National Action Agenda Updates and Next Steps
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National Action Agenda Updates and Next Steps April 2, 2021
Transcript of National Action Agenda Updates and Next Steps
National Action Agenda Updates and Next Steps
April 2, 2021
Today’s Agenda
• Welcome Back & Purpose of Webinar
• Overview of NAA and Action Recommendations
• Two Strategic Areas of Focus (2021)• Project UNIFY & Integrated Care for Kids• Privacy & Consent Utility Service
• InterOptimability Training Curriculum and Certification Program
• NIC/UNIFY Partner Presentations • Eric Jahn – HSLynk • Matt Bishop – Open City Labs• Dave Walsh – MITA TAC
• Next Steps, Get Involved and Discussion
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The Stewards of Change Institute (SOCI) is a nonprofit organization started in 2005 with the purpose of improving the futures of the most under-resourced and under-served populations by initiating, inspiring and advancing transformational change in health and human services systems at all levels of government, industry and nonprofits.
Background
The National Interoperability Collaborative (NIC) is a “Community of Networks” that increases collaboration across the spectrum of programs and sectors that enhance health, safety, education, race equity and well-being by advancing information-sharing, interoperability and standards-based technology. NIC has over 1,500 members and has held 52 webinars over the past year. It also hosted the 6-month National Action Agenda process in 2020/2021.
The National Interoperability Collaborative
NIC is a project of the Stewards of Change Institute. It is a
Community of Networks designed to increase
collaboration within and across multiple domains to
improve health, safety, well-being and operations.
We focus primarily on Six Domains:
Human Services, Public Health, Education, Public Safety,
Emergency Medical Response, Health Care IT
"NIC is an idea whose time has come!"David Fukazawa, Managing Director of Kresge Foundation's Health Program
Over the past year – participants in the National Action Agenda identified 6 Key Action Recommendations. We have begun to implement two of them.
We skated to where the puck was going … and arrived in January 2021.
What’s Next?
The NAA Timeline 2020/2021
SEPTEMBER
Convene, Introduce Thomson Family, Launch
Scenario
OCTOBER
Introduce Integrated
Care for Kids, Overview
“Project Unify Proof of
Concept”
NOVEMBER
Identify and Assess Initial Systems-Level Problems
and Action Recommendations
DECEMBER
Develop, Refine, Synthesize Action
Recommendations
JANUARY
Prioritize Action Recommendations, Showcase POC &
Prepare for Implementation
Begin
Implementing
2021
1. Lived Experience. Incorporate “people with lived experience” at all levels throughout organizational and governmental programs and systems.
2. Data Sharing and Integration. Demonstrate and document that data sharing can occur across diverse services and sectors.
3. Governance. Identify or develop a governance model that enables policy formulation, decision-making processes and organizational principles.
4. Care Coordination. Identify a guidance-and-support framework that outlines good/best practices; recognizes the ROI; and includes an adaptable and replicable means for cross-sector sharing.
5. Housing. Work to make housing an explicit, integral element of healthcare in policy and practice.
6. Civil Justice. Collect data to understand user experiences with the civil justice system to improve accessibility, enabled through technology.
Action Recommendation Summaries and Details
NAA Recommendations
• Project UNIFY & Integrated Care for Kids
• Privacy & Consent Utility Service
Two Strategic Areas of Focus (2021)
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Project Unify Vision:
Implement a proof of concept to demonstrate replicable,
standards-based information sharing and interoperability
across health, education and human services domains.
Achieve the vision by working collaboratively within an
open API/source technology framework.
Project Unify Core Team Participants
Healthcare, Medicaid, Child Welfare, Social Services, Education, Housing, Nutrition, Public Health and
Public Safety
• Stephanie Arntson: MiHINInteroperability Institute
• Noam Arzt: HLN Consulting
• Matt Bishop: Open City Labs
• Susan Fox: MITA TAC
• Brian Handspicker: Practical Markets
• Jennifer Hall: Community Partnerships, CO
• Ben Hogan: Senzing
• Eric Jahn: HSLynk
• Mary Kratz: MiHINInteroperability Institute
• Andrew Laing: Lantana Consulting
• Kristine McCoy MD: Children and Family Health Institute, VNA Central NJ
• Pradeep Podila: CDC
• Tom Silvious: GDIT
• Allen Tien: MDLogix
• Rita Torkzadeh: Consultant
• Arvinder Singh: Coherence
• Daniel Stein: Stewards of Change Institute
• Dave Walsh: MITA TAC
• Paul Wormeli: Wormeli Consulting
Special Thanks to Those Who Invested in Creating Unify Technical Demos:
ServingLynk – www.servinglynk.com
Open City Labs – www.opencitylabs.com
MITATAC – [email protected]
Mary Kratz - Interoperability Institute
Project Unify: Goals and Objectives
Demonstrate the exchange of data and identify governance constructs
between domains using source or target domain-specific standard protocols.
Develop domain specific identity-matching patterns and demonstrate
application of industry standard tools and approaches.
Create cross-domain data maps and reusable interfaces/APIs to facilitate
and accelerate industry adoption.
Incorporate and demonstrate the use of industry standard security protocols
to implement these data exchanges and document lessons learned and best
practices.
Create an open source/APIs repository to accelerate the use of these
assets to facilitate and accelerate industry adoption.
Integrated Approach
Based on SDOH & Integrated Care for Kids
Project UNIFY Has Been Making Progress in 2021…
▪ Weekly Planning Meetings, Technical Working Groups, Demo Development with UNIFY Partners including: • HSLynk • Open City Lab• MITA TAC• Interoperability Institute / MiHIN• And many others
▪ Created 3 Technical Demonstrations (Recordings on UNIFY Site on HUB):• Homeless SDoH Dataflow• PRAPARE to EHR to CBRO Dataflow • Homeless Rehab COVID Dataflow
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Project Unify Homeless SDoH Dataflow
HUD HMIS
STANDARDS
FHIR Subscription
or Polling Service
FHIR ServiceRequest
or 360X over Direct
or Fax or Print/Post
Housing Instability -
Homelessness (SNOMED
32911000)
SNAP Food Assistance
Piton Shelter Mgmt App
Human Services
Case Management
Homeless Management
Information System
Rental Assistance
HUD – Chronically Homeless
Project Unify - PRAPARE to EHR to CBRO Dataflow
FHIR
Questionnaire/
Response
FHIR Subscription
or Polling ServiceFHIR ServiceRequest
or 360X over Direct
or Fax or Print/Post
Condition – Health
Concern: Food Insecurity
(SNOMED 733423003)
Child Care CBO
PRAPARE Survey App
Human Services
Case Management
Electronic Health
Records System
WIC Health Agency
Observation –Yes to
PRAPARE Food Insecurity
(LOINC 93031-3)
Project Unify - Homeless Rehab COVID Dataflow
FHIR
Questionnaire/
Response
FHIR Subscription
or Polling Service FHIR Subscription
Condition – Health
Concern: Suspected
SARS2 (SNOMED
733423003)
COVID Survey App
Community
Infectious Disease
Alerts Service
Electronic Health
Records SystemHomeless/Rehab Center
Observation –Yes to COVID
Suspected COVID
School/Corporate Campus
Assisted Living/Nursing Home
Developing an Open-Source Utility to Manage Consent across Domains
▪ Consent is Critical for Realizing Comprehensive Care Coordination
▪ Multiple, overlapping consent requirements for HIPAA, FERPA, 42 CFR Part2,
Advance Directives to address SDOH
▪ Current situation: extensive duplication and reinvention; no standards or
guidance, no national roadmap; unknown number of approaches
▪ No national models available to replicate that incorporate SDOH
▪ SOCI/NIC will conduct a national scan of leading & promising Consent
approaches, standards and models over the next several months.
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Project Unify Partner Presentations
▪ Eric Jahn – HSLynk▪ Matt Bishop – Open City Labs▪ Dave Walsh – MITA TAC
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Open Source Community
Data Exchange
break free from your stand-alone vendors
Project Unify
. . . apps that play nice together
a part of...
do you like open source APIs and code? we got ‘em
docs.hslynk.com
github.com/servinglynk/hslynk-open-source
powering custom community apps and legacy system interoperability
connect to the access-controlled big data warehouse with any analytics package of your choice
Other Notable Differences in HSLynk(compared to other Community Data Exchanges)
● complex project groupings and sharing and rules
● client consent controls - consent2share interop in future
● open source master person index microservice at the center
● golden view of a client, across services
● usage based pricing (not user license seats)
● customizable resource matching workflows
28© Open City Labs, Inc. 2020
OPEN CITY LABS
Our Mission: to make health & human servicespersonalized,accessible,one click away.
• Manage Programs
• Applicants & Providers
• Outcomes
• Coalition Analytics
• Health + SDOH
• Referral
• Eligibility
• Benefits
• 360 View
• Goals
• Access Health, Human Services
• One-Stop-Shop
CARE Navigator
AgencyPopulation
PeopleProvider
s
AdminsAnalytics
360
Community Exchange
Community Exchange = Case Management + One Stop
Person & Family95% Form Fields and Refer
>300
Recommend & Eligibility Screening for Govt Benefits
Refer Patients to
Apply & Autofill Up to
29© Open City Labs, Inc.
1/2Less Staff Time
>2.5MHealthcare & Human Service
Providers
Single point of signup and referral for government programs, healthcare and social services that are administered on platform (Agency 360), or referrals received off platform (e.g. FHIR or Direct, API)
AUTOMATIONACCESS UNDERSTANDING
360 View Health & Well-being
Comprehensive Enrollment -Autofill Application Forms
1
2
3
Staff (Navigator) & Patient (CARE Portal)
Screen for Eligibility Programs
4 Refer Patients in ½ the time
Recommendations of Programs based on Goals & Assessments
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Review, Approve or Decline Applications
1
2
3
Agency 360 – Manage Program Enrollment & Providers
Manage Eligibility Criterion for Applicants & Providers Implementing Programs
4 Track Performance of Coalition
Create and Update Program Details
Last Updated 4/2/2021 | © Open City Labs, Inc. 2021 | CONFIDENTIAL | 31
Longitudinal Record Person’s Journey
Last Updated 4/2/2021 | © Open City Labs, Inc. 2021 | CONFIDENTIAL | 32
1
2Get updates about a healthcare human service domain
Customizable 360 View Health & Well-being
3Assessment Results (e.g. Food Insecurity etc.)
How Referrals are Made Today
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Referrals Don’t Cross Systems
Not Closed LoopDon’t know if
Patient Receives Services
Don't know if we are having
an impact
Advancing Open Standards To Make Interoperability Affordable
EHR
Referral Tool
Case Mgt
$10,000
50 Referral Partners
$1 Million Interoperability Costs
=
Status Quo – Pay Pint-to-Point Integration
$10,000
+
$20,000
Direct National, Crowdsourced Directory 2.5 Million Providers
One time Integration
Human Service Providers Added to Direct Send HIPAA Compliant Secure Messages
Cost per message < $0.05
Why Open Standards?
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Data Discoverability
Workflow Automation
Shared Understanding
Among Partners
360 Case/Care Management
Population Equity
Without standards case mgrs must dig through notes. Search is inefficient without codes (e.g. SNOMED, LOINC #).
To reuse data, we need shared semantic definitions
To Maintain a shared understanding of a client's life circumstances and needs.
To inform care across health and social services
To set & track progress against health, economic & racial equity requires common metrics on what ”success” looks like.
Individual Benefits Team Benefits Coalition Benefits Community Benefits
Want to Learn More?Contact Us
Matt Bishop, [email protected]
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Unify UX (FHIR-FLI)
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• Makes it easier to built applications for Health and SDOH
• Build testing tools
• Promote interoperability / security
Growth of UX Tools
Unify UX Extensible Framework
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• Framework for developing Health and SDOH applications
• Open source
• New, widely supported, open-tech stack - DART/Flutter
• Growing community - Slack
• Supports all versions of FHIR and all FHIR resources
• Many languages, including Bidirectional (BiDi)
• Reuse focused (Packages)
• Custom widgets
Target Environments
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• Mobile (IoS, Android)
• Many form factors (phone, tablet, tv . . .)
• Browser (any modern one)
• Desktop (Windows, MacOS, Linux)
• IoT (emerging market)
• Familiar UI (Material Design, Cupertino)
1st Applications Using FHIR-FLI
• Questionnaire / Needs-Assessment Tool• Gravity aligned
• FHIR compatible (all versions)
• Extensible
• Mobile first (tablet / phone)
• Browser in Q3 2021
• MVP
• EMS Procedure Guide• Q2 2021
• Vaccination Guide• Q3 2021
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InterOptimability
Training Curriculum
and Certification
Program (ITCC)
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SOC Institute is launching the InterOptimability
Training Curriculum and Certification Program:
➢ Offers a systems-level approach for addressing the
challenges of multi-domain information sharing.
➢ Provides a common vocabulary, knowledge, skills and
tools to build competencies needed to build and
sustain interoperability efforts.
➢ Designed to help people and organizations build,
implement and sustain responsible information
sharing to support person-centered, value-based care
across the care spectrum.
➢ Agile module development supports sustainability
through its certification program and with a Strategic
Action Planning approach.
National Action Agenda Hub Site and Microsites
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Ways You Can Get Involved:
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• Join NIC and participate in Project UNIFY
• Participate in Unify workgroups:
• UNIFY Proof of Concept Demonstrations
• Privacy & Consent Utility Service
• Person Matching
• Governance
• UX/UI
• Domain Ontologies and Data Models
• User Stories/Data Sharing
• Architecture
• Volunteer to curate one of the affinity groups
• Sponsor/Support NIC
Resources
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• National Interoperability Collaborative Hub: https://hub.nic-us.org/• Project Unify homepage on the NIC Hub: https://hub.nic-us.org/groups/project-unify• NAA Action Recommendations Summary and Detailed Assessments• Unify User Stories: https://hub.nic-us.org/groups/project-unify/resources/2020-collection-of-project-unify-use-
cases• Demos:
• Unify Single Parent SDoH demo video (PRAPARE Survey App-to-EHR-to-Case Referral Manager-to-WIC Referral - January 25, 2021): https://youtu.be/DxbkpfWLrbc?list=PLeI2juMpKM4NsnUqFdPgdWI4Q0RcVTHaC&t=2187
• Unify Homeless SDoH demo video (Homeless Management Informtion Service-to-Case Referral Manager-to-Housing Rental Assistance Referral - November 6, 2020): https://hub.nic-us.org/videos/project-unify-proof-of-concept-demonstration-nov-6-2020
• NAA/NIC/Unify Webinar and Demo (January 25, 2021): https://www.youtube.com/watch?v=DxbkpfWLrbc&list=PLeI2juMpKM4NsnUqFdPgdWI4Q0RcVTHaC&index=3
• Social Determinants of Health– HIMSS SDOH Report
Questions & Discussion
Next Steps
Get Involved!
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Daniel Stein President, Steward of Change InstituteDaniel@stewardsofchange.orgwww.stewardsofchange.org631-385-9246
