ONC HIT Policy Committee Interoperability and HIE Workgroup

Panel 3: State/Federal Perspectives August 22, 2014

Jennifer Fritz, MPHDeputy Director

Office of Health Information TechnologyMinnesota Department of Health

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MN Health Information Exchange Oversight Law

• Minnesota Statute 62J.498 – 62J.4982• Purpose: Provides a Governance Framework to ensure

that a patients electronic information follows them across the full continuum of care; To prevent fragmentation, encourage collaboration between market partners, while ensuring the use of HIE national standards so that data integrity is maintained and that information is shared in a safe, secure manner.

• Currently, Minnesota has 1 State-Certified HIO and 6 State-Certified HDIs

Minnesota HIE Oversight Requirements

• HIOs required to obtain full EHNAC HIE accreditation• Both HIOs and HDIs – Not required (but all have agreed to

participate so far):– Direct Trust member/participation/EHNAC accreditation for HISPs– MN Statewide Shared HIE Services

• Look up a direct address• Record opt-out of record locator services• Standards for query across record locator services

• Monitor through quarterly reports and annual re-certification requirements

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Minnesota Statewide

Shared Services

Health Information Organization

Health Data Intermediary

Private IDN and ACO

EHR Vendor Hub

Peer to Peer

Interstate HIE and

HealtheWay

Acknowledgement of Types of HIE Mechanisms in Minnesota*

• Robust Requirements in HIE Oversight Law

• Non Profit• State Shared Services

Architect

• Included in Oversight Law

• Direct/Push/Pull• HIE protocols may be

proprietary• May be a HISP and/or

provide HISP to HISP connectivity

• HIE between affiliated providers

• Common EHR or information system

• May or may not be using National HIE Standard Protocols

• EHR may act as HISP- push only

• EHR may use another HIE Service Provider for HISP services- push and pull

• Connects Provider A to Provider B

• Uses Push/Pull/Query but may not be using National HIE Standard Protocols

• No Standard Trust Agreement

• Difficult to Scale

• Push/Pull/Query but may not be using National HIE Standard Protocols

• Interstate consent needed

• HealtheWay- developing Nationwide connectivity

Currently defined in HIE Oversight Law4* December 9, 2013

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Example Definitions / Consensus Needed – Governance +

• Common definition, components, and minimum standards for a strong governance structure from different perspectives/roles (e.g., provider, consumer, intermediary)

• Common core sets of HIE services and standards that support health care reform• Standards for interoperability across services• Accreditations/certifications – minimum / recommended• Framework/mechanisms for interoperability across entities providing HIE services and

for providers/payers seeking to participate in HIE– Consent management/ granular consent / tracking consent / auditing– Clinical data query– Data aggregation Models– Terminology Mapping– Message Conversion– Case/Care and Population Management– Data Access Models– Provider authentication– HIE user directories– Patient matching– Record access logging

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Questions?

• Jennifer Fritz– Jennifer.Fritz@state.mn.us

http://www.health.state.mn.us/e-health