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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

THE LEARNING HEALTH SYSTEM SERIES EMERGING STRONGER FROM COVID-19 Priorities for Health System Transformation National Academy of Medicine NAM Leadership Consortium: Collaboration for a Learning Health System PREPUBLICATION COPY—Uncorrected Proofs

THE NATIONAL ACADEMIES PRESS 500 Fifth Stre et, NW Washington, D C 20001 This publication has undergone peer review according to procedures established by the National Academy of Medicine (NAM). Publication by the NAM signifies that it is the product of a carefully considered process and is a contribution worthy of public attention, but does not constitute endorsement of conclusions and recommendations by the NAM. The views presented in this publication are those of individual contributors and do not represent formal consensus positions of the authors’ organizations; the NAM; or the National Academies of Sciences, Engineering, and Medicine. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/26657 Library of Congress Catalog Number: 2022XXXXXX Copyright 2022 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academy of Medicine. 2022. Emerging Stronger from COVID-19: Priorities for Health System Transformation. A. Anise, L. Adams, M. Ahmed, A. Bailey, P. S. Chua, C. S. Chukwurah, M. Cocchiola, A. Cupito, K. Kadakia, J. Lee, and A.Williams, editors. NAM Special Publication. Washington, DC: National Academies Press. https://doi.org/10.17226/26657. PREPUBLICATION COPY—Uncorrected Proofs

“Knowing is not enough; we must apply. Willing is not enough; we must do” —GOETHE PREPUBLICATION COPY—Uncorrected Proofs

AB OUT THE NATIONAL ACADEMY OF MEDICINE The National Academy of Medicine is one of three Academies constituting the National Academies of Sciences, Engineering, and Medicine (the National Academies).The National Academies provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on issues of health, health care, and biomedical science and technology. Members are elected by their peers for distinguished contributions to medicine and health. Dr.Victor J. Dzau is president. Learn more about the National Academy of Medicine at NAM.edu. PREPUBLICATION COPY—Uncorrected Proofs

EMERGING STRONGER FROM COVID-19: PRIORITIES FOR HEALTH SYSTEM TRANSFORMATION Steering Committee and Lead Authors AMY ABERNETHY, Verily JEFFREY BALSER,Vanderbilt University Medical Center CAROLYN CLANCY, Veterans Health Administration NAKELA COOK, Patient-Centered Outcomes Research Institute KAREN DeSALVO, Google KATE GOODRICH, Humana ROBERT HUGHES, Missouri Foundation for Health (former) FREDERICK ISASI, Families USA MICHAEL LAUER, National Institutes of Health PETER LEE, Microsoft Research JAMES MADARA, American Medical Association MATHAI MAMMEN, Janssen/Johnson & Johnson MARK McCLELLAN, Duke University SUZANNE MIYAMOTO, American Academy of Nursing VASANT NARASIMHAN, Novartis MARY NAYLOR, University of Pennsylvania RAHUL RAJKUMAR, Optum Care Solutions JAEWON RYU, Geisinger DAVID SKORTON, Association of American Medical Colleges NAM Staff Development of this publication was facilitated by contributions of the following NAM staff, under the guidance of J. Michael McGinnis, Leonard D. Schaeffer Executive Officer and Executive Director of the NAM Leadership Consortium: Collaboration for a Learning Health System: v PREPUBLICATION COPY—Uncorrected Proofs

LAURA ADAMS, Special Advisor MAHNOOR AHMED, Associate Program Officer AYODOLA ANISE, Deputy Director, NAM Leadership Consortium ARIANA BAILEY, Senior Program Assistant (until August 2021) PEAK SEN CHUA, Consultant CHINENYE STEPHEN CHUKWURAH, Research Associate (until July 2021) MICHAEL COCCHIOLA, Associate Program Officer (until July 2022) ANNA CUPITO, Associate Program Officer (until July 2021) KUSHAL KADAKIA, Consultant (until August 2021) JENNIFER LEE, Special Advisor (until August 2022) JENNA L. OGILVIE, Deputy Director of Communications ASIA WILLIAMS, Associate Program Officer vi PREPUBLICATION COPY—Uncorrected Proofs

REVIEWERS T he papers in this volume were reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with review procedures established by the National Academy of Medicine (NAM). We wish to thank the following individuals for their contributions: VINEET ARORA, University of Chicago School of Medicine ELIZABETH BACA, Deloitte DAVID BAKER, The Joint Commission DONALD BERWICK, Institute for Healthcare Improvement ANDREW BINDMAN, Kaiser Permanente F. DUBOIS BOWMAN, University of Michigan School of Public Health HELEN BURSTIN, Council of Medical Specialty Societies ATUL BUTTE, University of California, San Francisco JANET CORRIGAN, National Quality Forum (former) LORI FREEMAN, National Association of County and City Health Officials TERRY FULMER, The John A. Hartford Foundation PATRICIA GABOW, University of Colorado SHERRY GLIED, New York University ADAM GLUCK, Sanofi U.S. DAVID GROSSMAN, Kaiser Permanente JOHN HALAMKA, Mayo Clinic Platform MUKESH JAIN, Brown University CHRISSIE JULIANO, Big Cities Health Coalition ALEX KRIST, Virginia Commonwealth University TRACY LIEU, Kaiser Permanente Bernard J. Tyson School of Medicine JOSHUA MAKOWER, Stanford University HUSSEINI K. MANJI, Science for Minds at Johnson & Johnson VELMA McBRIDE MURRY, Vanderbilt University LEON McDOUGLE, The Ohio State University Wexner Medical Center vii PREPUBLICATION COPY—Uncorrected Proofs

PHYLLIS D. MEADOWS, The Kresge Foundation BERNADETTE MELNYK, The Ohio State University DAVID MEYERS, Agency for Healthcare Research and Quality JOSÉ MONTERO, Center for State, Tribal, Local, and Territorial Support JULIE MORITA, Robert Wood Johnson Foundation MEREDITH ROSENTHAL, Harvard T.H. Chan School of Public Health JOHN SANTA, OpenNotes MONICA SCHOCH-SPANA, Johns Hopkins Center for Health Security NIRAV SHAH, Stanford University PAMELA TENAERTS, Medable, Inc. GEORGE THIBAULT, Harvard Medical School KARA ODOM WALKER, Nemours Children’s Health System KEITH YAMAMOTO, University of California, San Francisco The reviewers listed above provided many constructive comments and suggestions, but they were not asked to endorse the content of the individual papers, and did not see the final draft before it was published. Review of these papers was overseen by AYODOLA ANISE, Deputy Director, NAM Leadership Consortium; LAURA ADAMS, Special Advisor; MAHNOOR AHMED, Associate Program Officer; JENNIFER LEE, Special Advisor; and J. MICHAEL McGINNIS, Leonard D. Schaeffer Executive Officer. Responsibility for the final content of this publication rests entirely with the editors and the NAM. viii PREPUBLICATION COPY—Uncorrected Proofs

PREFACE W e know from Isaac Newton’s third law that forces come in pairs: for every action, there is an equal and opposite reaction. But when it comes to human catastrophe, a post-acute human tendency often sets in to diffuse the reactive forces from what ought to be their primary directionality. Without a strong resolve to keep sharp focus on the most basic lessons learned about preparedness shortfalls, the stage is set, seamlessly and senselessly, for the tragedy of the next event. In 2001, terrorism on American soil drew collective attention to the gaps in national security that made our nation vulnerable to attack. In 2004, Hurricane Katrina made clear the need for infrastructure that is resilient to natural disaster. Both responses have led to focused change, albeit imperfect, in the nation’s preparedness. On the other hand, the tragedy of mass murders, such as the 2014 shooting in Sandy Hook, have been followed by societal inaction, and left the nation unprotected from the full force of the occurrence of similar catastrophes. To date, in mid-2022, the United States has lost more than a million people to the COVID-19 pandemic. We have been real-time witnesses to heroic front-line responses to the disease, death, inequity, and economic strife unleashed by the virus, but we have also been real-time witnesses to the consequences not only of poor preparedness to contend with newly emerging health threats, but especially to the consequences of structural failures of our health system.The nation’s health system is poised at a critical junction point, with the opportunity to emerge stronger not merely in resistance to a novel infectious disease threat, but as a secure and sustained steward of the human condition over time. For decades, the U.S. health system has fallen far short of its potential to produce individual and population health. In contrast to health care spending that exceeds that of any Organisation for Economic Co-operation and Development (OECD) nation, the U.S. experiences lower life expectancies, higher suicide rates, higher chronic disease burdens, higher obesity rates, and higher hospitalization rates from preventable causes than any of its peers. The inequities, lack of community ix PREPUBLICATION COPY—Uncorrected Proofs

x | Preface engagement, misaligned resources and incentives, untapped digital potential, and slow rate of evidence mobilization that belie these trends were also at the root of the nation’s experience with COVID-19. To fully realize the health system effectiveness, efficiency, equity, and continuous learning that will translate to better and more holistic health and well-being, leaders from across the U.S. health system must take action to leverage both the learnings and the transformational opportunities that have accompanied the pandemic’s devastation. Cognizant of the potential near-term and long-term importance of understanding in detail the features, impacts, and responses within and between various health sectors during the pandemic, the National Academy of Medicine’s (NAM’s) Leadership Consortium, comprised of the leadership of organizations from all major health system sectors, has undertaken a sector-by-sector review of the U.S. health system. The papers contained within assess the weaknesses that existed prior to COVID-19, how each sector has responded to the pandemic, and the opportunities that exist for health system strengthening and transformation. The resulting sectoral impact assessments are presented here in Emerging Stronger from COVID-19: Priorities for Health System Transformation. Each assessment team has been led by members of the NAM Leadership Consortium. Emerging Stronger is comprised of nine chapters that summarize the findings, opportunities, and collaborative options for sectoral transformation, followed by a chapter on cross- sector priorities for change, including:   1.  Patients, Families, and Communities   2.  Clinicians and Professional Societies   3.  Care Systems   4.  Digital Health   5.  Public Health   6.  Health Care Payers   7.  Health Product Manufacturers and Innovators   8.  Biomedical Research   9.  Quality, Safety, and Standards Organizations 10.  Health System Transformation: Common Priorities Across Sectors The summary insights, drawn from the shared perspectives of the sector authors, underscore three deeply rooted common features leading to the core problems within each sector:   1.  Systemic fragmentation,   2.  Perverse incentives, and   3.  Structural inequities. PREPUBLICATION COPY—Uncorrected Proofs

Preface | xi Accordingly, the authors note the importance of forceful collaborative engagement of transformational opportunities for stakeholders setting priorities for organizations in each of their sectors: 1. Financing that is linked, integrated, seamless, and focused on outcomes for people and populations; 2.  Digital interoperability and shared data; 3. Culture and accountability focused on outcomes most important to people and their communities; 4.  Learning that is real world, continuous, and timely; and 5. Public health integrity as an explicit responsibility of every organization. Taken together, the assessments in Emerging Stronger provide a unique and comprehensive review of the U.S. health system’s experience throughout the pandemic, as well as a roadmap toward a healthier future. It integrates the deep and growing knowledge base of the NAM with the expertise of leaders engaging the pandemic in real-time, offering both information and inspiration for aligned action on key opportunities. In this respect, we extend our deep appreciation to the members of the NAM Leadership Consortium, the project Steering Committee composed of the lead authors of each sector assessment, their collaborating colleagues from the field, the expert reviewers of each of the papers, and the superb NAM staff who coordinated and facilitated their work. As Americans, innovation, improvement, and invention is our shared birthright. This publication underscores the imperative and the promise of applying the full strength of the nation for system-wide transformation as we apply the clarity of the lessons learned to create a health system that is effective, efficient, equitable— and continuously learning. Victor J. Dzau J. Michael McGinnis President Leonard D. Schaeffer Executive Officer National Academy of Medicine Executive Director, NAM Leadership  Consortium National Academy of Medicine PREPUBLICATION COPY—Uncorrected Proofs

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CONTENTS Acronyms and Abbreviations������������������������������������������������������� xxi 1 Patients, Families, and Communities COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ��������������������1 Frederick Isasi, JD, MPH; Mary D. Naylor, PhD, RN; David Skorton, MD; David C. Grabowski, PhD; Sandra Hernández, MD; and Valerie Montgomery Rice, MD 2C  linicians and Professional Societies COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ������������������ 79 James Madara, MD; Suzanne Miyamoto, PhD, RN; Jason E. Farley, PhD, MPH, ANP-BC; Michelle Gong, MD, MS; Millicent Gorham, PhD(Hon), MBA; Holly Humphrey, MD, MACP; Mira Irons, MD; Ateev Mehrotra, MD, MPH; Jack Resneck, Jr., MD; Cynda Rushton, PhD, MSN, RN; and Tait Shanafelt, MD 3 Care Systems COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ���������������������������������� 127 Jeffrey Balser, MD, PhD; Jaewon Ryu, MD, JD; Michelle Hood, MHA; Gary Kaplan, MD; Jonathan Perlin, MD, PhD; and Bruce Siegel, MD, MPH 4 Digital Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ���������������������������������� 177 Peter Lee, PhD; Amy Abernethy, MD, PhD; David Shaywitz, MD, PhD; Adi V. Gundlapalli, MD, PhD, MS; Jim Weinstein, DO; P. Murali Doraiswamy, MBBS, FRCP; Kevin Schulman, MD; and Subha Madhavan, PhD xiii PREPUBLICATION COPY—Uncorrected Proofs

xiv | Contents 5P  ublic Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ���������������������������������� 235 Karen DeSalvo, MD, MPH, MSc; Bob Hughes, PhD; Mary Bassett, MD, MPH; Georges Benjamin, MD; Michael Fraser, PhD, CAE; Sandro Galea, MD, MPH, DrPH; J. Nadine Gracia, MD, MSCE; and Jeffrey Howard, MD, MBA, MPH 6H  ealth Care Payers COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ���������������������������������� 283 Mark McClellan, MD, PhD; Rahul Rajkumar, MD, JD; Marion Couch, MD, MBA; Diane Holder, MS; Peter Long, PhD; Rhonda Medows, MD; Amol Navathe, MD, PhD; Mai Pham, MD, MPH; Lewis Sandy, MD, MBA; William Shrank, MD, MSHS; and Mark Smith, MD, MBA 7H  ealth Product Manufacturers and Innovators COVID-19 Impact Assessment: Lessons Learned and Compelling Needs������������������������������������������������������������ 335 Mathai Mammen, MD, PhD; Vasant Narasimhan, MD, MPP; Richard Kuntz, MD, MSc; Freda Lewis-Hall, MD; Mojdeh Poul, MBA, MEng; and Adam H. Schechter 8 Biomedical Research COVID-19 Impact Assessment: Lessons Learned and Compelling Needs ���������������������������������� 393 Nakela L. Cook, MD, MPH; and Michael S. Lauer, MD  uality, Safety, and Standards Organizations 9Q COVID-19 Impact Assessment: Lessons Learned and Compelling Needs������������������������������������������������������������ 441 Carolyn Clancy, MD; Kate Goodrich, MD, MHS; Jean Moody-Williams, RN, MPP; Karen Dorsey Sheares, MD, PhD; Margaret O’Kane, MS, MHS; Stephen Cha, MD, MHS; and Shantanu Agrawal, MD 10 H  ealth System Transformation: Common Priorities Across Sectors���������������������������������������������������������������������� 473 Amy Abernethy, MD, PhD; Jeffrey Balser, MD, PhD; Carolyn Clancy, MD; Karen DeSalvo, MD, MPH, MSc; Kate Goodrich, MD, MHS; Robert Hughes, PhD; Frederick Isasi, JD, MPH; Peter Lee, PhD; James Madara, MD; Mathai Mammen, MD, PhD; Mark McClellan, MD, PhD; Suzanne Miyamoto, PhD, RN; Vasant Narasimhan, MD, MPP; Mary Naylor, PhD, RN; Rahul Rajkumar, MD, JD; Jaewon Ryu, MD, JD; and David Skorton, MD PREPUBLICATION COPY—Uncorrected Proofs

B OXES, FIGURES, AND TABLES B OXES 1-1 Stories of Lived Experience: Impact of Being a Frontline Employee During COVID-19, 13 1-2 Stories of Lived Experience: Impact of Isolating to Prevent Transmission to Family Members, 14 1-3 Stories of Lived Experience: Challenges Faced by Elizabeth de Garcia and Her Family in Navigating the Health System During the COVID-19 Pandemic, 19 1-4 Stories of Lived Experience: Challenges Faced by Joe Merlino and His Family in Navigating the Health System During the COVID-19 Pandemic, 20 1-5 Stories of Lived Experience: Impact of Suicide on Loved Ones, 24 1-6 Stories of Lived Experience: Health Care Disparities During COVID-19, 33 1-7 Stories of Lived Experience: Communicating Science to the Public, 36 1-8 Stories of Lived Experience: Perceptions of the Pandemic Response, 37 1-9 Stories of Lived Experience: Challenges with Communicating COVID-19 Messaging, 37 1-10 Stories of Lived Experience: Community Collaboration and Resilience in Support of Individuals During COVID-19, 39 1-11 Considerations for Facilitating Active, Continued, and Meaningful Community and Health Care Engagement with Patients and Families, 42 1-12 Considerations for Building and Restoring Trust Through Improved Communication, Trusted Sources, and Translation of Scientific Practices, 44 1-13 Considerations for Prioritizing Investment in Solutions Designed to Advance Health Equity, 46 1-14 Considerations for Realigning Care Approaches to Meet and Engage the Health-Related Needs of People and Their Families, and Strengthen Community Capacity, 48 xv PREPUBLICATION COPY—Uncorrected Proofs

xvi | Boxes, Figures, and Tables 1-15 Considerations for Examining Critical Intersections and Implementing Aligned Solutions Between Patients, Families, and Communities and Other Sectors, 51 2-1 Considerations for Investing in Clinician Well-Being, 103 2-2 Considerations for Advancing Innovations in Clinician Practice, 105 2-3 Considerations for Promoting Financial Resilience for Clinicians, 107 2-4 Considerations for Transforming Education and Training, 109 2-5 Considerations for Addressing Health Disparities, 110 3-1 Considerations to Enhance the Financial Resiliency of Health Systems, 148 3-2 Considerations to Strengthen Health System Supply Chains, 150 3-3 Considerations for Investing in Workforce Development, 151 3-4 Considerations for Health System Capacity Building, 152 3-5 Considerations for Renewing Commitments and Instituting Concrete Actions for Health Equity, 153 3-6 Considerations for Addressing Subsector Specific Challenges, 157 3-7 Considerations for Fostering Linkages Between Health Systems and Public Health, 158 4-1 Definition of Digital Health, 178 5-1 Considerations for Transforming Public Health Funding, 257 5-2 Considerations for Affirming the Mandate for Public Health, 259 5-3 Considerations for Promoting Structural Alignment Across the Public Health Sector, 261 5-4 Considerations for Investing in Leadership and Workforce Development, 263 5-5 Considerations for Modernizing Data and IT Capabilities, 264 5-6 Considerations for Supporting Partnerships and Community Engagement, 265 6-1 Considerations for Accelerating the Transition to Value-Based Payment, 309 6-2 Considerations for Extending Flexibilities for Virtual Health Services and Capabilities, 312 6-3 Considerations for Rethinking Benefit Design Using the Lens of Value-Based Insurance, 313 6-4 Considerations for Aligning Incentives and Investments to Address Health Inequities, 314 PREPUBLICATION COPY—Uncorrected Proofs

Boxes, Figures, and Tables | xvii 6-5 Considerations for Creating Mechanisms for Collective Action During Public Health Emergencies, 316 6-6 Considerations for Coordinating Payment Reforms with Public Health Functions, 318 10-1 Centering Health System Actions and Accountability on Individuals, Families, and Communities, 507 10-2 Committing to the Pursuit of Equity as Core to Health System Performance, 509 10-3 Securing the Public Health Infrastructure to Address 21st Century Population Health Challenges, 510 10-4 Building a Robust and Integrated Digital Health and Data Sharing Infrastructure, 512 10-5 Integrating Telehealth into Payment and Delivery Systems, 513 10-6 Investing in Workforce Capacity and Readiness, 515 10-7 Streamlining Innovation Pathways for Biomedical Science, 516 10-8 Enhancing Stewardship of the Health Product Supply Chain, 518 10-9 Restructuring Health Care Payments to Focus on Outcomes and Population Health, 519 10-10 Fostering Communication and Collaboration Across Sectors and Stakeholders, 521 FIGURES 1-1 Impact of the Pandemic on Patients, Families, and Communities, 3 1-2 Experiences of Patients, Families, and Communities During COVID-19, 11 1-3 Impact of COVID-19 on Patients, Families, and Communities’ Relationship to the Health System, 35 2-1 The Clinician Response to COVID-19, 81 2-2 COVID-19 Stressors for Clinicians, 92 2-3 Priority Areas for the Clinician Sector, 101 3-1 Landscape of U.S. Health System, 128 3-2 Health System Functions During COVID-19, 130 3-3 Cross-Cutting Public Health Functions for COVID-19, 134 3-4 Priority Actions for Sector Transformation and Emergency Preparedness, 146 4-1 Lifecycle for Continuous Management and Refinement of AI Models, 208 PREPUBLICATION COPY—Uncorrected Proofs

xviii | Boxes, Figures, and Tables 5-1 Models of Public Health Governance, 238 5-2 Frameworks for Essential Services and Foundational Capabilities in Public Health, 239 5-3 Pre-Pandemic Challenge Areas for the Public Health Sector, 240 5-4 Key Challenges for Local and State Health Departments During COVID-19, 250 6-1 Overview of America’s Multi-Payer Landscape, 284 6-2 Payer Responses to COVID-19 Challenges, 286 6-3 Key Challenges for Payers for the Post-Pandemic Era, 294 6-4 Opportunities for Sector-Wide Improvement, 302 6-5 Select Examples of Clinical Use Cases for Telehealth, 303 7-1 Profile of the Health Products Sector, 337 7-2 Elective Procedure Volume Weekly Trends, 347 7-3 Weekly Volumes of New Prescription (Rx) of Branded Therapeutics, 353 7-4 Telemedicine Use Among Healthcare Provider Organizations, 355 7-5 Opportunities for Sector-Wide Transformation, 366 9-1 Key Levers for Care Quality and Safety, 442 9-2 Vulnerabilities in Quality & Standards Exposed by COVID-19, 447 10-1 COVID-19 Stakeholder Sectors Legend, 476 10-2 Overview of Sector Changes, Challenges, and Transformation Opportunities, 477 10-3 Select Examples of Leadership and Advances During COVID-19, 479 TABLES 1-1 Pre-Pandemic Experiences of Patients, Families, and Communities, 5 1-2 The Disparate Impact of COVID-19 on Communities of Color, 32 2-1 Key Challenges for the Clinician Sector, 90 3-1 Health System Challenges During COVID-19, 137 3-2 Drivers of Supply Chain Vulnerability, 140 4-1 Digital Health Challenges and Opportunities Revealed in the Eight Other Sector Papers, 184 5-1 Role of Foundational Capabilities for Public Health During the COVID-19 Response, 244 PREPUBLICATION COPY—Uncorrected Proofs

Boxes, Figures, and Tables | xix 6-1 Payer Support for the Social Determinants of Health, 288 6-2 Payer Strategies to Support the Transition to Virtual Care, 293 7-1 Examples of Collaborations Which Emerged During COVID-19, 358 10-1 Select Examples of Cross-Cutting Challenges and Experiences of Sectors for COVID-19, 488 PREPUBLICATION COPY—Uncorrected Proofs

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ACRONYMS AND ABBREVIATIONS AACN American Association of Colleges of Nursing AAMC Association of American Medical Colleges AAP American Academy of Pediatrics ACA Affordable Care Act ACCORD Accelerating COVID-19 Research & Development platform ACGME Accreditation Council for Graduate Medical Education ACLA American Clinical Laboratory Association ACO accountable care organization ACTIV Accelerating COVID-19 Therapeutic Interventions and Vaccines ADHD attention deficit and hyperactivity disorder AHA American Hospital Association AHRQ Agency for Healthcare Research and Quality AI artificial intelligence AMA American Medical Association AMC academic medical center ANA American Nurses Association AO accrediting organization APA American Psychological Association API application programming interface APM alternative payment model ARPA-H Advanced Research Projects Agency for Health ASC ambulatory surgical center BARDA Biomedical Advanced Research and Development Authority BBC British Broadcasting Company BLS Bureau of Labor Statistics CAH critical access hospital CARES Act Coronavirus Aid, Relief, and Economic Security Act xxi PREPUBLICATION COPY—Uncorrected Proofs

xxii | Acronyms and Abbreviations CBO community-based organization CCNE Commission on Collegiate Nursing Education CCO coordinated care organization CCPA California Consumer Privacy Act CDC Centers for Disease Control and Prevention CDM PCORnet Common Data Model CEAL NIH Community Engagement Alliance CHART Community Health Access and Rural Transformation Model CHW community health worker CLIA Clinical Laboratory Improvement Amendments CMS Centers for Medicare & Medicaid Services CoP condition of participation COVID-19 coronavirus disease 2019 CoVPN COVID-19 Prevention Network CPT Current Procedural Terminology CRS Congressional Research Service CTL Crisis Text Line DOD Department of Defense DOJ Department of Justice DPA U.S. Defense Production Act DR2 NIH Disaster Research Response Program ED emergency department EHR electronic health record EUA emergency use authorization FAIR findable, accessible, interoperable, and reusable FCC Federal Communications Commission FDA U.S. Food and Drug Administration FEMA Federal Emergency Management Agency FFS fee-for-service FHIR® Fast Healthcare Interoperability Resources® FTC Federal Trade Commission FY fiscal year GDPR General Data Protection Regulation GME graduate medical education GPO group purchasing organization PREPUBLICATION COPY—Uncorrected Proofs

Acronyms and Abbreviations | xxiii HaH Hospital at Home HAI hospital acquired infection HCBS home- and community-based services HHS U.S. Department of Health and Human Services HIPAA Health Insurance Portability and Accountability Act HITECH Act Health Information Technology for Economic and Clinical Health Act HIV human immunodeficiency virus HPMI health product manufacturers and innovators HRSA Health Resources and Services Administration ICU intensive care unit IDN integrated delivery network IDSA Infectious Diseases Society of America IHI Institute for Healthcare Improvement IMP investigational medicinal product IOM Institute of Medicine IoT internet-of-things IP intellectual property IT information technology JHU Johns Hopkins University KFF Kaiser Family Foundation LGBTQ+ lesbian, gay, bisexual, transgender, queer or questioning, and other gender identities and sexual orientations LHS learning health system MIPS Merit-based Incentive Payment System ML machine learning MLR medical loss ratio N3C National COVID Cohort Collaborative NAM National Academy of Medicine NCHS National Center for Health Statistics NCQA National Center for Quality Assurance NGS next generation sequencing NHLBI National Heart, Lung, and Blood Institute PREPUBLICATION COPY—Uncorrected Proofs

xxiv | Acronyms and Abbreviations NHSN National Healthcare Safety Network NIAID National Institute of Allergy and Infectious Diseases NIH National Institutes of Health NPI nonpharmaceutical intervention NQF National Quality Forum NRC National Research Council OASH Office of the Assistant Secretary for Health OASPE Office of the Assistant Secretary for Planning and Evaluation OCR Office for Civil Rights OHDSI Observational Health Data Sciences and Informatics OHRP Office for Human Research Protections OIG Office of Inspector General ONC Office of the National Coordinator for Health Information Technology OSHA Occupational Safety and Health Administration OSTP Office of Science and Technology Policy OWS Operation Warp Speed PA physician assistant PCORI Patient-Centered Outcomes Research Institute PCR polymerase chain reaction PHAB Public Health Accreditation Board PHR personal health record PHRASES Public Health Reaching Across Sectors PPE personal protective equipment PTSD posttraumatic stress disorder QIN-QIO Quality Innovation Network-QIO QIO Quality Improvement Organization QR quick response R&D research and development RADx Rapid Acceleration of Diagnostics initiative RN registered nurse RWD real-world data SAMHSA Substance Abuse and Mental Health Services Administration SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 SDoH social determinants of health PREPUBLICATION COPY—Uncorrected Proofs

Acronyms and Abbreviations | xxv SNAP Supplemental Nutrition Assistance Program SNF skilled nursing facility SNS Strategic National Stockpile UCSF University of California, San Francisco UK United Kingdom UPMC University of Pittsburgh Medical Center U.S. United States USCDI United States Core Data for Interoperability USNS U.S. Navy Ship VA U.S. Department of Veterans Affairs VAERS Vaccine Adverse Event Reporting System VTEU Vaccine and Treatment Evaluation Unit WHO World Health Organization WIC Special Supplemental Nutrition Program for Women, Infants, and Children PREPUBLICATION COPY—Uncorrected Proofs

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