REALD Technical Workgroup Meeting
Welcome to the REALD Technical Workgroup Meeting on December 17, 2020. Join us for discussions on REALD Compliance Plan, OHA updates, open Q&A sessions, and 2021 planning. Learn about technical coordination for REALD implementation and more.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
REALD Technical Workgroup Meeting December 17, 2020
Agenda Welcome and Introductions REALD Compliance Plan and other OHA responses from 12/7 OHA Updates Open discussion/Q&A/Updates from you Next Steps 2021 Technical Workgroup Meetings Other Resources/Reference Slides
Welcome and Introductions Hospitals/Health Systems: Hospitals/Health Systems: Asante Kaiser Legacy OHSU PeaceHealth Providence Salem Health Samaritan Sky Lakes Southern Coos Hospital & Health Center St. Charles Health Care FQHCs and Partners: FQHCs and Partners: Klamath Health Partnership (FQHC) Multnomah County (FQHC) Neighborhood Health Center (FQHC) Northwest Human Services (FQHC) Yakima Valley Farm Workers(FQHC) Oregon Primary Care Association OCHIN Other Guests: Other Guests: Apprise Health Insights CareOregon Epic HIT Commons
OHA Staff Susan Otter, Director of Health IT, OHA Belle Shepherd, MPH, HB4212/REALD Lead, OHA External Relations Marjorie McGee, Ph.D., OHA Equity and Inclusion Division Michelle Barber, Interoperability Director, Acute & Communicable Disease Prevention Helen Kidane and Renee Harger, Acute & Communicable Disease Prevention Shannon O Fallon, Dept. Of Justice Karen Hale, Oregon Provider Directory Program Manager and Certified EHR Technology standards lead, Office of Health IT
Technical Coordination on Implementation OHA Technical Workgroup for coordinating REALD implementation approaches (October-December) EHR implementation -system updates to incorporate REALD Reporting to OHA/Public Health options for electronic reporting All Phase 1 organizations are welcome to join OHA Tiger team to align REALD data to existing data reporting requirements (e.g., CEHRT, HRSA and NIH) and structures Epic coordination supported through single Epic technical coordinator Need to schedule/plan for 2021 Meetings
REALD Compliance Plan and Other OHA Responses from 12/7/2020 Belle Shepherd, Shannon O'Fallon
REALD Compliance Plan Providers that are unable to comply with HB4212, sections 40-43, reporting requirements by the timeline outlined in rule 333-018-0011 must submitREALD Compliance Plans that: Describe how providers within an organization are working to come into compliance with HB4212 to collect and report REALD data to OHA. OHA will review the plan and may ask for additional information or clarification. OHA will approve plans that provide sufficient detail to demonstrate a good faith effort to come into compliance in a timely manner. Submit plans to Belle Shepherd (BELLE.SHEPHERD@dhsoha.state.or.us). Plans are due no later than 12/31/2020.
OHA Enforcement Discretion OHA will use its enforcement discretion and not take any formal enforcement action against an individual health care provider or facility in Phase I,so long as the health care provider or facility: submitted a Compliance Plan no later than 12/31/2020, is submitting some REALD information to OHA and is fully in compliance by the agreed upon date in the approved REALD Compliance Plan. Any adjustments needed to the plan are subject to re-approval by OHA.
Compliance Plan Criteria: REALD Submission For providers at FQHCs or those employed within a health system: REALD reporting must include making a good faith effort to submit REALD information for a majority of their COVID-19 cases. OHA expects providers to submit REALD data for as many of their COVID cases as possible while they work to come in compliance, in accordance with their REALD Compliance Plan.
Compliance Plan Criteria: REALD Submission - Hospitals For hospitals: At a minimum, hospitals must ensure that REALD information is collected and reported for all COVID-19 hospitalizations. For the purposes of this expectation, OHA will review hospitalization data by hospital facility (not individual hospital providers) REALD information submitted must include complete responses (allowing for declined, unknown and missing data due to incapacity).
Compliance Plan Template: Current Status Estimate of current % of COVID-19 patient encounters for which REALD is being reported to OHA. For providers at FQHC or those employed within a health system, please be specific about the portion of COVID cases you project you are reporting. How is REALD information currently being collected from patients? How is REALD information currently being provided to OHA?
Compliance Plan Template: REALD Plan Detailed plan for collectingREALD information from patients, depending on setting, include start date and completion date. Please include: your EHR implementation project plan, plans related to training, and indicate your planned workflows for collecting REALD, anticipated go live dates or any proposed phasing of REALD implementation. Detailed plan for reportingREALD information to OHA, including start date and completion date Including whether/when you plan to report via CSV file Note: OHA will be asking for monthly progress towards implementing the REALD plan.
New/Updated REALD Resources Monthly Provider Webinarseries with community, including: REALD Conversations: COVID-19 and the Impact on People with Disabilities December18, 2020, noon-1:30 p.m. *Register:https://www.eventbrite.com/e/reald-conversations-covid-19-and-the-impact-on-people-with- disabilities-tickets-132328222275 Asking the English Proficiency question with ELL, LEP panel members -January2021 series (TBD) Community educationto impacted communities in order to provide education about collecting and reporting REALD information Educational opportunitiesfor all partners by request Searchable FAQ webpage:https://www.oregon.gov/oha/OEI/Pages/REALD-FAQ.aspx
Q&A: How should a provider report REALD in cases of Q&A: How should a provider report REALD in cases of hospitalization/death reporting hospitalization/death reporting in particular, how should we identify the attributing provider? identify the attributing provider? in particular, how should we Hospitals have discretion within our guidance as to how they decide attributing provider. Key factors in the guidance: Timing: REALD data should be reported at the time the COVID hospitalizations are reported to OHA (which are reported immediately or within 24 hours of hospitalization (admission) or death), or no later than 10pm Sunday of that week. Attributed provider: The disease reporting rule does not specify that the provider that had the encounter (as that is defined in HB 4212) be listed in the reportable disease report, but best practice would be that whichever provider had the encounter, and thus has the duty to collect REALD, is listed on the form of report. REALD already submitted with COVID test: If a COVID hospitalized patient had a recent COVID positive test with REALD data already reported to OHA (and/or REALD had been submitted within the past 12 months to OHA) the provider does not need to resend REALD information associated with the hospitalization or death.
Q&A: What are the requirements for collecting and reporting Q&A: What are the requirements for collecting and reporting REALD for patients who are out REALD for patients who are out- -of of- -state residents? state residents? HB 4212 does not distinguish between COVID encounters with residents and non- residents. Technically, if the encounter is happening in Oregon, REALD information should be collected regardless of where the person lives. However, the purpose of REALD data collection is to provide demographic information about Oregon COVID disease reporting, support case investigation efforts, and assess and modify Oregon s approach to addressing the COVID pandemic for Oregon s diverse populations. Given this, REALD information should be submitted for Oregon residents only, although individuals whose permanent resident if out of state but are residing in Oregon for an extended time (such as migrant farm workers, college students, etc.) should be included. OHA will be matching REALD information to COVID disease reporting data, so providers may err on the side of over-reporting REALD when in doubt.
Q&A, cont. Can Canadditional categories can additional categories canbe added to REALD questions? be added to REALD questions? The current REALD data standards are the minimum standards. If providers would like to add additional categories, they may do so. Additionally, providers may advocate for additional race/ethnicity categories during the permanent rulemaking process. Can OHA create a system where patients can Can OHA create a system where patients can send in their own data or orpatient portal? patient portal? OHA is exploring the creation of a patient portal or survey tool whichwould allow patients to enter their REALD data related to a COVIDencounter, but it is unlikely that such a tool, if possible, would beavailable anytime soon. send in their own datausing a survey using a survey
Reporting Tools Updates CSV update-current is Version 1.6, updates expected: Guidance for submitting other values and including write in answers Written and spoken language and interpreter questions to be conditional and not required Code set for interpreter values Added declined and don t know values to Appendix B Changes are pending final revision and approval They should be published on the website next week
Open Discussion, Q&A, Updates from You
2021 Technical Workgroup Current status: No further Technical Workgroup meetings have been scheduled OHA is planning to host office hours for organizations that have questions about implementing REALD Questions for the Group:Should we continue the Technical Workgroup in2021? Option 1 schedule a Technical Workgroup meeting in mid-February to check in and see how implementation is going Option 2 schedule recurring Technical Workgroup meetings (monthly?) Option 3 Close the Technical Workgroup for now, keep OHA office hours as needed
Next steps OHA Technical Workgroup Tribal Consult on REALD Non-Epic groups OHA office hours Exploring future REALD collection options Updated FAQs, webinars, additional communication and outreach Workflow and EHR Implementation remaining issues? Tiger Team on race/ethnicity crosswalk to federal standards (completed for now) Potential: Future REALD collection options input Potential: Interoperability of REALD data
Other Resources, Reference Slides
REALD Resources For more information: HB 4212 and REALD: https://www.oregon.gov/OHA/OEI/Pages/REALD- Providers.aspx REALD Response Guide https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le7721b.pdf COVID-19 Reporting Portal -healthoregon.org/howtoreport CSV File Specifications are available at the Electronic Case Reporting page. Contacts: REALD: Marjorie McGee at marjorie.g.mcgee@dhsoha.state.or.us HB 4212 requirements: Belle.Shepherd@dhsoha.state.or.us To establish CSV reporting: ELR.project@dhsoha.state.or.us Technical Workgroup: Susan.Otter@dhsoha.state.or.us
HB 4212 REALD data collection and reporting Requires OHA to establish rules for phased REALD data collection and reportingby providers for COVID-19 encounters REALD data are required when reporting COVID-19 encounters that arereportable under Oregon Disease Reporting rules (OAR 333-018-0011)* COVID-19 encounters: Interaction with provider for health care services related to COVID-19 includes ordering COVID-19 test. Note: Clinical laboratories excluded until 10/1/2021 COVID Disease reporting includes: COVID-19 tests (positive and negative) COVID-19 cases COVID-19 hospitalizations COVID-19 deaths MIS-C (Multisystem Inflammatory Syndrome in Children) *Temporary rules in place; final rules March 2021
Who is subject to report and when? March 1, 2021: Oct. 1, 2021: Oct. 1, 2020: PHASE 2 Health care facilities* Health care providers working in or with individuals in a congregate setting Excludes clinical laboratories PHASE 1 Hospitals, except for licensed psychiatric hospitals Providers within a health system Providers working in an FQHC Excludes clinical laboratories Enforcement starting December 31, 2020 All providers All must report usingelectronic method *ORS 442.015(12) *ORS 442.015(12)(a) Health care facility means: (A) (A) A hospital; (B) (B) A long term care facility; (C) (C) An ambulatory surgical center; (D) (D) A freestanding birthing center; (E) (E) An outpatient renal dialysis facility; or or (F) (F) An extended stay center. https://www.oregonlaws.org/ors/442.015 26
How often are data collected and reported? Annual REALD data collection is required Providers must collect REALD data from a patient at the time of an encounter or as soon as possible thereafter If a provider has collected REALD data from a patient within the last year (12 months/365 days) and the patient has a subsequent encounter, providers may use the REALD data previously collected to report to OHA Reporting REALD is tied to COVID disease reporting REALD data can be reported either at the time of the COVID disease reporting or can be batched to be sent daily or at least weekly.
Key Updates to REALD Rules Amends "health system" definition as follows: Health system means an organization that delivers health care through at least one hospital in Oregon and through other facilities, clinics, medical groups, and other entities, all under common control or ownership. Excludes clinical labs from the definitions of Phase 1 and Phase 2 providers. Clarifies that labs are not subject to collecting REALD in situations where a hospital lab iscollecting specimens for COVID tests ordered by community providers, or for COVID testing events.
FAQ: Are extensions to the Phase 1 reporting deadline available? OHA has made a form available to submit a request for extension. OHA will not grant an extension on the basis that a health care provider lacks the current capability of capturing REALD data in their electronic health records. A detailed explanation of why the health care provider cannot meet the deadlines must be provided in the extension request. Resources: Extension requests process/forms https://www.oregon.gov/oha/OEI/REALD%20Documents/HB-4212- Extension-Requests.pdf
Current Reporting Method: COVID-19 Portal Data Entry Portal entry includes: Provider/submitter information Patient information REALD data (option to note if previously submitted) Sexual Orientation and Gender Identity (SOGI) optional COVID-19 clinical details, test information, and MIS-C Opportunity to print report COVID-19 Reporting Portal at healthoregon.org/howtoreport
Current Reporting Options: CSV file CSV File Requires OHA approval, follows OHA specification Spec. includes REALD, patient and provider identifying data,for those submitting ELR or case reporting otherwise Onboarding expected to take 1 week if an SFTP data exchange process is already in place Frequency of submission: Daily submission is preferred Weekly is acceptable -Data for the preceding week must be received by OHA/Public Health Division not later than 10 pm each Sunday. Resources: CSV File Specification (Version 1.6) is available at the Electronic Case Reporting page. To establish CSV reporting: ELR.project@dhsoha.state.or.us
Future: Electronic Lab Reporting (ELR) or Electronic Case Reporting (ECR) OHA is exploring ELR and ECR options for REALD OHA is exploring ELR and ECR options for REALD Codes will need to be created for Oregon s REALD standards in conjunction with HL7 experts ELR: Jurisdiction-specific fields can be added in Ask on Order Entry (AOE)segments ECR:There are no easy ways to add jurisdiction-specific fields to the EICR specification. Coding would need to be proposed/balloted with the international HL7 organization, which could take multiple years After coding is created, OHA would need to create specification and vendors would need to update lab/EHR systems
