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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Resource Overview

  • Rationale
  • Challenges
  • Approach

Mobile health (mHealth) tools have the potential to play a pivotal role in fostering a sense of greater patient engagement within underserved populations. By facilitating patient use of mHealth applications in collaboration with electronic health record (EHR) and personal health record (PHR) systems there is an opportunity to empower individuals to take a more active role toward managing their health conditions.

The proliferation of consumer mobile health applications and devices is creating new opprotunities for engaging patients in their care and leaves little doubt as to the impact that these tools will have on the way that people manage their health, health information, and health communications with their care providers, family and friends. This shift to increased self-management of health by consumers will change a patient’s relationship with their doctor and the way healthcare is practiced.
The current laws and standards in place to ensure patient’s privacy and health information security will need further review to determine whether mobile health technologies create unique situations that are not yet addressed. This poses many challenges for health centers as to how best to support patient use of these tools and ways in which to incorporate them into their own clincial support systems.

Mobile health characterizes a shift in the point of care for the patient. The point of care has classically been located at the hospital or clinic. Mobile health is beginning to shift this model so that the point of care is more frequently a matter of where the person happens to be located at that time, consequently providing opportunities for more timely care. It is also important to note that these tools help to increase the accessibility of Healthcare to populations where direct access to Healthcare professionals is limited and so health management is more frequently left in the hands of the consumer.

The tools provide in this resource cover a range of different mobile health tools, strategies, and guidelines for consideration as Health Centers seek to leverage these technologies to better engage and activate their patients.

Mobile Health Resources

Health Center Resilience in the Face of Cyber Adversity
Health Center Resilience in the Face of Cyber Adversity

Health Center Resilience in the Face of Cyber Adversity

The use of ransomware — malicious software that restricts access to computer systems with financial demands — has escalated, targeting health centers and putting countless lives at risk. This dire reality came to the forefront during the alarming ransomware attack on the Family Health Center of Worcester, Inc. (FHCW), where the personal health information and care continuity for thousands of patients were compromised. This resource uses FHCW's experience as a case study to demonstrate the imperative of preparedness and the strength of a community-centered response in ensuring the continuity of healthcare services amidst the ever-growing tide of cyber vulnerabilities.
Navigating Compliance Challenges with the Information Blocking Rule: A Collection of Case Studies
Navigating Compliance Challenges with the Information Blocking Rule: A Collection of Case Studies

Navigating Compliance Challenges with the Information Blocking Rule: A Collection of Case Studies

The Office of the National Coordinator for Health Information Technology’s (ONC) 21st Century Cures Act Information Blocking Rule (Info Blocking Rule) prohibits covered actors – including health care providers, health IT developers of certified health IT, and health information exchanges/health information networks– from engaging in practices likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (EHI). The Info Blocking Rule includes eight exceptions that provide actors with certainty that, when their practice interferes with the access, exchange, or use of EHI and meets the conditions of one or more exception, such practice will not be considered information blocking. An actor’s practice that does not meet all the conditions of an exception will be evaluated on a case-by-case basis to determine whether information blocking has occurred.

Sensitive Information and the Electronic Patient Record
Sensitive Information and the Electronic Patient Record

Sensitive Information and the Electronic Patient Record

With nearly 100% of community health centers utilizing electronic health records (EHR) to care for patients, focus has pivoted from implementation and new workflow development to enhancement in order to drive value and reflect patient needs and population trends. EHR technology presents potential opportunities and significant constraints. Providers frequently document and share potentially sensitive information in the EHR, such as risk for intimate partner violence (IPV), consistent offers of pre-exposure prophylaxis (PrEP), or patient sexual orientation and gender identity (SOGI). Capturing such information can be immensely helpful in providing care tailored to individuals’ needs, but additionally challenges teams to develop workflows that keep the data private rather than risk harm to patients through improper or unintended disclosure.

Health Center Information Blocking Avenger
Health Center Information Blocking Avenger

Health Center Information Blocking Avenger

In March 2019, the Office of the National Coordinator for Health Information Technology (ONC) issued a Proposed Rule, 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program. ONC released a final rule in March 2020, published in the Federal Register on May 1, 2020. The Final Rule on Information Blocking prohibits actors from blocking the exchange of electronic health information and seeks to increase the ease and choices available for patients to access their data

Click Read More below to understand how this impacts health centers.
SAMHSA 42 CFR Part 2 Revised Rule
SAMHSA 42 CFR Part 2 Revised Rule

SAMHSA 42 CFR Part 2 Revised Rule

New guidelines from SAMHSA released in July 2020 are designed to improve coordination of care for patients in treatment for substance disorder, while protecting confidentiality against unauthorized disclosure and use of patient information. View this HITEQ webinar on changes to SAMHSA’s 42 CFR Part 2 rule (Part 2) which protects individuals receiving substance use disorder treatment by defining privacy and security requirements for written, electronic and verbal information. This webinar features expert presenters from the University of New Hampshire Institute for Health Policy and Practice and the Center of Excellence for Protected Health Information who present on the new final Part 2 rule and future changes in the CARES Act, including what has changed, what has not changed, what this means for health centers in regard to consents and disclosures, and the implications for care coordination. This presentation also addresses privacy considerations for tele-behavioral health and exceptions during the state of emergency waiver.

Behavioral Health Consent Management
Behavioral Health Consent Management

Behavioral Health Consent Management

The timely exchange of health information between behavioral health providers and physical health providers to support care coordination is a critical element of the National Quality Strategy and health reform efforts. However, privacy and confidentiality concerns are currently limiting the inclusion of behavioral health data in electronic health information exchange efforts.

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable suggestions and contributions from HITEQ Project collaborators.

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