Lance's Corner

AHRQ Issues CDSiC Newsletter

Jun 18, 2024

The Agency for Healthcare Research and Quality (AHRQ) has issued its Clinical Decision Support Innovation Collaborative (CDSiC) newsletter.

Issue Number 19 | June 18, 2024
In this edition of the Insider, we highlight several AHRQ CDSiC updates, including the project's recent Annual Meeting, upcoming conference presentations, and a new factsheet that provides an overview of standards for patient-centered clinical decision support (PC CDS).
Table of Contents:
Last year, the AHRQ CDSiC developed a comprehensive Environmental Scan that assessed the current landscape of standards and regulatory frameworks of PC CDS to determine gaps, challenges, and opportunities. The scan mapped findings related to PC CDS standards to the eight stages of the PC CDS technical landscape.
 
To accompany this report, the AHRQ CDSiC produced a two-page summary factsheet that shares key findings from the full Environmental Scan, highlighting available standards and future opportunities for each stage.
Read the factsheet by clicking below!

 
(L-R) Mustafa Ozkaynak, Prashila Dullabh, Polina Kukhareva, and Rachel Richesson presenting during the Scaling and Measuring PC CDS session. 
(L-R) Tiffany Peterson, Deborah Collyar, Kistein Monkhouse, Angela Dobes, and Rina Dhopeshwarkar participating in the Patient Roundtable session.

On May 14, AHRQ CDSiC stakeholders were invited to convene at AHRQ's headquarters in Rockville, Maryland for the second CDSiC Annual Meeting. The meeting, attended by about 85 in-person and virtual participants, was highly engaging and informative.  

The meeting featured the theme Building on a strong foundation to reach new heights: How can we chart a path forward for PC CDS? Throughout the day, participants engaged in interactive presentations on the CDSiC's cutting-edge work thus far, sessions highlighting new directions for the field such as artificial intelligence and assessing return on investment, and reflections from patient advocates on future opportunities for the AHRQ CDSiC.

AHRQ recently released a Notice of Request for Information calling for ideas and to identify possible collaborators in creating a new sustainment model for CDS Connect, a platform to assist the healthcare community in creating and disseminating CDS. AHRQ seeks comment on models and possible partnerships to strengthen and sustain CDS Connect as a national hub for CDS. Submissions should address the qualifications of potential partnering organizations, the proposed governance structure of a public-private partnership, the content of improvements to the CDS Connect platform, the business model, and community engagement.

Comments on this notice must be received by July 31, 2024.
We look forward to AcademyHealth's upcoming Annual Research Meeting (ARM), which will take place from June 29 – July 2 in Baltimore, Maryland. NORC at the University of Chicago and the AHRQ CDSiC will be featured in two posters of interest to the PC CDS community.
 
More information about these sessions can be found at the links below.
Scaling, Measurement, and Dissemination of CDS Workgroup: Approaches to Measuring Patient-Centered CDS Workflow and Lifeflow Impact

Developed by the AHRQ CDSiC Scaling, Measurement, and Dissemination of CDS Workgroup, this report summarizes workflow and lifeflow impacts captured in the literature and provides a framework to help identify the optimal point for a patient-centered CDS tool's deployment in a patient's lifeflow.
Standards and Regulatory Frameworks Workgroup: Improving Interoperability of Patient Apps with the Health IT Ecosystem

Developed by the AHRQ CDSiC Standards and Regulatory Frameworks Workgroup, this report identifies several opportunities for further advancement of PC CDS standards to support the interoperability between patient apps and electronic health records and other health information technology systems.
Outcomes and Objectives Workgroup: Integration of Patient-Centered Clinical Decision Support into Shared Decision-Making

Developed by the AHRQ CDSiC Outcomes and Objectives Workgroup, this report provides a framework demonstrating the potential for PC CDS to facilitate shared decision-making.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc