From the President’s Desk
Submitted by Chelsey Davidson
Hello AAHQ Members!
As we begin to wrap up our business in 2022, amidst all of the hustle and bustle that comes with the holidays, I hope you are all warm, well, and taking the time to reflect on and enjoy all of your accomplishments and blessings from this year. One of my greatest sources of joy in 2022 has been serving as the AAHQ Board President. In a time when it’s impossible to not hear healthcare leaders from across our state and nation comment on the severity of the challenges being faced by institutions and individuals who serve in this sector, including the present financial and staffing constraints, we have been forced to creatively work to overcome these obstacles so we can continue to provide high-quality healthcare to the patients and families in our state. But I don’t have to tell you this – you all live and breathe this each and every day! It has been an absolute privilege to work alongside the members of the AAHQ Board to serve as a resource for and maintain connections with healthcare quality professionals in Arkansas, despite the challenges we’re all faced with – Thank you for allowing me to serve in this role. In January of next year, Devin Terry will move into the role of AAHQ Board President. Devin currently serves as the Director of Clinical Education at UAMS and is currently seeking her Ph.D. in the UAMS College of Nursing. She will do a fantastic job serving as Board President and I ask that you all give her a warm welcome. I would also like to mention that current members of AAHQ should be receiving a package in the mail that contains a membership gift, just in time for the holidays. This gift is a Weekly To-Do List Mousepad and is a small token of appreciation for you and all that you do for the field of healthcare quality. Be on the lookout!
Happy Holidays & Merry Christmas!
Chelsey Davidson, CPHQ
2022 AAHQ Board President
Professional Development Roundup
Submitted by Justin Villines
It was with great sadness that the 2022 AAHQ Conference scheduled for Friday, December 9th was canceled. With the amount of viral respiratory illnesses affecting so many and the staffing issues many of our healthcare institutions are facing, the AAHQ Executive Board recognized that taking time away from work may not be the most feasible or responsible choice for many. The decision to cancel this event was not an easy one for our Board to make, as it would have been our first in-person event for our members since before the beginning of COVID and we were all so looking forward to bringing our state’s healthcare quality community together.
The Professional Development Team is hopeful we’ll be able to pull our membership together next year for educational and networking events. We do plan to host an educational event in the Spring of 2023 to help meet this need.
Again, THANK YOU for all you do in quality to improve the lives of Arkansas residents.
Wishing you a very Happy Holidays and New Year!
Justin Villines
2022 Professional Development Team Lead
Membership Services Update
Submitted by Tim Copeland
Please enjoy our membership spotlight below.
Membership Highlight
Distinguished Member of 2022
Dalana Pittman, BSN RN CPHQ
Dalana is the Director of Data Abstraction Services for American Data Network(ADN) in
Little Rock, AR. ADN provides a wide range of services that assist Healthcare
Organizations aggregate and mine data to identify patterns, trends, and priorities within
the clinical, quality financial, and patient safety domains. Dalana graduated from
Henderson State University with her Bachelor of Science in Nursing in 1998. She began
her career in ICU and quickly transitioned to the Emergency Room where she worked
for 10 years. In 2010, she moved to the Quality Department and began her work in Core
Measures and Process Improvement. She accepted her position at American Data
Network in 2012. Dalana has been a member of NAHQ and AAHQ since 2012 and
earned her CPHQ in 2013. She then joined the AAHQ Board in 2014. Dalana has
served in various roles benefiting AAHQ, including Member at Large, Secretary, and,
most recently, Communications Team Lead. She has been critical to the leadership of
AAHQ in harnessing the power of the Internet and other communication tools at our
disposal. Through her efforts, AAHQ continued to maintain contact with members
even as the organization navigated the pandemic.
If you are not a member of AAHQ today, please honestly consider joining RIGHT NOW! Why are you waiting? To join visit our website Membership | Arkansas Association for Healthcare Quality (arkahq.org) and sign up online or print the paper form and mail it in with payment. Then connect with other healthcare professionals across the state to provide higher quality direct patient care to all Arkansans. If you have questions or need help, please submit an online question at | Arkansas Association for Healthcare Quality (arkahq.org) or call AAHQ at 501-224-7878.
Tim Copeland
2023 Membership Services Team Lead
Communications Update
Submitted by Dalana Pittman
It is with mixed emotions that I announce my retirement from the AAHQ Executive Board. It has been an honor to spend the last decade learning from and networking with various Board members. I will forever be grateful for my time with this team and encourage anyone interested in joining the Board to reach out to a Board member. Not only will you be networking with the quality leaders in the state, but you can learn so many other things that can enhance your skillset, i.e., website design and maintenance, bylaw creation, organizational finance, newsletter creation, conference planning, social media, and membership recruitment and activities. Please reach out to a Board member and join one of our teams today!
I leave the Communications Team Lead role in good hands. In 2023, Joel Anderson will be joining our Board in the lead role for communications. Joel has worked in quality for numerous years and currently works for Jefferson Regional Medical Center in Pine Bluff. I wish him well in his new role and look forward to all the wonderful things to come in the future for AAHQ!
Dalana Pittman
2022 Communications Team Lead
Finance Action Team Update
No financial update was available at the time of this publication, but we are in good standing. Official end-of-year data will be provided in the next publication.
Protocol Update
Submitted by Erin Bolton
Congratulations to Kristi Toblesky for being elected as the AAHQ
Secretary for 2023-2024! Thank you to all of you who submitted your votes.
We are looking for AAHQ members who would like to participate on the Protocol Team. As a member of the protocol team, you would be asked to help with by-law changes, elections for the board positions, and new projects that we might come up with to improve AAHQ for our membership. We would love to have you participate and the commitment level is minimal. If you are interested in learning more about the protocol team or any of our other teams, please reach out to me at boltone@jrmc.org and I would be glad to get you some information! Merry Christmas and Happy New Year to everyone! Hoping to get to see some of you in 2023!
Erin Bolton, RN
2022 Protocol Team Lead
21st Century Cures Act or Final Rule
Submitted by Justin Villines
You may have heard the 21st Century Cures Act or Final Rule mentioned at your practice/hospital and still wondered what the Cures Act is or what it seeks to accomplish. Let’s explore how the Cures Act came to be, how it may impact your practice/hospital, and how you can be compliant with this 21st Century Cures Act summary. The Cures Act was signed into law by President Barack Obama on Dec. 13, 2016. The bipartisan legislation seeks to increase choice and access for patients and providers.
WHAT IS THE 21ST CENTURY CURES ACT?
It contains provisions to streamline the development and delivery of drugs and medical devices, accelerate research into serious illnesses, address the opioid crisis, and improve mental health services. The Cures Act also seeks to ease regulatory burdens associated with the use of electronic health record (EHR) systems and health information technology (IT). It contains provisions focused on advancing interoperability and requiring developers not to engage in information blocking — or preventing or interfering with the access, exchange, or use of electronic health information (EHI).
21ST CENTURY CURES ACT SUMMARY: THE FINAL RULE
After the Cures Act was signed into law, it passed to the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) for review. ONC and CMS produced two sets of rules based on the Cures Act’s interoperability, patient access, and information-blocking provisions. These rules guide members of the industry, such as providers, payers, and technology vendors, as they design their health IT systems. The U.S. Department of Health and Human Services (HHS) finalized the two sets of rules in March 2020, ushering in the next phase of the Cures Act. At the time, HHS called the rules “the most extensive healthcare data sharing policies the federal government has implemented.” The ONC Final Rule lays out regulations to prevent information-blocking practices by providers, health IT developers, health information exchanges (HIEs), and health information networks. The original deadline for stakeholders to comply with Cures Act information blocking rules was Nov. 2, 2020. In October 2020, HHS moved the information blocking compliance date to April 5, 2021, citing an interest in allowing the healthcare system to focus on COVID-19 concerns.
WHAT IS THE MEANING OF INFORMATION BLOCKING IN THE FINAL RULE?
Information blocking can occur in a variety of scenarios. In general, it refers to practices that are likely to interfere with the access, exchange, or use of EHI. The ONC defines information blocking and shares examples of practices that could constitute information blocking here. Because its definition of information blocking is open-ended, ONC provides eight categories of “reasonable and necessary” activities that do not constitute information blocking, given certain conditions are met. These are called information-blocking exceptions.
- Still, more than a year after the public release of the Final Rule, confusion about information blocking remains widespread.
- In March 2021, Life Image, a medical evidence network for clinical and imaging data, surveyed about 4,000 healthcare industry leaders. Nearly half of the respondents, or 47%, said they were unfamiliar with information blocking.
- Although 70% of survey respondents said they were aware of the rules, roughly half of the same respondents said they engage in practices that meet the ONC’s definition of information blocking, such as charging patients a fee to obtain records.
- The survey showed that many healthcare system stakeholders remain unclear about rule requirements, as well as what steps they need to take to comply with the Final Rule, which, as of April 5, 2021, has taken effect.
WHAT DOES THE 21ST CENTURY CURES ACT, IN SUM, MEAN FOR MY PRACTICE OR HOSPITAL?
Information blocking applies to a variety of parties, including providers, payers, and IT developers. While you may have a general idea of what the requirements are, how can you ensure your practice and hospital complies? When it comes to patient requests for data, the Cures Act prohibits providers, developers, and health information networks from engaging in practices that would inhibit patients from receiving their own data or practices that inhibit patient data from flowing where patients would like it to go.
Is your team prepared to respond to requests for health information, either from patients or third parties, under the new requirements? Cures Act and information blocking focuses on EHI or the data stored in your EHR or in other electronic forms. If a patient asks for their data, there are several options available:
- Printing the data from the EHR
- Exporting it through a Continuity of Care Document (CCD) in the EHR
- Directing patients to view and download data using a patient portal
The first step in information sharing is providing U.S. Core Data for Interoperability (USCDI) formatted data. A patient portal is a key component of providing information to patients. Patients can receive USCDI data directly in the portal and share that information with other providers through direct email functionality. Or they can send it to themselves or their health proxies.
WHAT ARE THE INFORMATION-BLOCKING EXCEPTIONS?
What if a provider is unable to share information in the format the patient requests? Should the provider send the patient to the EHR vendor? Because practices are viewed as the guardians of information, the immediate answer should be no. Directing the patient to the EHR vendor could be construed as information blocking. You can, however, reach out to your EHR vendor and walk-through information blocking and the exceptions to understand which if any may apply.
Determining whether information requests fall into the exception category starts with a clear understanding of the eight exceptions mentioned previously in this 21st Century Cures Act summary:
- Preventing harm
- Privacy
- Security
- Infeasibility
- Health IT performance
- Content and manner
- Fees
- Licensing
Within your practice/hospital, you should establish a process for evaluating information requests and ensure staff members are knowledgeable about the exceptions involved. Additionally, you should continue to summarize the 21st Century Cures Act for your staff. It may be helpful to create a checklist or series of checklists that outline the information you need to evaluate.
21ST CENTURY CURES ACT TIMELINE SUMMARY
A final step in Cures Act preparation is having a good grasp of the timeline. Here’s a summary of key 21st Century Cures Act milestones through 2023:
- April 5, 2021: Applicability date for information blocking provisions.
- Oct. 6, 2022: EHI definition is no longer limited to EHI identified by data elements in USCDI.
- Dec. 31, 2022: New HL7 FHIR API capability and other criteria must be made available.
- Dec. 31, 2023: EHI export capability must be made available.
Justin Villines
2022 Professional Development Team Lead
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2022 Board Members
President – Chelsey Davidson
chelsey.davidson@conwayregional.org\
Past-President – Pam Blake
blakep@jrmc.org
Secretary – Kristi Toblesky
ktoblesky@americandatanetwork.com
Protocol Team Lead – Erin Bolton
boltone@jrmc.org
Member At Large – Shanda Guenther
shandaguenther@gmail.com
Communications Team Lead – Dalana Pittman dpittman@americandatanetwork.com
Professional Development – Justin Villines justin.villines@hit.arkansas.gov
Membership Services – Devin Terry
dkterry2@uams.edu
External Relations – Christy Whatley
cwhatley@stvincenthealth.com
Finance Team Lead – Clay Leigh
clayton.leigh@va.gov
Member at Large – Amanda Wyatt Hutto amanda.wyatthutto@tmf.org
Member-at-large – Tim Copeland
thcopeland@uams.edu
