David Director of National Vaccine Program - under … for Health at OASH
Valeria Marshall OASH Deputy National Vaccine Program, Vaccine Safety
Susan Farrell OASH David public Health Advisor - Equity in COVID vaccine
Sarah Price
Julia SkapikValeria Marshall OASH
Jen Du Mond
Sum of the Adult Immunization ProgramAndrea Price
...
What is going on with the Adult Immunization services, how are you measuring, what would you like us to know?
What has been the progress
around equity
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Direct funds to the states that are lagging in IIS bi-directionality, standards, etc. Not requiring ppl to provide data to IIS, when they are not getting data back from the IIS.
Normalize data at the state level - raw data can be moved back and forth.
IZ Gateway
Create an incentive to want to be connected - care teams will get info that they need to provide better care, as states are getting data to do populatoin helath.
Jen - burden is on EHR vendors - staff are already burdened - Julia - makes sense to tackle this vendor-wide, not do a site-by-site fix at CHCs.
If we had a magic wand - what would you have us do:
Julia:
EHR is not designed to improve the quality of care - it’s designed to support a fee-for-service model. Designed to support episodes of care. If we had, in addition to feed at IIS, we had a feed available to organizations dashboard by practice. A human has to open the chart and ask it: does this person need vaccines? And the person has to be coming into the office. An IIS that does this… make it possible to get text messages out to patients.
we both work with the vendors, sties, states to talk about how we enable these workflows and getting organizations work together to help automated continuous improvement part of the process of care.
David: vendors want to be paid for it. It is on HHS and CDC’s radar.
Julia
Do a program whereby you get an incentive payment for reaching a certain bar on interoperability - sending and receiving as well as creating dashboard. Do it at the HCCN level.
For the orgs that do not have that - infrastructure to support closing care gaps - bidirectional data flow and … around the dashboard.
Has anything changed on the bundled payment system of payment of FQHC - offering vaccines is a disincentive to CHCs
Julia and Sarah - No.
Pass on the question to see if
based on vaccination rates could health centers get bonus payments as opposed to it being part of a bundled service where it hurts you if it is part of a bundle?
The vaccines are expensive to purchase and they are getting little back for giving them.
Julia -
refrigeration breaks down - vaccine has to be shared between sites - allow transfer of supplies from place to place - when vax have to expire unused rather than moved to another place. We have fabulous supply chain… how can we manage our resources better?
If you could change how the system works, money is no object, an office policy recommendation - to encourage vax, prevent financial downfall, and make records easier to use.
Julia - these things are all linked we cannot manage the supply chain and manage the IIS if we don't know:
if we don’t know who needs a vax
where they live
who is coming due
who already has the vax