September 13, 2022

The U.S. Department of Health and Human Services has declared the U.S. monkeypox outbreak a public health emergency. Building on lessons learned during the COVID pandemic, OCHIN is providing community health care providers with the tools and resources they need to respond.

Addressing health disparities

As was seen in the COVID-19 pandemic, underlying structural inequities have placed underserved community members at increased risk of catching monkeypox. National data has shown that, in addition to most cases being concentrated primarily among men who have sex with men, racial and ethnic disparities also exist — with Black and Latino people shouldering a disproportionate burden of cases to date.

“Responding to this urgent public health problem has raised issues of equity, and our members are well-poised to provide care to those who need it most,” said Stacie Carney, M.D., Chief Medical Informatics Officer at OCHIN. “Our members are patient-centered and sensitive to the needs of their communities, and they are once again going the extra mile to do public health outreach and provide vaccines.”

Providing a rapid response

Still reeling from nearly two years of ongoing public health emergency response, OCHIN members jumped to the forefront of responding to the monkeypox outbreak as they became part of the Federal vaccination effort. Over Fourth of July weekend in 2022, the Massachusetts Department of Health notified OCHIN member Outer Cape Health Services that it would be one of four sites in the state to begin administering monkeypox vaccine the following week.

“Our request for assistance from OCHIN was met with incredible support for planning and developing the system needed for this to occur,” said Patricia Nadle, Chief Executive Officer of Outer Cape Health Services. “Within a week, we administered close to 800 doses of the vaccine to our communities supported by a smooth workflow for documentation and the necessary interface with the state’s vaccine system. We could not have accomplished all these unplanned, last-minute requirements without the support of all the talented folks at OCHIN!”

OCHIN’s public health emergency team, which was designed two years ago to make rapid changes based on members’ needs, mobilized to customize and configure OCHIN Epic and support members with additional tools and resources.

“Once we heard our members were getting a supply of the vaccine, we had 48 hours to get the billing and workflow set up so members could roll it out within the week,” said Lauren Alderson, M.D., Medical Informaticist on the public health emergency team at OCHIN.

To date, more than 14,909 monkeypox vaccinations have been given across the OCHIN network.

“What we have learned to do is a rapid response including all the things you quickly need to be able to address a new outbreak,” Carney said. “Building on the team that was put in place during COVID, our staff was quickly able to support vaccination and testing workflows and get the word out to members.”

Continuing support

OCHIN continues to monitor the guidelines and parameters around monkeypox vaccination to make sure the doses are correct and is watching carefully to see if there will be reporting requirements. A critical release pack has enabled OCHIN to facilitate any changes with vaccine guidelines within 24-48 hours, and a new Health Maintenance topic has been set up in OCHIN Epic to help with patients who are due for a second dose of the new Jynneos vaccine series. OCHIN has also enabled electronic case reporting in any participating state for monkeypox testing and made sure documentation on vaccine workflows is available to members.

“We’re being proactive with the tools we’re offering,” Alderson said. “For example, we’re working on a SmartSet in OCHIN Epic that is all-encompassing for vaccination and treatment and patient instructions. We’re getting feedback on what members need, and we have several things in the works to help support our members with vaccination and outreach.”

“We have a formal project in place that will be staying together so that members are able to get their needs met,” Carney said. “We will be watching how the vaccination effort expands from here and will be ready for support.”