Posts Tagged: data sharing

Does the U.S. Have a Clear COVID-19 Data Sharing Strategy?

Posted April 29, 2020 by Beth Osborne & filed under Healthcare, Pharmacy.

As pharmacies step up to expand coronavirus testing, again highlighting their pivotal role in the COVID-19 pandemic, there are still questions that remain about COVID-19 data sharing. Data has become a critical and valuable resource for understanding the virus. It’s also having an impact on the decisions that leaders make as they determine if it’s safe to lift stay at home bans. Data sharing is not new to the healthcare ecosystem, but it’s always been fraught with challenges. The question is, are those issues being addressed?

Pharmacies Announce Plans to Expand COVID-19 Testing

Walgreens recently announced a partnership with LabCorp to have drive-thru testing in 49 states and Puerto Rico. The implementation of these testing sites will be determined in collaboration with government officials. They expect to be able to test 50,000 individuals a week. However, patients still must meet certain criteria for testing, as outlined by the CDC. Walgreens will use the LabCorp nasal swab diagnostic test. The pharmacy chain did not clarify how the data will be collected and shared.

CVS also announced that it plans to offer self-swab testing at locations for those that meet the CDC requirements. They expect to have 1,000 locations with the capability by the end of May with the capacity to process 1.5 million tests each month. CVS also did not convey their strategy for COVID-19 data sharing.

Challenges Related to Aggregating and Sharing Testing Data

City, state, and federal officials are all diving deep into data to respond to coronavirus. That data is helping create predictive models regarding the proliferation and spread of the disease. Much of that is based on testing data, which has been under speculation, for several reasons:

Widespread testing isn’t yet available
To get tested, patients must meet specific criteria
There are different tests
Variables regarding false positives and negatives

In the world of big data, these aspects make the quality of the data questionable. It’s not simply the many variables—lots of data has variables. But remember, there was not a plan in place for how to test for a virus pandemic. The response has been hurried, emphasizing testing, yet states didn’t have the tests or a process.

In a perfect world, it would be possible to aggregate all these streams of data. However, healthcare data sharing has always been a complicated process. COVID-19 has made this all too apparent.

Patient-Level COVID-19 Data

One of the biggest concerns is that patient-level COVID-19 data is not publicly available. The available data lacks comprehensive detail beyond the typical points. To understand the virus and its path, global researchers need access to the data. No such database exists, and it would be a difficult path to make it happen.

If the U.S. already has a world of challenges related to data sharing, which were to be somewhat corrected by the new interoperability rule, then merging information from every nation would seem impossible.

The reason for a database not existing isn’t because of the absence of technology or precedent. For example, the Medical Information Mart for Intensive Care (MIMIC) has been a model of publicly available, de-identified electronic health record data sharing. With MIMIC as a prototype, it’s evidence of the possibility.

Right now, the U.S. is up against many challenges to set a new path—regulatory hurdles, budgets, collection processes, and more.

Interoperability Is Critical Concern in COVID-19 Data Sharing

It is possible to have a greater data sharing initiative with COVID-19, but interoperability deals a lot of uncertainty. First, there is the fact that if pharmacies are acting as testing sites, where does the data go? Pharmacies don’t have EHRs; instead, they use pharmacy software to track patients and medications. It’s not entirely unlike an EHR, but in most cases, the information a pharmacy stores on a patient isn’t what the hospital or medical practice has.

Further, while HIPAA governs regulations on the collection, use, and transmission of PHI, each state has different policies. Those policies are different because insurance is regulated at the state level.

Without national standards on interoperability, the process lacks consistency. It’s already hard to share patient data with another provider, not in their network. How can this possibly scale on a national or global level?

COVID-19 Will Forever Change Data Sharing in Healthcare

The U.S. healthcare system already knew it had a PHI data sharing problem. While we depend on technology to drive efficiency and convenience, it often doesn’t work out that way in healthcare. While the new interoperability rule was already published (its enforcement has since been extended), the coronavirus pandemic will certainly inform it, and any further calls for improved data sharing in the future.

What do you think? What are some practical and proactive steps the country can take right now to improve data sharing?

The Role of Pharmacy in the COVID-19 Outbreak

Posted April 9, 2020 by Beth Osborne & filed under Pharmacy, Regulatory News.

The healthcare ecosystem is on the frontlines of fighting coronavirus. Each stakeholder plays an essential role in responding to the virus. That includes pharmacists. The role of pharmacy in the COVID-19 outbreak is evolving and changing, providing critical ways to help mitigate the spread, deliver medications, and assisting with testing.

HHS Authorizes Pharmacists for COVID-19 Testing

On April 8, HHS issued a statement that authorizes licensed pharmacists to order and administer COVID-19 tests. With this one decision, pharmacists can now provide easier access to testing. By doing so, pharmacists are now able to speed up diagnosis. This can lead to earlier treatment and reduce the chance that the person will infect others.

Pharmacists have long acted as counsel to patients. They’ve been a key player in immunizations as well. This new ability to test for COVID-19 allows them to make a difference in their patients’ health.

Shortages Are Becoming More Common

Drug shortages have been an emerging fear for patients and the healthcare community. These concerns include the increased demand for medications that can treat COVID-19 as well as the medication taken for chronic conditions.

Some reports have actually found these two points converging. Those with autoimmune diseases, like lupus, are now facing shortages. Hydroxychloroquine is a prescription that helps those with lupus fight off flares. It’s now been making headlines because it may be a possible treatment for coronavirus. Patients are scared they’ll be cut off because of new demand.

Supply, Demand, and 90-Day Fills

Further, pharmacists are also facing new requests for those with chronic diseases, asking for 90-day supplies due to the concern with needing to shelter in place. The problem many may be facing is that not all insurance providers allow 90-day fills for medications.

It’s a perfect storm of concerns with access, demand, and supply. Finding new suppliers is challenging and often comes with a heftier price tag. As the role of pharmacy in the COVID-19 pandemic grows, each pharmacy must contend with ensuring that their patients have the medications they need.

What Pharmacists Need to Address Operational Challenges and Care Continuity

Pharmacy organizations issued a joint policy recommendation to enable pharmacists to do more. To address the issue of shortages in medication and workforce, these groups have requested a relaxation of operational barriers.

In short, they want to introduce flexible staffing that allows pharmacists and techs to work across state lines, open satellite locations in pharmacy deserts, and waive limitations on who can staff the pharmacy. Additionally, they have called for the ability to provide early refills and more 90-day supplies.

When looking at the shortage of medication issues, pharmacists would like to be able to allow therapeutic interchange and substitution. Further, they want expiration dates extended and more transparency from the FDA about supply chain shortages.

With these changes, pharmacists can be better prepared to keep serving their communities.

Keeping Patients Informed

As a direct point of access for many patients, pharmacists have become providers of information as well. Many pharmacies are using different channels to communicate with patients. That includes signage at stores that offer advice from the medical community or sending communications to patients to update them on how their response to the virus. Patients need to hear from pharmacists now. This reassurance could minimize their worries.

Sharing Data: Essential in Tracking the Virus

The ability to share pharmacy data without different entities could offer the healthcare community more insight. The HHS announcement did not provide any details on how pharmacies will share test results. While they are likely to submit them to government entities like HHS and the CDC, other studies may benefit from them as well.

Currently, John’s Hopkins has a coronavirus tracker, which provides information by state. There is also an IHME Model, which projects hospital resource use. Researchers and experts at multiple pharmaceutical and healthcare companies are scrambling to create a vaccine, and pharmacy data could help.

The pharmacy data of prescriptions for those with COVID-19 could deliver key information to learning what’s working and what isn’t. Data sharing is a critical need right now, as we all come to understand the virus better.

Pharmacy on the Frontlines

As with any healthcare emergency, each segment of the industry has a role to play. Pharmacists just like physicians, nurses, and other clinicians, are on the frontlines of COVID-19. As a partner to the healthcare community, we appreciate all you do. We’re here to support you along the way.

Telemedicine Challenges and How to Resolve Them

Posted April 2, 2020 by Beth Osborne & filed under Healthcare, Regulatory News.

Telemedicine is exactly the kind of digital transformation healthcare needed. It’s revolutionized care, saving money, time, and possibly lives. Now, the need for telemedicine is heightened as the world faces the COVID-19 pandemic. Even though telemedicine has evolved, it’s not perfect. Let’s look at some of the current telemedicine challenges and ideas for solving them.

COVID-19 Has Led to Relaxed Restrictions

CMS and other entities have relaxed restrictions on telemedicine in response to the coronavirus. Medicare coverage of telehealth visits has expanded, adding 85 new services that are covered. Following suit, states and payers have rolled back previous restrictions. Coverage has long been a telemedicine challenge, and the environment has prompted swifter change.

While some restrictions have been removed, private insurers still have inconsistencies. Regulation of insurance occurs at the state level. That means that national insurers could have different rules for each state. This issue needs to be addressed with standardization.

Post-pandemic, all payers should reconsider coverage of telehealth visits. Having this option for all patients could encourage better preventive care while allowing providers to treat more efficiently.

One of the biggest gaps, still unaltered by an ease in restrictions, is that therapy sessions still remain uncovered. Mental health is just as important as physical health. Having easier access to mental health resources could have a significant impact on patients.

Lack of Broadband Internet Access

Even though we live in a digital world, about 10% of the U.S. population doesn’t use it or have it. The internet isn’t considered a public utility. Many have propositioned that local governments should build their own broadband networks instead of relying on internet service providers (ISPs).

There is an opportunity for payers to get involved in the discussion. They could offer incentives for using telemedicine. To determine if this would be cost-effective, payers will need to look at all the costs. Could providing internet to patients without it actually decrease overall healthcare costs? It’s a question CMS and private payers should consider.

Interoperability and Integration

If you’re new to telemedicine, you may be concerned about how to select and roll out a program. There are lots of pieces that need to fit together, especially regarding interoperability and integration. Can your telemedicine platform gather information or transfer it to your EHR? As a user, you want a tool that fits in with your workflow and makes it easy to collect and share patient records. On top of this, you’ll need to consider HIPAA compliance.

Launching new software is critical right now, but it’s not something you want to deploy without ensuring it’s effective and efficient. What may be holding you back is the additional strain it may put on your internal IT resources. Partnering with a provider that can compliantly share PHI can accelerate deployment and adoption.

Embracing Telemedicine Now and in the Future

Telemedicine is really about offering access. Patients, especially those in rural areas, need expanded options. By solving some of the remaining telemedicine challenges, the healthcare ecosystem can scale and truly provide unabated access.

What do you think? Is telemedicine the future of healthcare?