Lance's Corner

AHRQ Issues CDSiC Newsletter

Jul 22, 2024

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

Issue Number 20 | July 22, 2024
In this edition of The Insider, we highlight several AHRQ CDSiC updates, including new reports and a journal publication focused on cutting-edge patient-centered clinical decision support (PC CDS) topics, along with funding opportunities from AHRQ.
Table of Contents:
Collecting and using patient preferences to inform healthcare decision-making are central to patient-centered care. However, the collection of patient preferences varies widely, and few PC CDS tools take these preferences into account. To help address these challenges, the AHRQ CDSiC Measurement and Outcomes Workgroup developed an inventory of 43 patient preference measurement tools.
 
Presented as a filterable, sortable spreadsheet and accompanying report, the inventory supports users in identifying patient preference measurement tools relevant to their needs, and outlines future areas of research to further elicit and measure patient preferences relevant to PC CDS.          


Read the report by clicking below!

As the use of artificial intelligence (AI) in healthcare settings continues to increase, there is a fundamental need to understand patient and caregiver views on the role of AI in healthcare, especially given its applications in PC CDS. Recognizing the importance of incorporating patient and caregiver perspectives throughout the development and use of PC CDS tools, the AHRQ CDSiC Trust and Patient-Centeredness Workgroup developed a report that documents these essential perspectives.
 
The report shares findings in four key areas: 1) participant views on the use of AI in healthcare; 2) factors that influence trust in AI technology; 3) the impact of AI use on the patient-clinician relationship; and 4) considerations for the implementation and use of AI in PC CDS. Stakeholders can use this report’s considerations to support the development of trustworthy AI-powered PC CDS.




Read the report by clicking below!
The Journal of the American Medical Informatics Association (JAMIA) recently published research from the AHRQ CDSiC Innovation Center. The article describes the development of workflow execution models, which were then used to explore three PC CDS-relevant use cases: 1) the collection and use of patient-reported outcomes (PROs) data; 2) the collection and use of patient-generated health data other than PROs; and 3) the identification of opportunities for shared clinical decision-making.
 
These use cases revealed a number of challenges, opportunities, and considerations for PC CDS "processes, procedures, technology, and expertise required to support new workflows."

Implementing and Evaluating PC CDS Strategies in Real-World Settings (U18)

AHRQ recently published a Notice of Funding Opportunity (NOFO) titled Implementing and Evaluating PC CDS Strategies in Real-World Settings RFA-HS-24-003 (U18). Applicants will propose innovative collaborative research to understand how CDS tools in real-world healthcare settings can be improved to become more patient-centered. Funded research will contribute to generalizable knowledge about how patients, families, and caregivers can become meaningful partners in the codesign, implementation, use, and evaluation of PC CDS.

Since 2016, AHRQ's Patient-Centered Outcomes Research (PCOR) CDS Initiative, and the CDSiC in particular, have developed resources that are now publicly available for investigator-initiated research to further develop, test, and build upon in real-world healthcare settings. Using these resources as starting materials, applicants will propose innovative collaborative research to understand how CDS tools in real-world healthcare settings can be improved to become more patient centered. Read more about this exciting opportunity here.

Additionally, AHRQ will hold a technical assistance webinar to provide potential applicants with information about RFA-HS-24-003 and respond to questions. The technical assistance webinar will take place on Thursday, August 1, 2024, from 1:00-2:00pm ET. To attend this webinar, you must complete the registration form at https://cma.ahrq.gov/rfa-hs-24-003. Registrants will receive login information approximately three days before the webinar. The technical assistance webinar is open to any individual or organization interested in the NOFO. Attendance at this webinar is optional and not required to submit an application. Participants are encouraged to submit questions by Friday, July 26, 2024 in advance of the webinar. Please e-mail any questions to clinicaldecisionsupport@ahrq.hhs.gov with the subject header "TA Webinar Question."

Applications for this opportunity are due on September 12, 2024.

Notice of Request for Information on Designing the Future of a National Hub for Clinical Decision Support – Last chance to submit your ideas!

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 comments 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.

On July 24 from 2:30-4:00pm ET, join AHRQ's National Webinar to hear from an expert panel on the ways that quality improvement efforts and digital healthcare tools, including CDS systems, can help reduce medication errors, improve provider effectiveness, and enhance patient safety in clinical settings.
The 2024 MCBK Global Meeting will take place virtually on October 23, 2024. The meeting will focus on exploring generative AI, including the role generative AI can play in improving human health by mobilizing computable knowledge around the world.
 
Find out more – and register for free – at the MCBK website.
All 19 past issues of the Insider are now available on our website! Click here to view our past issues, which share more about the AHRQ CDSiC products that have been produced so far and important resources for PC CDS stakeholders.

Taxonomy of Patient Preferences

Developed by the AHRQ CDSiC Outcomes and Objectives Workgroup, this report provides a framework for developers, evaluators, patient advocates, and organizations looking to advance patient-centered care by incorporating patient preferences into the delivery of PC CDS.

An Introductory Handbook for Patient Engagement Throughout the Patient-Centered Clinical Decision Support Lifecycle

Developed by the AHRQ CDSiC Trust and Patient-Centeredness Workgroup, this handbook provides guidance on the best methods to engage patients in the development of PC CDS tools.
 
The Clinical Decision Support Innovation Collaborative (CDSiC) is a community of broad, diverse stakeholders at the forefront of using technology to better support care teams, patients, and caregivers. The CDSiC is working toward healthcare decisions that are driven by both patient-centered and patient-specific information and that align with patient needs, preferences, and values. The CDSiC is funded by the Agency for Healthcare Research and Quality (AHRQ) as part of a multi-component initiative to help advance patient-centered outcomes research into practice through CDS. For any inquiries regarding the CDSiC you may contact the project team at CDSiC@norc.org.

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