to info rm so urc e ) d a ta c o lle c tio n d e c isio n ma ke rs
Member Recommendations/ Evidence-based Strategies T e le he a lth & RPM E xpa nsion • De velo p the b usiness c a se (c o st-be ne fits) fo rthe p e rma ne nt e xp a nsio n o f te le he alth a nd sta nd a rdize d re imbur se me nt ra te s o f a p p ro priate tele he alth se rvic es sa me a s in- p e rso n. • Build c o nse nsus o n wha t to mo nito r , a nd ho w to c ura te the d a ta fo r c ha nge , a nd the n und e rsta nd ho w to e nga ge p a tie nts/ the p ub lic to ke e p p a tie nts sa fe . • E mp ha size the ne e d fo r e xp a nd e d re mo te p atie nt mo nito r ing fo r me nta l he alth given the a fte rma th o f the so c ial a nd e c o no mic impac ts o f COVI D-19 a nd inte grate RPM d a ta into e le c tronic he a lth re c o rd s to e liminate silos. • Sup p o rt o ngo ing e ffo rts to e xp a nd b ro a d b and to sup p o rt te le health se rvic es a nd o the r virtual c a re a c c e ss. 12
State Telehealth Response to COVID -19 Alana Lerer Ma na g e r, G o v e rnme nt Re la tio ns 13 13
State Telehealth Changes • L ic e nsure Re quire me nts • Me dic aid c ove rage • Comme rc ial insuranc e c ove rage 14
Licensure Waivers for Telehealth Be for e e me r g e nc y de c la r a tion... ...49 sta te s a nd D.C. re q uire d tha t pro vide rs de live ring te le he a lth must b e lic e nse d in the sta te whe re the pa tie nt is lo c a te d Dur ing de c la r a tion... ...a ll 50 sta te s a nd D.C. a re te mpo ra rily wa iving lic e nsing re q uire me nts fo r te le he a lth, inc luding o ne o r mo re o f the fo llo wing : • Pro vide rs c a n pra c tic e a c ro ss sta te line s • Pro c e ss e xpe dite d to pro vide te mpo ra ry lic e nse s to q ua lifie d me dic a l pro fe ssio na ls 15
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