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Public Policy / Informatics Checkpoints

Public Policy / Informatics Checkpoints

Owned by Melanie Kourbage
Last updated: Feb 14, 2025
6 min read

Feb 14, 2025

Attendees

  • Mel, Vanessa, Michelle

  • Mandi

Updates

  • Thank you for joining our virtual Informatics Committee meeting this week!

  • Policy Updates

    • PHDW: Michelle is working with M Foreman to tell Informatics story

      • Blog posts, lab matters articles, podcasts

    • Global example: 12p document of all APHL Global work that was in progress - Policy created a one-pager - this is what will stop (Donna)

    • Need to be strategic of what and how we put our stories out there

    • CR for FY2025 ends 3/14/25

      • Floating idea of 6-month resolution

      • New one-pager: what won’t get done if gov’t shuts down (domestically)

        • Michelle provided that information for intermediary already

      • Need the same level of information from the programmatic side - what will stop?

      • Think about a non-informatics audience

        • Impact to clinical labs and HCOs, to a patient

        • Michelle: send that list to Mel to “humanize”

          Michelle will send list of AIMS impacts for Mel to “humanize”

    • Concerns around certain topics

      • AWS is on the periphery

      • Quest Diagnostics is an important healthcare partner

      • What story is going to resonate with decision-makers

      • The Hill is focused on budget, not on funding freeze; need to hear the impact

      • APHL hasn’t gone out to the Hill yet

      • Is HIMSS speaking out on public health’s behalf?

      • If OPHDST is on the outskirts, it will be absolute confusion in public health informatics

        • Open opportunities for private organizations to take over tech

        • USDS COVID resources

        • NCE for Report Stream

      • Future of CFA is uncertain

      • Rapid Response Enterprise Data I…

        • RREDI

        • Related to 1CDP? Internal System for collaboration within CDC?

        • AIMS is the ONLY connection from STLT to 1CDP, sending data on a daily basis

        • CMS and HHS tech lead is Palantir - Chris Klomp

        • Need to separate infrastructure from data

        • Related to CFA

        • Duplicating what AIMS already produces

        • WA DOH has good information on CFA initiatives

          • Bryant Karras and Chris Baumgartner

            Mel will set up a mtg between Mandi and Chris to understand RREDI and CFA - what’s already working and shouldn’t be broken v what is not in production

        • CIO, DHS - CDC adjacent agencies

          • AIMS plays a role in national security, collecting data from STLTs; if it goes away, federal agencies wouldn’t be getting data from STLTs

  • Success Stories Update

  • JPHIT Updates

    • JPHIT need to tell the same story - they rely on our infrastructure

    • Half-day virtual call 2/13

    • Strategic outlook on JPHIT

    • Current activities and JPHIT’s response - share success stories and the criticality of public health system

  • Congressional report on lab data - updates on intended release?

    •  

  • Proposed Rules & Standards

    • USCDI V6 draft released in January 15th

    • Slimmed down Final HTI-2 and Final HTI-3 released with limited impact to public health

Dec 6, 2024

Attendees

  • Mel, Vanessa, Michelle

  • Peter, Mandy

Introductions

  • Mel will be working with Vanessa

Updates

Conferences & Meetings

  • ASTP ONC Annual Meeting

    • December 4-5, 2024 in DC

    • Public Health was a hot topic; Michelle was a plenary speaker; OPHDST was well-represented, as were FDA, CMS, VHA, and HRSA

    • Other key themes: TEFCA, USCDI+, AI

    • Meeting was done well; it is a forum to communicate current projects, successes, etc.

    • Michelle had many networking meetings

    • The drive towards policy in the informatics world has been very strong

      • Frustration that we can’t all meet that level of preparedness that is cited in the rules

      • APHL can be seen as the efficiency that is helping HHS meet public health goals

      • Cautiously optimistic on AIMS persistence

    • Stanford Healthcare quote “I’m a huge APHL fan.”

    • Abigail Viall from ASTP - big proponent of public health and of AIMS (Desiree’s influence?)

      • Sara Armson from ASTP is responsible for the report - could stem from the congressional hearing

    • TEFCA Milestone repeated multiple times: eCR flowing (no mention of AIMS)

    • Congressional report on Laboratory Data - expected to be released “soon”

  • JPHIT in-person meeting

    • December 3, 2024 in DC

    • “What is JPHIT?” It has to be collaborative, with action by all agencies

    • Ready-made governance structure for AIMS, but more likely as a governance model

    • JPHIT is not ready

    • Discussions/ideas: eHealth Exchange, other non-profit Healthcare orgs could join to help manage the platform??

    • If AIMS = Public Health Intermediary, APHL will receive Public Health Authority; will reduce liability issues

    • JPHIT had advocacy workgroup at one point; it was folded into “Federal Priorities and Advocacy” (VH’s group), but may need new separate group again in 2025 to focus on public policy

  • eHealth Exchange Annual Meeting

    • December 10, 2024 in Nashville, TN

    • Michelle will be a plenary speaker

    • TEFCA QHIN meeting

    • IHS announced at ASTP meeting that they will use eHealth Exchange as QHIN

    • APHL will be meeting with eHealth Exchange and with implementation center organizers (ASTHO)

    • Sequoia - RCE - non-profit arm of eHealth Exchange

  • Informatics Committee Meeting in February 2025

    • Feb 11-13, 2025 in APHL HQ

    • Mandy and Peter are invited

  • HIMSS Global Conference

    • Public Health Preconference Forum on March 3, 2025 in Las Vegas, NV

    • Limited scholarships available for public health attendees

    • Interoperability Showcase is $60K

    • APHL can support 3 members

  • AMIA 2025 Symposium

    • November 15-19, 2025 in Atlanta, GA

    • Theme: Modernizing Public Health Data and Information Systems

    • Brian Dixon AMIA

    • AMIA is more academic than HIMSS

Other Topics

  • OPHDST Collaboration

  • Peter needs Basic Descriptions of the work that APHL Informatics does

    • Learn-to-read level

    • What happens if the work is not done?

    • APHL Success Stories update?

    • Indvidual success stories

    • NBS ETOR story would be good

    • $$$ spent on goods and services - economic impact of public health initiatives

      • Michelle promised to provide spreadsheets, estimates

      • Software, hardware, consulting services

  • AIMS Service Discussion

    • All data flowing on AIMS has some kind of lab component except IZ Gateway

    • PPRL linkages, e.g.

    • Not every service directly benefits APHL members, but there is a tangential benefit

    • AIMS is built to move data and for surveillance

    • APHL members need help around managing data, but not all of that can be done as shared service

    • What’s next if AIMS = intermediary

      • Rebranding

      • “legacy AIMS” has to evolve

        • Monitor, maintain support existing services (program level)

        • Build new technology at collaborative level across agencies and organization, not at a project level

      • Utility not a tool

      • ETOR technology foundation can be used in many use cases

      • It shouldn’t be competitive; it’s a public health resource; there shouldn’t be a mindset that other agencies are simply going to be build something better than AIMS

      • Who owns New AIMS?

        • APHL will own the technology / IP - central coordinating entity

          • Gateway to public health

        • Governance

        • It is a separate nonprofit entity like an FFRDC

          • Pieces that are critical infrastructure

          • APHL will be contributor to the FFRDC

          • Pull out of CoAg, supported under a different model

          • 2-yr NCE to get us through 2026; limit requests for new $$ temporarily

      • Who creates the non-profit?

        • APHL would lead; in discussions with Troy

        • FFRDC would require support from CDC / HHS

          • MITRE = FFRDC

      • Critical: PH has trust in APHL leadership with regard to data security and privacy

        • APHL has a track record of safeguarding state data

      • CDC-F argument - WAI - Is there funding available for informatics bridge work?

  • Peter’s updates

    • December budget resolution deadline is the first priority for congress

    • Interest in adding language to CRM to limit/eliminate impoundment

    • Broader issue in re: impoundment - litigation by state/local gov’ts that want the money earmarked for them

    • President has 45 days to submit explanation to Congress if admin doesn’t want to spend money

    • OMB has to apportion $ to agencies - ability to include footnote with requirements

    • Increasing communication channels with partners

    • Professional judgment budget - federal agencies can create documents to explain what they would do with bigger budgets

  • Report Stream future

    • There are a lot of teams that are working on Report Stream

    • USDS that built RS are out of CDC now - they were CDC FTE

    • The system and tools that were built on RS will transfer to AIMS if they are deemed valid and useful by the PH Community

      • CDC will need to decide if they are going to defund that contract mechanism

      • Pitch to Jen Leyden - if they’re good and believe in PH mission, they could develop tools and resources for AIMS - would require workstyle alignment

Draft Rules & Policies & Standards

  • Policy Engagement Confluence Space

  • ASTP Draft FHIR Action Plan - APHL submitted comments on 11/25/24 - list of FHIR implementation guides and their relative maturity

  • ASTP released more USCDI+ data set for public comment - cancer use cases and respiratory illness (clinical trials); APHL reviewed and did not comment

  • TEFCA - Two more public health sub XPs are expected in 2025 (Case notifications and …)

Action Items

On the Backburner

  • Expect more USCDI+ data sets

  •