As the process for booking a vaccine appointment eased a bit last week with the introduction of a zip-code-driven search tool and a new state-run call-in center, Massachusetts hospitals assisted in the effort by setting up clinical vaccination sites across the state. 
  
Hospitals are especially focused on setting up sites in hard-hit communities. More than a dozen such sites already have been launched, including ones in Lowell, Worcester, Chelsea, Revere, Dorchester, and Fall River; more are expected in coming weeks.
  
Patients over age 75 began getting vaccinated at these locations last week. Hospitals are reaching out directly to their patients to schedule appointments, using criteria that place special emphasis on equity. Providers are using their patient portals, direct calls, text messages, and other communications platforms to contact patients.

Citing improvements in COVID-19 data, Governor Charlie Baker, effective today, has increased from 25% to 40% the capacity limits at restaurants, gyms, and offices.
  
Also effective today, Massachusetts has moved four of the five regions of the state from Tier 4 to Tier 3, which relates to the capacity limits at hospitals within those regions. Tier 3 means the hospitals and health systems are at high risk as opposed to persistently high risk in Tier 4; the higher tier mandates more frequent meetings and coordination through each region’s DPH-led Health and Medical Coordinating Coalition (HMCC). Region 5 (Southeastern Massachusetts and the Cape and Islands) remains in Tier 4. 
  
The communication and coordination made possible through the regional HMCC meetings allows for load balancing between and within regions and timely situational awareness, which in turn allows hospitals to collaborate to provide the best care to patients. 
  
Baker’s easing of certain businesses capacity limits was accompanied by his warning to the public not to let its guard down. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, last week also urged people who may have been planning traditional Super Bowl gatherings in their homes to “just lay low and cool it.”
  
The hope is that this morning people are suffering nothing more than the effects of eating and drinking too much after spending four hours in front of the TV, as opposed to having contracted the coronavirus after dropping their guard against infection.
  
MHA’s President & CEO Steve Walsh in thanking the governor for making swift adjustments based on public health trends, added, “This is also an important opportunity to remind community members how quickly things can change when we let our guard down. For the good of our healthcare system and the caregivers who have now fought this battle for over a year, we are again asking everyone to continue following all of the public health measures that have gotten us this far.”

Last week, the Executive Office of Health and Human Services (EOHHS) issued a hospital provider bulletin detailing a new hospital-at-home program that covers certain inpatient care provided to MassHealth patients by qualified hospitals. 
  
MassHealth will now permit acute inpatient hospitals that the Centers for Medicare and Medicaid Services (CMS) has authorized to provide services to Medicare patients through the federal hospital-at-home program to participate in the new state program in an identical fashion. Authorized hospitals will need to first notify MassHealth and will be required to follow all rules governing the CMS program, as well as any other rules and requirements MassHealth issues.
  
Under CMS rules, all patients must enter its hospital-at-home program from either an emergency department or an inpatient hospital setting, and hospitals are required to meet a variety of conditions to continue care at home to those patients where this option is appropriate. Reimbursement for MassHealth hospital-at-home services will be the full MassHealth inpatient reimbursement rate.
  
MHA applauded EOHHS and MassHealth for putting forward the innovative program that allows patients to receive high-quality care in their homes when appropriate, and that could help address capacity and resource challenges from the COVID-19 emergency. 

The state launched its “Trust the Facts. Get the Vax” public awareness campaign last Friday. While vaccine enthusiasm remains high among certain demographics in the commonwealth, this effort is aimed to educate and persuade those who are most hesitant to get vaccinated.
  
Hospitals will be amplifying the campaign, which was scheduled to premier its first ad (in the link above) before yesterday’s Super Bowl. That ad features several doctors from Massachusetts hospitals speaking on the safety, efficacy, and importance of getting vaccinated. Public opinion research indicates that doctors are among the most trusted messengers on the topic, along with those who have already gotten their dose and can speak about their experience. A Spanish language version of the video was also created.

Organizations wishing to create policies to decrease workplace violence and create safe work environments can follow a five-step process that MHA helped create, according to a an article from MHA’s Vice President of Clinical Affairs Patricia Noga, R.N., PhD, which has been published in the recent issue of Policy, Politics, & Nursing Practice.
 
“All health systems, institutions, and organizations can create environments that are safe, positive, humane, and respectful of the rights, responsibilities, needs, and contributions of patients, their families, nurses, and all health professionals,” Noga writes in the article entitled Developing Statewide Violence Prevention Programs in Health Care: An Exemplar From Massachusetts.
 
Noga lays out the specific actions organizations can take within these five broad steps: 1) identify the issue and set organizational priority; 2) involve and connect stakeholders to form a workgroup; 3) mobilize teams, take action, gather data, and share information; 4) create evidence-based guidelines and disseminate to hospitals; and 5) collect data and share results.
 
Throughout the process that Noga details, MHA created a Healthcare Safety & Violence Prevention Workgroup, which eventually developed and deployed a comprehensive survey to membership. That survey in turn informed the work of MHA and its stakeholders. MHA also create a Promoting Employee Wellbeing Committee that in turn created the Caring for the Caregiver initiative. 
 
“This work to reduce workplace violence has evolved over several years through the combined efforts of committed professionals representing many disciplines and many hospitals, health systems, and stakeholders across all geographic regions of Massachusetts,” Noga writes. “These working groups provided leadership in identifying education and training tools that could be shared to help employees manage aggressive behavior(s) in patients, visitors, and others within a facility.”

President Biden signed an executive order on legal immigration last Tuesday that directed federal agencies to review several issues related to immigration, including the Trump Administration’s “public charge” rule. Under the public charge, permission to enter the country could be denied to someone seeking a green card or other legal immigration status due to their disabilities or lack of economic resources, since those factors may signal the possibility of their needing public assistance, including Medicaid. Under the Biden directive last week, a review will be required of any “immigration policies which undermine the inclusion of immigrants in American life and to respond to concerns on public charge policies.” During the presidential campaign, then-candidate Biden pledged to rescind the public charge rule and this review is expected to result in the rule being withdrawn. MHA, along with healthcare providers and other advocates across the country, had strongly opposed the rule from the outset, arguing that immigrants would avoid seeking care – even care they are entitled to – due to the fear of having their immigration status revoked.

MHA held a webinar last week entitled What’s Next in Healthcare Innovation? that drew a large audience. Now MHA is making a recording of the webinar available through the above link. Digital health expanded exponentially in 2020 during the global pandemic, as did telehealth. The question now is what other types of health technologies are emerging faster than we may have thought possible just a year ago? And how will they change the patient experience? The webinar featured tech leaders focusing on, among other topics, digital infrastructures being created to better serve patients, home technologies and wearables, and how hospitals are using artificial intelligence applications.

Clinical Documentation Strategies for 2021

Tuesday, February 23; 1:30 - 2:45 p.m. 

 

Citing improvements in COVID-19 data, Governor Charlie Baker, effective today, has increased from 25% to 40% the capacity limits at restaurants, gyms, and offices.
  
Also effective today, Massachusetts has moved four of the five regions of the state from Tier 4 to Tier 3, which relates to the capacity limits at hospitals within those regions. Tier 3 means the hospitals and health systems are at high risk as opposed to persistently high risk in Tier 4; the higher tier mandates more frequent meetings and coordination through each region’s DPH-led Health and Medical Coordinating Coalition (HMCC). Region 5 (Southeastern Massachusetts and the Cape and Islands) remains in Tier 4. 
  
Improved severity reporting through accurate and appropriate clinical documentation has never been a greater priority for healthcare organizations. The increased demand for organizations to deliver high-quality, cost-efficient care has resulted in the evolutionary quickening of clinical documentation integrity (CDI) initiatives. Now more than ever, it is crucial to capture the full breadth and depth of patient severity and not limit efforts to appropriate DRG assignments alone. In this session, we will make a case for implementing severity reporting solutions that give you a competitive advantage, and that are provider focused and driven by performance and actionable data. Click here to learn more and to register.