Population Health

We are witnessing a race in the vaccine rollout. A race towards the light at the end of a tunnel and a race which will likely define the next few years, according to Dr Charles Alessi, chief clinical officer at HIMSS. 

President-elect Joe Biden announced this week that he had nominated Dr. Rachel Levine to be the assistant secretary of the U.S. Department of Health and Human Services. Levine would be the first openly transgender person to be confirmed to a federal appointment by the U.S. Senate.  "Dr. Rachel Levine will bring the steady leadership and essential expertise we need to get people through this pandemic – no matter their ZIP code, race, religion, sexual orientation, gender identity, or disability – and meet the public health needs of our country in this critical moment and beyond," said Biden in a statement.   WHY IT MATTERS   Levine, a pediatrician who is also a professor at the Penn State College of Medicine, is currently Pennsylvania's top health official. Prior to that, she served as the state's physician general. As Biden's statement notes, Levine was confirmed for her positions three times by the Republican-controlled Pennsylvania state legislature.  As Pennsylvania's Secretary of Health, Levine has made addressing the state's opioid crisis a primary focus of her work, writing a standing order prescription for the general public to have access to naloxone.    In 2019, she also said she would work with the legislature to legalize safe syringe programs, community-based prevention programs that can provide linkage to substance use disorder treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases, among other services.   More recently, Pennsylvania became the first state to include information about sexual orientation or gender identity in its collection of COVID-19 patient data.    “We’ve had challenges in terms of the reporting, but we are adding to that reporting sexual orientation and gender identity to the (National Electronic Disease Surveillance) System,” Levine said at the time. “So, we would like as much data as possible about all the demographics of patients who have this disease.”   As LGBTQ+ Reporter Kate Sosin noted for The 19th, many of the anti-LGBTQ HHS rules enacted under the Trump administration may be challenging to reverse quickly during a Biden presidency.  In June 2020, HHS moved to roll back protections for trans people under the Affordable Care Act, sparking alarm for providers who worried LGBTQ people will avoid sharing their identities with clinicians out of fear of discrimination.   "Whenever you think that identifying yourself is going to cause problems for you or put you at risk, it creates a culture of fear," said Heather Hitson, SOGI Project Manager at UCLA Health, this past June. "It's absolutely what we don't want."   THE LARGER TREND Levine's nomination comes on the heels of a flurry of other healthcare appointments by the Biden administration.   In December, Biden appointed California Attorney General Xavier Becerra to lead the HHS. Becerra helped drive passage of the Affordable Care Act and led the defense of the law in front of the U.S. Supreme Court in November 2020. Biden also named Dr. Vivek Murthy as Surgeon General, along with Dr. Rochelle Walensky as director of the Centers for Disease Control and Prevention. In addition, the president-elect tapped Dr. Marcella Nunez-Smith as COVID-19 equity task force chair; former White House and Pentagon senior advisor Natalie Quillian as deputy coordinator of the COVID-19 response; and Jeff Zients for COVID-19 response coordinator. Back in 2013, Zients led the charge to fix the error-riddled Healthcare.gov website.    ON THE RECORD    "Dr. Rachel Levine is a remarkable public servant with the knowledge and experience to help us contain this pandemic, and protect and improve the health and well-being of the American people," said Vice President-elect Kamala Harris in a statement.    "President-elect Biden and I look forward to working with her to meet the unprecedented challenges facing Americans and rebuild our country in a way that lifts everyone up," she said.     Kat Jercich is senior editor of Healthcare IT News. Twitter: @kjercich Email: kjercich@himss.org Healthcare IT News is a HIMSS Media publication.

Healthcare providers are still facing hurdles when it comes to connecting with patients, says Jim Rogers, president of HealthConnect Networks and Mission Broadband.

The right to health, not just the access to healthcare, requires a holistic understanding of how we can provide a better quality of life and wellbeing for the individual and society, argues Bogi Eliasen, director of health at the Copenhagen Institute for Future Studies and a member of the HIMSS Future50 Community.

The web-based Quick Vaccination tool enables customers to more easily administer the vaccine at multiple locations, and generates a certificate that's viewable in the patient portal.

The prototype, jointly developed by Mvine and iProov and backed by Innovate UK, proves immunity status without disclosing the user’s identity.

A senior official said that the information is intended to provide a snapshot of the status of U.S. healthcare facilities as COVID-19 vaccine rollouts continue.

The new coalition, which also includes Carin Alliance, Mayo Clinic, Microsoft and Salesforce, is using FHIR standards to enable more secure, interoperable access to digital vaccination records.

In lieu of a federal vaccine management system – at least for now – states have turned to their own technology for allocating and tracking the COVID-19 vaccine. As states begin to expand eligibility beyond healthcare providers alone, local officials are relying on a wide variety of tools to help manage the demand.    Given the logistical issues associated with the vaccines, in conjunction with the recent announcement from the U.S. Department of Health and Human Services that states already lagging behind will be penalized with fewer doses, it's more important than ever for allocation to be as seamless as possible.   Healthcare IT News spoke to health department representatives from dozens of states to learn how they're leveraging tools to respond to the vaccination needs of their residents – and how they anticipate using that IT going forward.   Most of the states take a hybrid approach, using a dashboard to direct would-be patients to the appropriate provider.    In South Dakota, for instance – which currently has one of the highest vaccine uptake rates in the country – individuals can use the interactive map to contact the county-appropriate provider. Those providers, in turn, are using a wide variety of ways to sign people up for the vaccine, including SurveyMonkey forms and hotlines.    "As you know, SD is one of the top states leading the nation in vaccination efforts, and we consider our efficiency and transparency a big part of this," said a spokesperson for the South Dakota Department of Health. The state also notes that the CDC's vaccine locator, vaccinefinder.org, will be updated with providers once the COVID-19 vaccine is more widely available. Similarly, Michigan is directing residents 65 or older to local health departments via a state dashboard. These departments and affiliated providers are using tools such as Alchemer surveys or electronic health record portals to sign individuals up.   When it comes to tracking, a Michigan health department spokesperson said, "All doses of vaccine are reported to the Michigan Care Improvement Registry. We also track all vaccine inventories within this system."   In Arkansas, residents can use a map to be directed to community-based pharmacies that are allocating the vaccine to those who qualify. "The Arkansas Department of Health is coordinating allocations of the vaccine and providers around the state schedule vaccinations. The information is then entered by providers into our immunizations database," said a spokesperson.   And in Colorado, the state is supporting public health agencies, providers and pharmacies to "distribute the vaccine as equitably and efficiently as possible," said a spokesperson. This includes, the spokesperson continued, supporting them in setting up online sign-up opportunities and ensuring links to those are available on the state website.    "Providers are required to enter all administered vaccines into the Colorado Immunization Information System within 72 hours of vaccine administration. The secure site includes basic identification of everyone who has received a vaccine," said the spokesperson. "Authorized individuals can access immunization information in CIIS only for clinical (including data entry), quality assurance, public health, or school entry law purposes."   Other states using a dashboard model to connect individuals with local health departments or providers are Arizona, Tennessee, California, Utah and North Carolina.   Some states, meanwhile, are offering wider-ranging scheduling systems or are planning to do so as vaccinations ramp up.    People in Indiana over the age of 70 who are healthcare workers or who are first responders can sign up through a scheduling app through the state's website.   Idaho Department of Health and Welfare representatives directed Healthcare IT News to the state's Immunization Reminder Information System, which will "track, forecast, and help remind patients when immunizations are needed." In Mississippi, patients older than 65 or who have underlying medical conditions can use an online signup system.   And a spokesperson for the Vermont department of health said that the state is in the process of "setting up a registration system to get people registered for appointments." "We will have more about this when the system is up and running and when we are ready to start providing vaccines to people in the first age grouping of our next phase," said the spokesperson.   Still other states did not appear to have IT infrastructure in place on a statewide level to allow individuals to register for the vaccine, although some note they have tracking systems to send data to the federal government once individuals are vaccinated. Alabama, for example, is relying on a vaccine-scheduling phone hotline and using a Statewide ImmPRINT Registry for providers to report to the government. In Florida, some county health departments infamously turned to Eventbrite to help manage the demand. In Washington, the state has allocated doses to providers, who schedule their own clinics or appointments. And a Kentucky spokesperson said that the state health department does not have a "framework for scheduling."  "The Kentucky Department for Public Health does not have a framework for scheduling. KDPH has a framework for allocations and utilizes a collaborative approach, which integrates feedback and input from internal and external stakeholders along with community partners," said the spokesperson.  Regardless of the means, experts caution that the states especially vulnerable to COVID-19 are already falling behind when it comes to getting vaccines into arms. A report this week from Surgo Ventures found that the states it rates as being most potentially affected by negative consequences of a COVID-19 outbreak have been slower to administer their doses.   "If these vaccination trends continue, it will spell trouble for our most vulnerable communities, which need extra support due to their susceptibility to a range of health-related, socioeconomic, and structural problems," said Dr. Sema Sgaier, Surgo Ventures cofounder and CEO, in a statement.      Kat Jercich is senior editor of Healthcare IT News. Twitter: @kjercich Healthcare IT News is a HIMSS Media publication.

Lower courts had blocked FDA in-person requirements for abortion medication last summer, finding them to be a "substantial obstacle" during the pandemic.