TGIF

AHRQ

TGIF

David Ermer–AHRQ, CDC, COVID-19–

The President declared COVID-19 to be a national emergency this afternoon. The Wall Street Journal reports that the President announced that efforts are well underway to greatly expand COVID-19 testing, including drive thru testing. Furthermore,

A new, high-speed coronavirus test was earlier granted emergency clearance by the Food and Drug Administration. Developed by Roche Holding AG, the test is designed to run on the company’s automated machines, which are already installed in more than 100 laboratories across the U.S. It will be available immediately.

The FEHBlog understand that these high speed tests can turn around results in 24 hours, rather than a few days.

The FEHBlog compared the Centers for Disease Control’s COVID-19 U.S. case statistics from last Friday compared to today.

CDC COVID-19 stats
6-Mar13-Mar
Travel-related36138
Person-to-person spread18129
Under Investigation1101362
Total cases1641629

That’s quite a jump. CMS and Healthcare Dive also have offered their perspectives on the import of the emergency declaration.

In other news

  • Healthcare Dive reports on a Rand study on the value of out of network cost controls.
  • On this last day of AHRQ’s Patient Safety Week, the agency called public attention to its “Guide to Patient and Family Engagement in Hospital Quality and Safety.” The FEHBlog thinks its important for health plans to help families to support their hospitalized family members.

This Guide reminded me of a related human nature anecdote that I heard on the Econtalk blog which I can share

Russ Roberts: I was talking to this nurse about the challenges of doing a good job because it can be a very boring job, and then all of a sudden it’s unbelievably intense. And at one point he said to me–and at this point, my brother and sister, our mom had all been in the room for hours over a course of three or four days.

He said, he conceded, that–he said, ‘It really helps to have family here with the patient.’

And I thought he was going to say, you know, ‘Because it helps them sustain their morale.’

He said, ‘I think it makes us do a better job.’

And I thought, of course, of Adam Smith’s impartial spectator. It’s like we’re the actual spectator, watching him, and he said–this was a great thing–he said, ‘It shouldn’t be that way.’ And he’s right, of course. It should be that you’re equally motivated whether no one’s watching. But as human beings we sometimes fall short. He said, ‘It shouldn’t be that way, but sometimes it is.’

Russ Roberts is a University of Chicago trained economist who has written on Adam Smith.

Midweek Update

David Ermer–AHRQ, COVID-19, OPM, Uncategorized–

The Office of Personnel Management issued a guidance letter to FEHB carriers on the COVID-19 virus today.

The Internal Revenue Service today issued a Notice 2020-15 which permits high deductible health plans used with health savings accounts (under Internal Revenue Code Section 223) to cover COVID-19 testing on a first dollar basis. To its credit, OPM references the IRS notice in the above linked carrier letter.

The U.S. Labor Department also issued FAQ guidance on COVID-19 or Other Public Health Emergencies and the Family and Medical Leave Act.

As noted on Monday, this is Patient Safety Awareness week. The patient safety organization ECRI Institute released a list of top 10 patient safety concerns. The Safety Week’s key sponsor HHS’s Agency for Healthcare Quality and Research issued

Making Healthcare Safer III, a comprehensive report whose pages are filled with practical information on how today’s clinicians can keep patients free from harm.

The report reviews roughly four dozen practices that target patient safety improvement across a variety of settings. If appropriately applied, many of these practices can dramatically reduce high-impact healthcare-related harms.

The 47 patient safety practices and evidence highlighted in the report include technological and staffing-related practices, a series of specific hygiene and disinfection interventions for reducing healthcare-associated infections, and several practices designed to prevent medication errors and reduce opioid misuse and overdoses.

Monday Musings

David Ermer–AHRQ, CDC, COVID-19, Electronic health records, OPM–

The U.S. Office of Personnel Management issued additional COVID-19 guidance and FAQs on Saturday March 7. The Federal News Network summarizes OPM’s issuances here.

Here are the Centers for Diseases Control’s March 9 COVID-19 statistics for the U.S.

  • Travel-related 72
  • Person-to-person spread 29
  • Under Investigation 322
  • Total cases 423

The CDC has issued guidance for people at risk of contracting serious illness from COVID-19. According to the CDC,

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

  • Older adults
  • People who have serious chronic medical conditions like:
  • Heart disease
  • Diabetes
  • Lung disease

Becker’s Hospital News reports on a study recently published in the Journal of American Medical Association. The study which was conducted in Singapore finds that from a contagion standpoint the COVID-19 virus does not linger in the air but it does contaminate surfaces.

As predicted, the Trump Administration released its final electronic health record interoperability and data blocking rules today. The objective of the rules is to give patients better access to their health records. The rules take effect as early as January 1, 2021. The implementation of the interoperability rule is staged over time.

Here are links to the government fact sheets on the final interoperability rule and the final data blocking rule. WEDI, which an information technology advisor to the HHS Secretary, prepared a helpful comparison of the proposed and final data blocking rules.

Healthcare Dive reports on industry reaction to the final rules. Healthcare Dive explains

The CMS rule requires Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Affordable Care Act exchange plans to provide their collective 125 million patients with free electronic access to their personal health data, including medical claims and encounter information including cost, by 2021.

MA plans, state Medicare and CHIP programs, CHIP managed care entities, Medicaid managed care plans and qualified health plans in the federal exchanges now have to “implement, test, and monitor” a Health Level Seven FHIR-compliant API, which the government has selected as the new national standard.

Those plans also have to make their provider directories available to current and potential enrollees through the API technology, too (excepting the federal exchanges, which already do so), by 2021, with the hope insurers will carry over those practices to private plans as well.

Finally it’s worth noting that HHS’s Agency for Healthcare Quality and Research has deemed this to be Patient Safety Awareness Week.