Valerie Rogers 00:10
You know, one of the areas that you know we have to talk capital is that the issue of trust and Vaccines credentials, you know, I think they really should be issued by authorized credentialing authorities such as your local or state governmental health agency to just engender trust and you know, the data itself that again, it’s connected with your immunization information system at the state so you can trust that it is your information.
Gregg Masters 00:41
PopHealth Week is brought to you by Health Innovation Media. Health Innovation Media brings your brand narrative alive via original or value-added digitally curated content for omnichannel distribution and engagement. Connect with us at www.popupstudio.productions Welcome everyone. I’m Gregg Masters, Managing Director of Health Innovation Media and the producer co host PopHealth Week. Joining me in the virtual studio is my partner collagen lead co-host of PopHealth Week, Fred Goldstein President of Accountable Health, LLC. On today’s show, our guest is Valerie Rogers director government relations for the Health Information Management System Society, also known as HIMSS. Prior to her role at HIMSS, Valerie worked on health system transformation and integration as the Senior Director of integration at the Association of State and Territorial Health Officials. She also served as the Chief of Staff for the Baltimore City Health Department where she had oversight of the department’s clinical information systems. Prior to her time in Baltimore. Valerie also worked for the National Association of county and city health officials as the Director of Public Health Informatics. Valerie holds a bachelor’s degree in sociology from Hampton University and a master’s degree in Public Health from Tulane University. So Fred, with that introduction over to you help us catch up with Valerie’s work at HIMSS, which is holding its first post-pandemic annual gala in Las Vegas for fully vaccinated participants from Monday, August 9 through Friday, August 13, 2021.
Fred Goldstein 02:27
Thanks so much, Greg. And Valerie, welcome to PopHealth Week.
Valerie Rogers 02:30
Thank you for having me, Fred.
Fred Goldstein 02:32
It’s a pleasure. We really appreciate you joining us this week. Obviously, this whole area of policy and government relations and the laws and the regs, etc. is fascinating in the population health field, but why don’t we start with your background? Could you give our audience a little sense of your background?
Valerie Rogers 02:45
Sure. Happy to so I am currently the Director for Government Relations at HIMSS, the Healthcare Information Management System Society, and I focus primarily on state and local governmental affairs, which is really driven by my background previously served as the Chief of Staff for the Baltimore City Health Department. And then was very involved in connecting systems across the spectrum of care in Baltimore, as a part of the city’s overall health equity initiatives. Prior to that, I worked for the National Association of County and City Health Officials, where I was one of the direct liaisons across from public health to the broader health care environment, if you will, I’m really focused on varying connectivity across the spectrum, including public health, you know, further than that, I would say, you know, my background as an environmental health policy, my MPH from Tulane University, and that have always been really interested and the role that data plays in determining policy in particular policies that impact the social determinants of health, those structural conditions that influence your health, like housing, neighborhood, education, food security, the environment, so really happy that having those experiences have influenced my ability to support HIMSS. And the really important work we’re doing to improve the overall global health ecosystem through information and technology and the use of data.
Fred Goldstein 04:28
A lot of people think about, you know, policy on a national level, particularly from a health IT approach, what are some of the key issues? You know, if healthcare is local, where all healthcare is local, what are some of the key issues that are more state-oriented, or perhaps community-oriented in from a policy perspective?
Valerie Rogers 04:45
Well, you know, I can’t say that there’s too much that isn’t global to local in impact. So what happens on a national scale often, you know, trickles down to impact what happens at a state level. So obviously right now, as we’re looking at our response and our burgeoning or ongoing preparedness around COVID-19, that is such a very strong and very important area for which we’re seeing the convergence of public health, population health, environment, even in our response to this global pandemic, which is impacting us locally. So it’s certainly important that we all just realize that what happens on a national and even a global scale and term in the policy realm often does have a strong impact at the local level,
Fred Goldstein 05:41
obviously, with COVID showed us a lot of things going on from a public health perspective, from an IT perspective, the growth of telehealth, what are you seeing? That’s that’s sort of the main key points we’ve learned regarding COVID and the use of IT or interconnectivity?
Valerie Rogers 05:57
Yeah, I think the key health IT-related issues are really around health system or in particular public health system modernization, vaccine deployment and administration certainly is a key component that we want to see those systems modernize moving from paper-based to more digital environment, reducing barriers to care, or as it relates to telehealth really stays to the permanent changes that would address barriers to access is really important, social determinants of health, of course, in many ways, ties into all of that, along with privacy, cybersecurity, and security being some of the key areas that we’ve we’ve been focused on.
Fred Goldstein 06:47
And how much of that is influenced by state policy versus federal policy?
Valerie Rogers 06:55
Well I would say that a lot of it is definitely influenced by state policy. Right now. I don’t know if people realize that there are in addition to legacy legacy technology, so we’re talking about modernization really is the name of the game and legacy technology is a key component, but there are also legacy policies that also have to be updated, given we are now sort of public health 3.0 health 3.0 environment, much more digital environment. And so, you know, we have to really think about how the many critical health systems are outdated IT systems and and anticipating more modernized systems and or infrastructure and our current aid package also has the line with new business processes, and new policies that would support the ability for our healthcare system and our public health system to do the work they need without relying on slow, laborious, antiquated methods are really just sort of outdated, outpaced by the technology.
Fred Goldstein 08:06
I agree with you wholeheartedly. One of the classics, obviously, is this whole idea of vaccination cards, and things like that, you know, and we’re seeing the use of paper. I know, my kids when they went to school, you know, get the paper record, send it over there. So are we seeing a major push? I was actually on a webinar a couple days ago. That was with the EU and with the US, I think it may have been HIMSS, webinar actually on the use of vaccine passports or developing those kinds of things. Are we seeing some major moves in that area? That may be something we finally get this stuff digitized?
Valerie Rogers 08:39
Absolutely. There’s been quite a bit of movement, both public and private around this issue. And I’m really encouraged by this administration’s work to really sort of open this up on the policy side for strong consideration of leveraging, you know, digital Vaccine credentials. I think we’re trying to move away from the idea of passport, that idea being somewhat of a an area where there’s some confusion about you know, what a passport means. But certainly having digitized credentials that is interoperable with say a state immunization information system, that’s secure that the public feels is a way for which they feel they can safely reenter the business world or schools, reopening the economy more broadly, during this pandemic, is certainly an area that you know, through my work, we are supporting at HIMSS. And even broadly with our partners so I would say it’s, it’s certainly on the rise and an area for which we, you know, really stand for standby I should say
Fred Goldstein 10:00
And It’s really about having a system that’s secure, trustworthy, and then can be used by the individual when they need to, but not necessarily looking at it from the other side, like you would, oh, it’s a passport, I can come in, or I can’t. But more from I’ve got this record, it’s my record, and I can can share it if I need to. Absolutely. You know, one of the areas that, you know, we have to talk tackle is that the issue of trust and bathroom credentials, you know, I think they really should be issued by authorized, credentialing authorities, such as your local or state governmental health agency, to just engender trust. And, you know, the data itself that, again, it’s connected with your immunization information system at the state, so you can trust that it it is your information. You know, right now, we’re seeing conversations around how blockchain, for example, could really support by providing an immutable record, it’s easily easy to confirm and verify. So that’s on the horizon, and very, very helpful and helping to secure a public trust and leveraging an electronic record. And I think that, you know, it’s it’s really interesting, it’s a global community conversation that’s happening. And I know that the US along with a wh, WHO are also aligning some of the principles and policy that would, you know, support, digital digitize or digital vaccine credentialing for the purpose of travel, international travel. So that’s really, you know, a fantastic opportunity, burgeoning opportunity that will hopefully help spur even greater feelings of Secureness and when traveling or going to sports events that everyone can feel good about. So and this, the pandemic really showed us. Unfortunately, the gaps we had in our public health system, and particularly from an IT perspective, do you see now the state’s beginning to say we’re going to adequately begin to fund these areas or at least ramp them up? We obviously have great technology companies in the United States and around the world that have created amazing things for other industries. Do you see that now beginning to be better recognized? And actually, other than just talked about actually funded?
Valerie Rogers 12:39
Yes, I do. As a matter of fact, with the passage of ARPA and the state and the packages that support public health data modernization, and healthcare modernization, we now see a more concerted effort to realize some of the, you know, sort of 3.0 modernized and more efficient systems that we need in place to be able to tackle this current crisis, the COVID-19 pandemic and future crises. You know, I, I would say that, you know, broadly in the United States, governmental, public health and health care agencies have had at hand an abundance of data and information for which we could improve research, interventions, health policy decision making, all of those things that would impact the determinants of health at many different levels. And what is exciting and especially important about the new resources that we see rolling out and sort of the shift in thinking both at the state and local governmental levels, as well as, you know, federally or nationally, is really the need to align and interoperate a number of systems and having the resources to now intensively focus on doing that. This is super important. And you know, what I think is really important to also recognize is that, along with our ability to modernize these systems, we also then improve the timeliness and the quality of the types of data that we that we’ve working with. You can better coordinate data activities and systems, reduce the burden on our data partners and including providers. So lifting some of that demand and burden on the providers in particular. And then I think it also opens the door to integrate more of the emergent tech Emerging Technologies more efficiently for the broader public to leverage. So it’s not just an opportunity here just for our systems, but also for the public. As we become more sophisticated, the ways in which we seek health care and our health-seeking behaviors have changed and shifted, and with access to more information really sort of demands much more quick, quicker, relevant, modernized systems that would allow for, you know, greater information flow to the public public as well.
Gregg Masters 15:44
And if you’re just tuning in to PopHealth Week, our guest is Valerie Rogers, Director government relations for the Health Information Management System Society, also known as HIMSS. HIMSS is holding its first in person gathering since the onset of the pandemic, Monday, August 9, and Friday, August 13, 2021. For more information, go to www.HIMSSconference.org.
Fred Goldstein 16:09
And you talk about information flow and interoperability obviously a key area that you know very well, there’s always been this healthcare. And Gregg and I have talked about this a bunch has been siloed, you know, very, very siloed, which also meant that the IT systems themselves, emulate the healthcare system and became siloed. Is there enough? I don’t know if pressure is the right word or whatever enough on there now that we’re beginning to see those walls break down. And whether it’s through FHIR or other means to create much more interoperability. And is that more of a policy push? Or is it more of a, hey, we need to become a more effective and efficient business are a little of both,
Valerie Rogers 16:50
I definitely see the policy aspects of this issue of siloing. And, you know, across healthcare and public health in particular, one of the main reasons why we’ve really had a public health system that sort of lag behind is sort of the lack of coordination and funding to support modernization across all of the systems that are needed during an emergency. So not only is that thinking about an immunization information system, but also your laboratory reporting system, for example, that also includes your health surveillance, what we call like syndromic, surveillance, or health surveillance systems, for example. So all of these really need to be thought of as more of an enterprise comprehensive scale. And I’m really supportive and happy to see the current administration embrace that the Office of the National Coordinator for Health IT has really, I think, starting to make inroads and a concerted effort to really sort of bring together a more comprehensive plan for modernization across the spectrum of public health systems, which is super important, because when there are siloed and treated as individual programs, you get what we we see now. In terms of you know, you might have a good, you know, syndromic surveillance system, but that needs to interoperate and be leveraged in a way that it might not be able to if you don’t have other systems within that, you know, public health catchment that are able and ready to go. So that’s super important. Yeah.
Fred Goldstein 18:40
You talked some earlier also about this whole issue of equity, social determinants of health or social influence or influencers of health. And obviously, we’re bringing in and people are saying, Let’s bring in more and more of this, these data points. Let’s understand this better. Is Is that something you’re beginning to see people act on? Or is it just still early that we’re aggregating the data begin to understand what it says obviously, the COVID pandemic showed just how bad the disparities are. And and hopefully now, everybody recognize that rather than the small group that really understood it early on, but from an IT perspective, are you seeing that now being moved into a phase of more of an operational area?
Valerie Rogers 19:21
Absolutely. You know, there are over 40 states, maybe just about all states now that have made attempts to address social determinants of health by, you know, expanding their partnerships around care coordination, in particular, and and improving their state infrastructure and processes related to a data capture around social needs. You have we’ve probably seen a lot of that through for example, our Medicaid managed care contracts are what are known as Medicaid 1115 waiver demonstration. You know, for example, really fantastic example is the state of Indiana, which launched the Indiana data hub was one of the first of its kind in the US that allows for sort of unprecedented public access to secure de-identified Medicaid patient data across the spectrum. So we’re talking about land use planning, go figure about land use planning, environmental solutions to the environmental aspects, touched on human services related data planning data, as I just mentioned, along with some of the public health data sources to really give both planners, the policymakers in particular, a more robust and significant framework for which to make for, to make policies around health care and public health, and also drive public health interventions as well. So we’re certainly beginning to see a lot of that. And I would just add, you know, we’re also seeing more states leverage health information exchanges, to support social determinants of health data sharing, what comes to mind specifically is the city of San Diego. So this is very local. In San Diego, California, they have one of, I think, the most mature models called the San Diego Health Connect. And that is a really robust example of a partnership, where we’re, we’re seeing data linked to social determinants of health data on electronic health records sort of combined to support a variety of community-based local policy planning resources.
Fred Goldstein 21:50
So this really is an example of the place where this silo that we’ve always seen in public health and the health care system is being integrated through an IT platform to bring in that data that the public health department has some main social determinants of health that the private sector has, etc.
Valerie Rogers 22:07
Absolutely. A strong public-private partnership that I think expands before, you know, last year, but it’s even more significant now given given the challenges that we have with COVID-19 and some of the health equity issues that it has exposed. So even more now, we’re seeing a concerted effort across states and local local health agencies to really, you know, focus in on modernization, integration and interoperability with across state agencies and these health information exchanges and other data platforms to really leverage data in a way that’s more robust modernize. And quick, in terms of supporting fast decision making when needed.
Fred Goldstein 23:06
And this whole issue, which has now been brought to the fore, again, we had redlining in communities before and still do, and now we have sort of this digital redlining, in a sense, with health IT availability to high-speed internet access, etc. But even that’s beginning to be addressed through policy. Are the states also playing a role in that? Or is that more of a federal level?
Valerie Rogers 23:29
No states states? Definitely. Well, let me just preface that is that without federal federal drive and support, um, you know, absolutely necessary. But states are definitely open and receptive to, you know, working with federal agencies, to really sort of rollout and support, you know, digitization across their communities through broadband, and having universal access to broadband connectivity has been prioritized. And a number of states because it is certainly critical. It’s an enabler for widespread telehealth access, one of if we’re talking about the healthcare arena, but it’s also an enabler for economic and educational factors that also, believe it or not contributed contribute to positive or positive health outcomes that we want to see.
Fred Goldstein 24:34
What are the if you were to pick one or two key policy areas we need to focus on as a country? What would they be in terms of IT?
Valerie Rogers 24:45
Wow, that’s, that’s a really fantastic question. Because, you know, in my mind, there’s a laundry list of key policy areas that we really need to be focused on. You know, right now, I think and this is something that you know, I’ve written about, you know, for HIMSS, through our global policy call to action is really focused on addressing the pandemic, it’s current, it’s an issue that is pervasive. And it means that we really need to be strategic in the way that we address this issue. So I talked a lot about modernization, that’s really sort of the name of the game in terms of strategic action on being able to establish a flexible and more adaptable healthcare environment, that’s really critical. That also means on the policy side that we have to look at those sort of antiquated policies that we have on the books at the state level that may limit data and the sharing of data across the spectrum of care. That’s something that really has to be, you know, stood up and modernized in a way that supports that flexibility and adaptability, particularly during emergencies. You know, the other thing I would say is that we should also focus on and this is something where HIMSS has been very strong, on and in building a foundation of interoperable platforms. And that goes back to being flexible and adaptable. In order to do that, you need the interoperability that was sort of underwrites, you know, the need to facilitate more broad-based data exchange across the spectrum of care. And, you know, we recognize that and in order to do that, we should also be strategic and thinking about the privacy and security protocols that would you know, current meet the current needs of this this crisis, but also thinking long term down the road of pending crises that we may encounter. And that doesn’t necessarily mean it’s an infectious disease crises, it may also mean, crises that are maybe more connected to climate change, for example, with natural disasters.
Fred Goldstein 26:58
Yeah, I can even think of some rather substantial chronic conditions that we could consider crises today that we can definitely work on and improve through the use of health IT technology and interoperability, I think your point of us really modernizing the system is sort of that foundational structure that we need to create, through policy through the technology to get us to where we end up not having a situation like we just had, and really improve in a lot of areas in healthcare. So I really appreciate you coming on Valerie. It’s been a pleasure.
Valerie Rogers 27:30
Well, thank you for having me. I’ve enjoyed our time together. And Fred and I’m certainly look forward to a more modernized public health future.
Fred Goldstein 27:42
That sounds fantastic. And with that, back to you, Gregg,
Gregg Masters 27:46
thank you for that is the last word on today’s broadcast. I want to thank Valerie Rogers, Director of government relations for the Health Information Management System Society, also known as HIMSS for her time and insights today, for more information on Valerie’s work, go to www.himss.org or follow her on Twitter via @VNRogers74 and @HIMSS. That’s h i m s s respectively. HIMSS is holding its first in person gathering since the onset of the pandemic, Monday, August 9 through Friday, August 13, 2021. For more information, go to www.himssconference.org. And finally, if you’re enjoying our work here at PopHealth Week, please subscribe to our channel on the podcast platform of your choice and do follow us on twitter via @PopHealth Week. Bye now