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Interoperability Call To Action & Environmental Scan · Indiana Health Information Exchange, Inc....
Transcript of Interoperability Call To Action & Environmental Scan · Indiana Health Information Exchange, Inc....
Interoperability Call To Action & Environmental ScanEvelyn Gallego, CPHIMS, MBA, MPH
HIMSS Interoperability & HIE Committee Chair 2017-2018
June 13, 2018
FY18 Interoperability & HIE Committee Members
Special thanks to all that contributed to this work:
Evelyn Gallego, MBA, CPHIMS, EMI Advisors LLC
Debi Car, CAHIMSS, DK Carr and Associates
Charles Christian, CHCIO, FCHIME, FHIMSS, LCHIME,
Indiana Health Information Exchange, Inc.
Rebecca Ettien, RN, MS, BSN, Cerner Corporation
Mishka Glaser, Deloitte Consulting
Elizabeth Hartley-Sommers, BSN, RN, Blue Cross and
Blue Shield of Louisiana
Andrew Klackiewicz, Mott Children’s Health Center
Brian Levy, MD
Michael Marchant, UC Davis Medical Center
Scott Mash, CPHIMS, FHIMSS, MSIT, Ohio Health
Information Partnership
John Middleton, MD, MSc, SCL Health
Melody Mulaik, MS, Coding Strategies, Inc.
Gerard Muro, MD, MI, Advanced Radiology Consultants
Joshua Rubin, JD, MBA, MPH, MPP, University of
Michigan Medical School
FY17 Interoperability & HIE Committee Members
Joseph Wagner, MPA, FHIMSS, Gevity Consulting
Robert Cothren, PhD, California Association of Health Information Exchange (CAHIE)
Mark Roche, MD, MS, Avanti iHealth
All other HIMSS staff and members who shared their expertise in the development of these resources.
1. Provide update on the Interoperability Call to Action
and discuss opportunities for engagement
2. Present the Interactive HIMSS Interoperability
Initiatives Environmental Scan
Why are we here today?
Interoperability Call to Action
• There is still work to be done. Seamless, secure, nationwide interoperable health information exchange continues to elude the country
• The information needs to follow the person. Without having the right information at the right time, payment reform and the transition to value-based care is nearly impossible.
• HIMSS has the brand, influence and capacity. Working on these issues for several decades, HIMSS is positioned to lead the field, ultimately realizing the goal of a learning health system.
Why HIMSS proposed a Call to Action
• Demand Integration between the Interoperability Approaches
and Trusted Exchange Frameworks for the Public Good
• Ensure Stakeholder Participation from Across the Care
Continuum, Including Patients and Caregivers
• Identify the “Minimum Necessary” Business Rules for Trusted
Exchange to Enhance Care Coordination
• Educate the Community to Appropriately Implement Existing
and Emerging Standards, Data Formats, and Use Cases to
Ensure a Comprehensive, Integrated Approach to Care
• Standardize and Adopt Identity Management Approaches
• Improve Usability for Data Use to Support Direct Care and
Research
HIMSS Interoperability Call to Action
Access the Full
Call to Action Here!
• Demand Integration between the Interoperability Approaches
and Trusted Exchange Frameworks for the Public Good
• Ensure Stakeholder Participation from Across the Care
Continuum, Including Patients and Caregivers
• Identify the “Minimum Necessary” Business Rules for Trusted
Exchange to Enhance Care Coordination
• Educate the Community to Appropriately Implement Existing
and Emerging Standards, Data Formats, and Use Cases to
Ensure a Comprehensive, Integrated Approach to Care
• Standardize and Adopt Identity Management Approaches
• Improve Usability for Data Use to Support Direct Care and
Research
Opportunities to Improve Approaches
• Demand Integration between the Interoperability Approaches
and Trusted Exchange Frameworks for the Public Good
• Ensure Stakeholder Participation from Across the Care
Continuum, Including Patients and Caregivers
• Identify the “Minimum Necessary” Business Rules for Trusted
Exchange to Enhance Care Coordination
• Educate the Community to Appropriately Implement Existing
and Emerging Standards, Data Formats, and Use Cases to
Ensure a Comprehensive, Integrated Approach to Care
• Standardize and Adopt Identity Management Approaches
• Improve Usability for Data Use to Support Direct Care and
Research
Opportunities to Improve Data
Calls on the Office of the National Coordinator (ONC) “to develop or
support a trusted exchange framework for trust policies and practices
and for a common agreement for exchange between health
information networks”…no later than 1 year after convening
stakeholders”.
Policy Drivers: 21st Century Cures Act
Many organizations have to join
multiple Health Information
Networks (HINs), and the HINs do
not share data with each other.
WHAT THE LAW REQUIRES
WHY DID CONGRESS REQUIRE THIS?
Healthcare organizations currently
burdened with creating many costly,
point-to-point interfaces between
organizations.
3 in 10 Hospitals use five or more interoperability methods.
https://www.healthit.gov/sites/default/files/draft-guide.pdf
Draft Trusted Exchange Framework and Common Agreement
• Draft Trusted Exchange Framework published by ONC on Jan. 5 2018 in response to Cures Act’s requirement
• Incorporates wide public comment and feedback from 3 listening sessions
• Presented in 2 parts:
– PART A: Principles for the Trusted Exchange Framework
– PART B: Minimum Required Terms and Conditions
https://www.healthit.gov/topic/interoperability/trusted-
exchange-framework-and-common-agreement
Draft Trusted Exchange Framework Principles and Terms of Conditions will
help to advance the HIMSS Call to Action.
Draft Trusted Exchange Framework and Call to Action
*The Trusted Exchange Framework and Common Agreement Final Rule scheduled to be
released late 2018
Policy Drivers: Inpatient Prospective Payment System (IPPS) Proposed Rule
• Published by Centers for Medicare and Medicaid Services (CMS)
on April 24, 2018
• Will further advance CMS’ priority of creating a patient-driven
healthcare system by achieving greater price transparency and
interoperability—essential components of value-based care
• Re-names Meaningful Use Program to “Promoting Interoperability”
as part of overall focus on strengthening interoperability and the
sharing of healthcare data between providers
• Included Request for Information on possibility of revising
Conditions of Participation to revive interoperability as a way to
increase electronic sharing of data by hospitals
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-04-
24.html
Interoperability Initiatives Environmental Scan
• Initiated during HIMSS17 in recognition of emerging
exchange frameworks
• Opportunity to define each framework for broader
national awareness and understanding in terms of:
– Organization Structure
– Technical and Operational Features
– Participant Details
Interoperability Initiatives Environmental Scan
Environmental Scan Landscape
Vendor-
mediated
exchange*
*For purposes of this scan, HIMSS’s Interop & HIE Committee used EPIC as one example (among many) of vendor-mediated exchange.
COMMUNITY
HIEs
Environmental Scan: Info Collected
Organization Structure
• Governance
• Date Founded
• Geographic reach
• Primary goals & objectives
• Participation costs
Technical and Operational
Features
• Standards
• Onboarding Requirements
• Certification & Testing Requirements
• How exchange is facilitated
Participant Details
• Type (i.e. network to network, consumer-directed, etc.)
• Primary participants
• Access method/use case
• Number of live connections
eHealth
Exchange
2012*
Sequoia
Carequality
2014
Care
Everywhere
(EPIC)**
2008
CommonWell
Health
Alliance
2013
NATE
2013
Surescripts
2008
Patient
Center Data
Home™
(SHIEC)
2015
Community
HIEs
2005
DirectTrust
2011
CARIN
Alliance
2016
Nationwide Interoperability Efforts
Key: Network-to-Network; Person-centric network; Provider-centric networkSecure messaging network/RLSConsumer-directed network
*Year of launch** For purposes of this scan, HIMSS’s Interop & HIE Committee used EPIC to represent one example of vendor-mediated exchange.
Interactive Environmental Scan
http://www.himss.org/library/interoperability-health-information-exchange/environmental-scan
• Carequality plans to enable 80% of hospitals and 70%+ of
physicians to exchange data in 3-5 years.
• CARIN Alliance transmitting multi-clinician data to consumers’
preferred app, & eliminating consumer-requested access issues
• Commonwell’s extending services across new care settings,
building new APIs, and expanding consumer-mediated exchange
• Community HIEs/SHIEC’s focusing on data cubes for analytics,
expanding clinical & claims data, and delivery methods
• DirectTrust wants to expand its PKI as a service to support other
tech, and thus help scale trust nationally.
The Future of Exchange(a few examples)
Key Findings from Environmental Scan
Multi-pronged
approach to exchange
Limited measurement of
standards
implementation,
adoption and use
Provider centric
system of exchange
Semantic interoperability
a barrier to data
exchange
Inconsistent quality
lowers value proposition
No common solution on
patient matching
A Multi-Pronged Approach to Exchange
Example…
One Epic client may use: CARE EVERYWHERETo share with other Epic clients
CAREQUALITYTo share with non-Epic EHRs on the Carequality Network
COMMONWELLTo share with non-Epic EHRs using CommonWell
COMMUNITY HIETo connect to other Hospitals/Providers in the region
DIRECT MESSAGINGTo connect to others not aligned with the above networks
FAXWhen all else fails…
• CommonWell & NATE are granting membership reciprocity.
• Surescripts is accredited by, and a member of, DirectTrust.
• CommonWell can be a Carequality implementer on behalf of its
members and clients, enabling subscribers to engage in directed
queries with any Carequality participant.
• Vendor exchanges (Allscripts, eClinicalWorks, etc.) belong to
DirectTrust; some serve as accredited HISPs to provide Direct
address and secure messaging.
• Many of SHIEC’s HIE members participate with DirectTrust,
Carequality, eHealth Exchange and NATE.
Widespread Collaboration (a few examples)
Next Steps…
• Environmental Scan – Available for download
• Interoperability Champions and Supporters
– Non-profit organizations can sign on to be a Champion and
Vendors and Provider organizations can become Supporters
– Both include opportunity to be listed on the HIMSS.org page
– Questions/Inquiries can be sent to [email protected].
• Join a HIMSS Interoperability & HIE Task Force or
Work Group
– Visit http://www.himss.org/get-
involved/committees/interoperability-hie
Next Steps:We want to engage with you!
Questions?