10 things for CMIOs to know during COVID-19 pandemic

Hospital and health system chief medical information officers are working day and night to help support staff with clinical and technical responses to COVID-19.

Here are 10 things for CMIOs to know:

1. HHS is now exercising enforcement discretion of its final interoperability rules to allow hospitals more time to focus on COVID-19. CMS will give hospitals an additional six months to meet new requirements under its interoperability and patient access final rule, while ONC will exercise enforcement discretion for three months after certain certification compliance dates for its final rule. CMS' original final rule would be effective six months after it was published in the Federal Register, which is scheduled for May 1; that has now been extended to one year.

2. Several hospitals and health systems are rolling out new tech to help enhance clinical care during the pandemic. Mayo Clinic created an EHR tool that alerts staff members who may have been exposed to an employee or patient who has tested positive for COVID-19; Seattle-based Swedish Health Services partnered with Microsoft to create an app for hospital workers to view and report real-time data on critical COVID-19 information including patient volumes and personal protective equipment. Other health systems are creating their own PPE by using 3D printing technology. 

3. To help maintain physician and patient connections, New York City-based Northwell Health equipped COVID-19 patients' rooms with Amazon Echo devices to allow providers to communicate with patients via two-way audio and video while reducing their exposure to the virus. In Boston, Massachusetts General Hospital workers created makeshift video portals by attaching iPads to IV poles so employees can communicate with COVID-19 patients in isolation rooms.

4. FDA has accelerated testing efforts, approving the first COVID-19 diagnostic test that can be taken at home by patients as well as a new type of swab to use for COVID-19 testing in response to a critical shortage of cotton swabs. The lack of necessary cotton swabs has been one of the biggest obstacles in expanding COVID-19 testing in the U.S. A recent Harvard University report found that the U.S. must perform 5 million COVID-19 tests daily by June to lift social distancing restrictions. The average number of tests per day from April 12-19 were 151,000.

5. Google Cloud expanded access of its Cloud Healthcare API to the entire healthcare industry, allowing organizations to input and manage health data in real time. The API uses analytics and machine learning at scale to help organizations understand data inputs. Google has been powering the Healthcare API in partnership with Rochester, Minn.-based Mayo Clinic since last year; the health system uses the technology to store and share clinical data.

6. Oracle partnered with HHS and donated its online platform Therapeutic Learning System so physicians and clinicians can report on their work and provide data about how patients respond to COVID-19 treatment. The FDA also launched an online portal aimed at expanding COVID-19 resources; the website connects recovered COVID-19 patients with access to information and locations of plasma donation sites. Memphis, Tenn.-based St. Jude Children's Research Hospital and the International Society of Paediatric Oncology created a global COVID-19 data registry and resource center for physicians treating pediatric cancer patients.

7. Health system IT departments are eager to share their COVID-19 response plans and initiatives; Cleveland Clinic published its COVID-19 Digital Health Playbook, which offers insights and tips about how the health system rapidly scaled its telehealth offerings. UW Medicine released a report detailing how it shifted its IT strategy after treating its first COVID-19 patient in late February. The health system also offered 10 must-do action items that hospital IT organizations can do now in response to COVID-19. On the clinical side, New York City-based Mount Sinai Health System and Nashville, Tenn.-based Vanderbilt University Medicine each created online training courses for their clinicians and medical students to enhance their critical care and telehealth skills.

8. Hospitals, universities, public health departments and tech companies are all focusing on data initiatives ranging from contact tracing to disease detection. Stanford (Calif.) Medicine teamed up with Scripps Research and Fitbit on a new study that aims to detect viral infections such as COVID-19 through data collected from wearable devices. The San Francisco public health department established a task force of researchers and medical students from UC San Francisco to trace interactions of people who tested positive for COVID-19 via an online app.

9. Field hospitals in New York City, Chicago and New Jersey implemented Epic EHRs, with the tech giant providing services and IT support at no cost. New York's health department deployed Epic at its 1,000-bed temporary hospital at the Javits Center through a partnership with NYC Health + Hospitals. Chicago's public health department tapped Rush University Medical Center to help roll out Epic at the 3,000-bed COVID-19 alternate care facility at McCormick Place Convention Center, and University Hospital in New Jersey partnered with Epic to transform the Meadowlands Exposition Center into a healthcare facility.

10. With CMS expanding Medicare coverage for telehealth services and loosening state license restrictions, telehealth has skyrocketed and is projected to keep growing. COVID-19 related care is expected to account for 900 million of the 1 billion virtual visits estimated for 2020, according to a Forrester report. Big payers such as UnitedHealthcare and Aetna have also waived copays and fees for telehealth visits during the pandemic. 

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