[Federal Register Volume 85, Number 109 (Friday, June 5, 2020)]
[Notices]
[Pages 34644-34645]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-12238]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Request for Information--Long-Term Monitoring of Health Care 
System Resilience

AGENCY: Office of the Assistant Secretary for Health, Office of the 
Secretary, Department of Health and Human Services.

ACTION: Request for Information.

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SUMMARY: The Office of the Assistant Secretary for Health (OASH) in the 
Department of Health and Human Services seeks to gain a more 
comprehensive understanding of how organizations, networks, non-federal 
government agencies, and other relevant stakeholders in the United 
States have operationally defined ``resilience'' in their respective 
components of the health system; including their use of data, analytic 
approaches and proven indicators. OASH also seeks to identify 
opportunities to strengthen the U.S. healthcare system, as a whole, 
through public-private partnerships in data sharing and comprehensive 
analytics. OASH welcomes any public feedback related to how these 
questions should be addressed and/or potential solutions. The set of 
questions is available in the SUPPLEMENTARY INFORMATION section below.

DATES: To be assured consideration, comments must be received at the 
email address provided below, no later than midnight Eastern Time (ET) 
on July 8, 2020.

ADDRESSES: Individuals are encouraged to submit responses 
electronically to [email protected]. Please indicate ``RFI 
RESPONSE'' in the subject line of your email. Submissions received 
after the deadline will not be reviewed. Responses to this notice are 
not offers and cannot be accepted by the federal government to form a 
binding contract or issue a grant. Respond concisely and in plain 
language. You may use any structure or layout that presents your 
information well. You may respond to some or all of our questions, and 
you can suggest other factors or relevant questions. You may also 
include links to online material or interactive presentations. Clearly 
mark any proprietary information, and place it in its own section or 
file. Your response will become government property, and we may publish 
some of its non-proprietary content.

FOR FURTHER INFORMATION CONTACT: Dr. Leith States, Chief Medical 
Officer, Office of the Assistant Secretary for Health (202) 260-2873.

SUPPLEMENTARY INFORMATION: 

Background

    On January 31st, the U.S. Department of Health and Human Services 
(HHS) declared a public health emergency due to the outbreak of the 
2019 Novel Coronavirus, now known as COVID-19. To date, the federal 
government has engaged in intensive efforts to prevent and mitigate the 
transmission of COVID-19 within the United States. These efforts 
required unprecedented changes in the functioning of private 
businesses, personal lives, the provision of public services and 
healthcare. Early interventions focused primarily on the redirection of 
the provision of healthcare resources towards individuals with COVID-19 
and mitigation strategies to prevent the spread of the virus, including 
markedly diminished access to health system services.
    Anecdotal reports and experiences from the frontlines, and emerging 
data, indicate that the COVID-19 response has consequentially resulted 
in limited access to routine and emergency healthcare services in many, 
if not most, communities. In regions with significant burdens of COVID-
19 cases, local health systems have faced challenges with surge 
capacity needed to treat COVID-19 patients. Furthermore, mitigation 
strategies to reduce the transmission of COVID-19 have altered the 
delivery of healthcare services across the board, with many 
organizations shifting to providing care via telehealth, reducing the 
scale or scope of their healthcare services or eliminating access, 
altogether. Also, human behaviors around accessing healthcare have been 
altered in the midst of recommendations for social isolation/
distancing.
    Response to a health crisis, such as the COVID-19 pandemic, 
necessitates a robust public health response and a highly resilient, 
adaptable health care delivery system that can meet the evolving needs 
of communities. Although there is not a common definition of ``health 
system resilience'' (encompassing the provision of direct clinical 
care, preventive medicine and public health activities), the most 
referenced definition defines it as ``the capacity of health actors, 
institutions, and populations to prepare for and effectively respond to 
crises; maintain core functions when a crisis hits; and, informed by 
lessons learned during the crisis, reorganize if conditions require 
it.'' \1\ Maintaining health system resilience, particularly during and 
following the COVID-19, is a critical concern in order to ensure the 
delivery of high-quality care, from prevention to high-acuity inpatient 
care, for all conditions.
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    \1\ Available at: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2815%2960755-3.
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Scope and Assumptions

     The purpose of this Request for Information (RFI) is to 
gain a more comprehensive understanding of how organizations, networks, 
non-federal government agencies, and other relevant stakeholders in the 
United States have operationally defined ``resilience'' in their 
respective components of the health system; including their use of 
data, analytic approaches and proven indicators. These indicators and 
data sets should be able to quantify the impact of disturbances, such 
as the COVID-19 pandemic, on health care availability, access, 
timeliness, and quality.

[[Page 34645]]

     The RFI also seeks to identify opportunities to strengthen 
the U.S. healthcare system, as a whole, through public-private 
partnerships in data sharing and comprehensive analytics. The RFI seeks 
to identify organizations that would be interested in discussing the 
form and function of such collaborations.
     The definition of ``health'' system or services and/or 
``healthcare'' system or services, for the purposes of this RFI, is in 
the broadest sense. We seek to understand resilience implications on 
the provision of health services in all dimensions.

Our Questions

Barrier and Opportunities for Health System Resilience

    1. What have been the most significant barriers to assessing, 
monitoring, and strengthening health system resilience in the U.S.?
    2. What policies and programs can be improved to mitigate the risk 
of COVID-19 and avoid negative impacts on patient outcomes?
    3. What scientific advances are needed to assess and address 
vulnerabilities in the U.S. healthcare system during the COVID-19 
response and in future disturbances to the healthcare system?

Key Indicators & Data Sources of Health System Resilience

    1. What is your definition of health system resilience within the 
context of your organization? Does the definition of resilience need to 
be defined differently based on geographic region and/or the domain of 
healthcare being assessed?
    2. What key indicators or data sets are being used within your 
organization to assess health system resilience?
    3. What existing methods, data sources, and analytic approaches are 
being used to assess and monitor health system resilience in private 
healthcare systems?
    4. What selected health conditions should be used as indicators of 
healthcare availability, access, timeliness, and quality, in terms of 
treatment and preventive services?

Public/Private Data Sources

    1. What data sources does your organization use to assess the 
resilience of the health system? What demographic populations are 
covered by these data systems? Do these data systems capture urban-
rural and other geographic differences?
    2. How are you using these data sources to inform your public 
health response?

Public-Private Partnerships

    1. Provide ideas of the form and function of a public-private 
partnership model to continually assess and monitor health system 
resilience and individual as well as population health outcomes?
    2. What private and public sectors should HHS engage as part of 
such a collaborative effort?
    HHS encourages all potentially interested parties--individuals, 
associations, governmental, non-governmental organizations, academic 
institutions, and private sector entities--to respond. To facilitate 
review of the responses, please reference the question category and 
number in your response.

    Dated: June 2, 2020.
 Paul Reed,
Deputy Assistant Secretary for Health, Medicine & Science, Office of 
the Assistant Secretary for Health.
[FR Doc. 2020-12238 Filed 6-4-20; 8:45 am]
 BILLING CODE 4510-28-P