Vision for NACHC-CDC Multi-State Effort on COVID-19

The COVID-19 Pandemic has disporportionally affected populations which are traditionally cared for at federally-qualified health centers (FQHCs) including:

• the uninsured
• individuals with chronic disease
• people who people working in essential jobs such as environmental services, foodservice, grocery and retail, and caregiving roles
• people who are or have been in institutional settings, such as incarceration, hospitals, nursing homes, daycare
• minorities and tribal populations
• people with insecure housing or transportation
• people who live in crowded households or shared living space

As such, FQHCs are shouldering a heavy burden of the pandemic and providing critical public health services to address the pandemic to 

What are the components of our approach with NACHC-CDC?

1) Human-Centered Design: We ask our partners to bring in real patient stories (personas and use cases) to help us understand:

• The patient and care team story – and how to communicate this at the national level
• What data we may be missing by limiting ourselves to what is already being recorded
• The kinds of limitations that may affect patients and FQHCs in responding to the pandemic

2) Gathering and analyzing data that will tell us how FQHCs are responding to and being impacted by the pandemic including:

• Extent of testing and test positivity 
• Rate of infection and outcomes of COVID-19 diagnoses
• Impact of SDOH on infection and risk
• Changes to services due to the pandemic
• Immunization rates and patterns for influenza that may help us with SARS-CoV-2 vaccination
• Works with partners to automate and improve the collection of these data

3) Creating an enduring infrastructure for collecting and automating public health data that includes a common data dictionary and a cloud-based data storage facility with advanced analytic and data cleaning tools:

• Supports a single definition for each data element that builds over time to cover a greater percentage of the content that supports health centers and public health including:
  • Demographics and SDOH
  • Encounters both face-to-face and virtual
  • Labs
  • Medications and immunizations
  • Diagnoses
  • Administrative data including staffing, equipment, operations
  • Patient outcomes and patient reported data
• Can flex to include all types of content
• Can accept machine-to-machine data transfers
• Allows rapid and automated creation of dashboards and measures

4) Facilitates partner-driven opportunities to advance interoperability, data quality, and quality improvement in response to the pandemic and shares those with the CHC community:

• Advancing electronic case reporting to public health entities including taking advantage of federal resources to connect local and state public health organizations to the electronic reporting infrastructure
• Building local dashboards to facilitate COVID-19 case and risk management or vaccination
• Implementing data quality improvement efforts to fill data gaps and improve data quality
• Providing partners the opportunity to become the first outpatient sites to report data to the National Syndromic Surveillance Program (NSSP)
• Providing expanded support for operations at the clinic level in pandemic management
• Connecting to HIEs (health information exchanges), IISs (immunization information systems) and other clinical and data systems that will advance data completeness and real-time actions