Track 5: Clinical Quality in Times of Uncertainty

Clinical Quality in Times of Uncertainty: What we can do now to Prepare for the Next Public Health Threat

About This Track

During this breakout participants will apply a framework for defining and rapidly updating evaluation efforts of prevention, detection, and treatment strategies using  clinical, operational and resource data.

During emerging threats, the ultimate goal is to minimize morbidity and mortality through individual and community preventive and treatment countermeasures. This breakout will provide an introduction to the Clinical Response through Emerging Technology (CRET) framework, which was created by the US Department of Health and Human Services to improve medical response during a broad range of natural and manmade hazards, including communicable and vector-borne diseases, environmental exposures, and consequences of human activity.  The CRET approach allows health and public health organizations to define and rapidly update evaluation efforts of prevention, detection, and treatment strategies using  clinical, operational and resource data. Technical standards knowledge is not required.

The breakout will address clinical and operational needs for measuring performance and outcomes specific to emerging threats to help prepare guidance for new threats as they emerge, such as  COVID19, Zika and Ebola. The breakout will address how to proceed in an organized and thoughtful manner as new threats emerge in any area including, but not limited to infectious diseases, environmental risks, weather-related events, and human-generated events.

The co-leads will initiate the a facilitated discussion about the value of the CRET framework and how to improve it. The group will then focus on a simulated new pandemic event for attendees to draw on their experience with managing existing threats and surge capacity issues and address (a) the clinical care process, (b) resource requirements, and (c) information requirements for population management balanced with clinician burden concerns.

Concepts to guide the discussion include:

  • Managing situations that cross jurisdictional boundaries
  • Assuring clinicians have the most up-to-date and pertinent information (knowledge) to assess and treat patients at the point of care (including telehealth)
  • Assuring successful performance and value-based outcomes
  • Reporting critical information to public health
  • Differentiating critical interventions requiring clinician action from informative content
  • Managing rapid change in knowledge (assuring feedback for aggregate analysis and incorporating new knowledge quickly into the workflow)
  • Metadata requirements to assure information collected can meet needs for re-use in aggregate analysis and public health

The sessions will be collaborative and allow small group sub-breakout sessions based on attendee interest to clarify specific issues and report back to the larger group.

The breakout co-leads will consolidate the information identified in a summary session to generate consensus around:

  • Value of the CRET framework and recommendations for modification
  • Essential workflow triggers common to new emerging threats
  • Metadata requirements to successfully evaluate care quality and to efficiently and effectively implement clinical decision support as feedback and guidance for existing standards and clinical data resources

Conclusions from the session are somewhat dependent on participants’ interests. However, potential outcomes include recommendations to enhance the CRET framework, suggestions for advancing HL7 FHIR adoption to address emerging threats, recommendations for metadata requirements for essential data collected, a new framework for determining what is important to measure such that outcome requirements drive workflow, measurement, and decision support.

Who Should Attend

This track is for participants who want to help determine the information requirements to manage clinical and operational outcomes during critical emerging threats while also managing clinician burden and workflow. Previous knowledge is not required of clinical quality measurement or clinical decision support Health Level Seven (HL7), HL7 Fast Health Interoperability Resources (FHIR) or Business Process Modeling (BPM+) standards. Bring your knowledge about managing quality and workflow in uncertain times.

  1. Public Health professionals with interest in surveillance, case investigation, and population measurement.
  2. Clinicians (physicians, nurses, pharmacists, etc.) with interest in quality measurement and clinical workflow.
  3. Quality management professionals with interest in data analysis and data modeling for measures evaluating structure, process and outcome.

Track Leads

Floyd Eisenberg, MD, MPH, FACP

Dr. Eisenberg supports standards for electronic clinical quality measurement (eCQM) and clinical decision support (CDS). He manages the CMS Quality Data Model (QDM) and alignment with HL7 FHIR QI-Core. He also supports development of implementable ONC and CDC Opioid Prescribing Recommendations and the Clinical Response Through Emerging Technology (CRET) framework for clinical decision support in public health emergencies. He previously was technical lead for the HIMSS Immunization Integration Program, recognizing EHR products for immunization workflow. Dr. Eisenberg is an Infectious Diseases internist. He is currently HL7 Treasurer and co-chair of the HL7 Clinical Quality Information and the HL7 Cross-Project Workgroups.

Daniel Chaput

Daniel Chaput is an IT Specialist at the Office of the National Coordinator for Health Information Technology (Health and Human Services) in Washington D.C. As a public health informatician he addresses problems with an IT toolkit that includes statistics, system and software design, and database management in addition to his management experience. He brings a unique perspective to projects and initiatives at the ONC coming from both the private sector as well as State and Local Health Departments. In addition to his work on standards implementation and testing in ONC he works collaboratively with the Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services (CMS), State and local Public Health Departments, Healthcare Providers, Vendors, and Health IT developers to overcome implementation challenges with interoperable health systems.

Paula Braun, MS

Paula Braun is an Entrepreneur-in-Residence at the US Centers for Disease Control and Prevention. She tracks evolving tech trends and helps to communicate why they matter to public health. In 2019, she was named one of the top 50 Influencers in the Federal government on artificial intelligence.  She engages stakeholder groups from across government, academia, and industry to help improve public and population health. She is an internationally recognized expert on interoperability and innovation, and she collaborates with colleagues from across CDC to use design thinking and advances in technology to help address real world health challenges.

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