Enhance health care’s impact on addressing Social Determinants of Health (SDOH) and Health Related Social Needs (HRSN) by implementing actions such as those in the U.S. Playbook to Address Social Determinants of Health
- Statewide network connecting health care and social service providers in North Carolina: NCCARE360 is statewide network with a shared technology platform uniting health care and human service organizations. This network helps providers connect individuals and families with unmet social needs to community resources.
- Cross-sector partnerships in Seattle: The Seattle Indian Health Board connects thousands of Seattle-area residents to health and social services across the region. Funding from several foundations as well as from government is braided and blended to support the Board’s programs. One such program is the Gender-Based Violence programming that provides confidential services to individuals fleeing from or who are survivors of gender-based violence.
- Investment in SDOH in Oregon: Through Oregon’s SHARE initiative (Supporting Health for All through Reinvestment), coordinated care organizations (CCOs) must spend a portion of their net income on SDOH and equity efforts in their communities. Investments with community SDOH partners must be based on priorities in the CCO’s current Community Health Improvement Plan (CHIP), include a role in spending decisions for the CCO’s community advisory council (CAC), fit into one of four domains (economic stability, neighborhood and built environment, education, and social and community health), and address the Oregon Health Authority-designated Statewide priority (currently housing).
Bolster the national special pathogen system of care, as proposed by the National Emerging Special Pathogens Training and Education Center (NETEC)
- RESPETCs played a critical role prior to and during the COVID-19 pandemic: Through NETEC, a collaborative network of 10 Regional Emerging Special Pathogen Treatment Centers (RESPTCs) undertook readiness activities that included potential respiratory pathogens. These preparations, which took place before the COVID-19 pandemic, established a foundation of readiness that enabled RESPTCs to play a pivotal role in the U.S. COVID-19 pandemic response.
- Regional centers in action: Regional centers launched into action during the Ebola outbreak of 2014. This report highlights the activities and approaches used during the response.
- NYC RESPTC leads timely, patient-centered response to the mpox outbreak: The RESPTC based out of NYC Health + Hospitals/Bellevue (NYC H+H/Bellevue), activated its Special Pathogen Program to triage and treat patients infected with mpox. Through collaboration across multiple departments within Bellevue, hospitals across the city, and the NYC Department of Health and Mental Hygiene, the RESPTC established shared protocols, based in trauma-informed care, for patient transportation, screening, testing, treatment, vaccination, inpatient care, and telehealth services.
- Multi-state RESPTC exemplars pave the way: Hospitals HHS/ASPR currently funds 13 Regional Emerging Special Pathogen Treatment Centers (RESPTC) around the country. During the pandemic, these 13 hospitals cared for some of the most critically ill patients. The NETEC, together with representatives from the RESPTCs and other partners, developed a vision for a national special pathogen system of care; however, the limited number of hospitals and partners involved to date has made it difficult to garner support and develop a platform and a plan for national implementation.
Implement and invest in industry standard data interchange protocols with a focus on those identified by the CDC, ONC, CMS, or other federal partners (e.g., Fast Healthcare Interoperability Resources, FHIR® and United States Core Data for Interoperability)
- Implementing FHIR for value-based care: In fall 2023, Providence Health System – one of the largest U.S. health systems with 52 hospitals and more than 900 clinics across seven states – developed and implemented FHIR to support value-based care in partnership with Premera Blue Cross. This platform can be adopted by other providers to alleviate administrative and financial burdens of the transition to value-based care
- Chicago innovates with EHRs and Electronic Laboratory Reporting (ELR) during COVID-19: Following a public health order mandating data submission by all acute care hospitals in Chicago, health care and public health experts came together to develop a technical infrastructure to combine multiple data feeds from those EHR systems— a regional data hub to enhance public health surveillance. A cloud-based environment was created that received ELR, consolidated clinical data architecture, and bed capacity data feeds from sites.
- PACER pilot augments eCR: The PACER (Public Health Automated Case Event Reporting) model supports targeted queries from public health to the appropriate healthcare system to collect relevant data to support public health case investigation and follow-up. The nonprofit Public Health Informatics Institute (PHII) is coordinating this pilot.
- MENDS: Empowering public health with interoperable systems: Multi-state EHR-based Network for Disease (MENDS) aims to improve chronic disease surveillance and management through the use of electronic health records/health information systems. MENDS-on-FHIR demonstrates the ability to leverage OMOP common data model and FHIR standards for national chronic disease surveillance.
- Incorporation of FHIR into California’s eCR program: The California Reportable Disease Information Exchange – Electronic Case Reporting (CalREDIE eCR) module allows health care providers and organizations to more easily comply with the California Department of Public Health requirement for the reporting of certain diseases and conditions. CalREDIE eCR replaces traditional paper-based methods of case reporting for many reportable conditions in jurisdictions using CalREDIE.
Implement the revised demographic data collection standards from the Office of Management and Budget (OMB) once released as final in 2024
- AHIP calls for action on demographic data standards: To improve upon and harmonize existing demographic data standards, AHIP convened diverse groups of health insurance providers and other stakeholders to formulate and propose (via letter to HHS and OMB) demographic data standards and has continued to call for the federal government’s action on these standards to help decrease fragmentation across the health care sector.
- Oregon goes above and beyond federal standards: Oregon passed legislation in 2020 requiring health care providers to collect and report race, ethnicity, language, and disability data (REALD) from all health encounters for reportable COVID-19 conditions to the Oregon Health Authority (see February 2021 COVID-19 REALD report here). These granular Oregon REALD data standards go beyond federal data standards.
Participate in the Trusted Exchange Framework and Common Agreement (TEFCA)
- TEFCA is expanding by adding QHINs: Qualified Health Information Networks™ (QHINs™) are health care organizations capable of nationwide health data exchange governed by the Trusted Exchange Framework and Common AgreementSM (TEFCASM).
- TEFCA’s potential benefits: One benefit of widespread TEFCA implementation for disease detection will be more seamless and bidirectional case reporting of communicable diseases and syndromic data – from emergency room data and beyond – enabling faster identification of emerging issues in our communities.
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