Lance's Corner

AHRQ Issues CDSiC Newsletter

Feb 20, 2025

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

Issue Number 26 | February 20, 2025
In this edition of the Insider, we highlight three AHRQ CDSiC resources focused on assessing the impact of patient-centered clinical decision support (PC CDS), share the latest AHRQ CDSiC Stakeholder Center Progress report that outlines the Center's upcoming work, and provide an update on the February Mobilizing Computable Biomedical Knowledge (MCBK) North America Chapter Meeting.
Table of Contents:
Measuring the impact of PC CDS on healthcare delivery and healthcare outcomes has long been a priority for the AHRQ CDSiC, as this work lays the foundation for further scaling and implementing PC CDS across health settings.

The reports, resources, and tools created by the AHRQ CDSiC support the broader CDS community in advancing the consistent measurement and evaluation of PC CDS.  These include:
The AHRQ CDSiC will continue to explore this critical topic in 2025.  For a full list of the AHRQ CDSiC's measurement resources, click here!
The AHRQ CDSiC's Stakeholder Center provides the project's thought leadership through its four Workgroups, which produce resources that advance PC CDS for the broader community and help inform the overall work of the AHRQ CDSiC.

The Stakeholder Center's latest Quarterly Report describes its recent activities and upcoming work.  Over the course of 2025, the Workgroups will produce 11 resources centered on a range of key patient-centered topics, which include:
  • Advancing patient engagement in PC CDS research
  • Minimizing patient burden when providing data for PC CDS
  • Patient-informed considerations to guide the use of artificial intelligence (AI) in PC CDS
The AHRQ CDSiC will continue to share updates on these cutting-edge resources as work progresses.  In the meantime, learn more by reading the full report here!
MCBK is an international community from academia, the sciences, and government working together to ensure that biomedical knowledge in computable form is findable, accessible, interoperable, and reusable.  The group's next event, the MCBK North America Chapter Meeting, will take place virtually on February 27 and 28, 2025 from 1:00-5:00pm ET.  

The meeting will feature several topics of interest to AHRQ CDSiC stakeholders such as: 
  • Emerging synergies of AI in learning health systems
  • Industry engagement in computable biomedical knowledge 
  • Poster presentations and technical demonstrations on studies, conceptual analyses, and innovative systems, services, and designs relevant to computable biomedical knowledge 
Find out more – and register for free – on MCBK's website.  We hope to see you there!
This section highlights two recently published journal articles that feature topics of interest to AHRQ CDSiC stakeholders.  These articles further the PC CDS research agenda with their contributions to key topics, including:
  • How AI-supported CDS could impact the patient-clinician relationship
  • The identification of user-centered design recommendations to guide the creation of explanation user interfaces (XUIs) for AI-based CDS
Impacts of Clinical Decision Support Systems on the Relationship, Communication, and Shared Decision-Making Between Health Care Professionals and Patients: Multistakeholder Interview Study

This study explores how AI-supported CDS systems could influence the relationship between patients and clinicians.  Through interviews and focus group sessions, medical and nursing students shared that AI-supported CDS tools held promise for promoting patient empowerment, but noted that the effective use of these tools would require increased communication and patient education.
Overview of Basic Design Recommendations for User-Centered Explanation Interfaces for AI-Based Clinical Decision Support Systems: A Scoping Review

The persistent difficulty in understanding how the outputs of AI models are generated has limited the implementation of AI-based CDS in clinical settings.  To address this challenge, the scoping review identified recommendations for the effective design of XUIs, which present "any information that makes it easier for the user to make sense of or understand the system's output or to facilitate its appropriate use."
 
While the review resulted in 64 overarching recommendations to guide the user-centered design of XUIs, it also revealed the need for more evidence to develop more specific, implementable design recommendations in this area.
 
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