Lance's Corner

AHRQ Issues CDSiC Newsletter

Nov 19, 2024

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

Issue Number 24 | November 19, 2024
In this edition of the Insider, we highlight a new resource focused on assessing the value of patient-centered clinical decision support (PC CDS), reflect on the AHRQ CDSiC's accomplishments over the past year, and share a recent publication from the AHRQ CDSiC team.
Table of Contents:
More insight into the value of PC CDS is needed to promote the implementation and use of these tools. However, the impacts assessed in economic evaluations of CDS vary, which can limit the use of findings to assess value. Further, limited measures exist to gauge PC CDS value from the patient perspective.

To help address these gaps, the AHRQ CDSiC's Implementation, Adoption, and Scaling Workgroup developed a new report that identifies methods that can be used to assess the value of PC CDS. The report summarizes examples of the economic and clinical impacts used in evaluations of decision support interventions, discusses challenges in assessing PC CDS value, and presents alternative considerations. PC CDS stakeholders can use this report to support a more holistic approach to PC CDS value assessments, including by incorporating patient-centered factors. Read the full report here!
JAMIA Open recently published a new Perspective piece from members of the AHRQ CDSiC leadership team. The article summarizes key themes that arose from stakeholder discussions at the first AHRQ CDSiC Annual Meeting.

Meeting participants, including researchers, informaticians, federal representatives, clinicians, patients, and electronic health record developers, discussed seven key opportunities to advance PC CDS.  These opportunities offer guidance on future directions for the PC CDS field. Read more about these key opportunities here!
Since its launch, the AHRQ CDSiC has worked extensively to generate innovation in the field of PC CDS. A new AHRQ CDSiC report presents details on the project's key accomplishments and summarizes critical lessons learned from three years of leading the collaborative. Click here to read the full report and learn more about the AHRQ CDSiC team’s approach to evaluate the project's progress to date.

As described in the report, this project has produced 21 public-facing resources that provide concrete recommendations and guidance to advance the scalability, quality, and effectiveness of PC CDS over the past year. Click here to access all of these resources on the AHRQ CDSiC website.
The 2024 AMIA Annual Symposium took place this month in San Francisco, CA. The Symposium closed with the highly anticipated "Informatics Year in Review" session that featured recent publications AMIA Working Groups found significant and would recommend as part of a "reading list" for AMIA members. We are thrilled to share that during this session, AMIA highlighted a paper authored by AHRQ CDSiC leadership!

The paper, published in JAMIA, focuses on the PC CDS lifecycle framework developed and vetted by members of the AHRQ CDSiC. The article describes the work that must be completed in each of the framework's eight stages to realize the benefits of PC CDS, and identifies opportunities for patient and/or caregiver participation throughout. Read the full article here!
The 2024 MCBK Global Meeting took place virtually on October 23, 2024. The meeting focused on exploring generative artificial intelligence (AI), including the role generative AI can play in improving human health by mobilizing computable knowledge around the world.

Meeting materials, including the meeting program and lightning talk abstracts, are available on MCBK's website, and presentation recordings are accessible on MCBK's YouTube channel.

The CDSiC's work was highlighted in two lightning talks:
  • Prioritizing Patient Preferences for Standardization to Support PC CDS, part of the Standards, Interoperability, Metadata for CBK breakout room. 
  • Considerations and Opportunities for the Use of Artificial Intelligence to Scale PC CDS, part of the Synergy Between Goal-Based CBK and Generative AI breakout room.
Exploring Challenges and Opportunities for Patient Engagement, Implementation, Adoption, and Scaling Through PC CDS Case Studies

Developed by the AHRQ CDSiC's Implementation, Adoption, and Scaling Workgroup, this report offers insights from nine AHRQ-funded PC CDS projects and provides practical guidance across four domains: patient engagement, implementation, adoption, and scaling.
Prioritizing Patient Preferences for Standardization to Support PC CDS

Developed by the AHRQ CDSiC's Standards and Regulatory Frameworks Workgroup, this report identifies key themes related to the routine collection of patient preferences, patient information that should be prioritized for standardization, and challenges with standardizing patient preference information.
 
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