State HIE Update Barrows

8/8/2019 State HIE Update Barrows

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Deloitte Touche Tohmatsu 2006. All rights reserved.


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2004 Deloitte & Touche LLP. Private and Confidential2004 Deloitte & Touche LLPMember ofDeloitte Touche Tohmatsu Legal entity name 2006. All rights reserved.

State HIE Cooperative

Agreement Program

Update On

Columbia University

Center for Advanced Information Management,

Annual Informatics Update

Oct 5 2011


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2004 Deloitte & Touche LLP. Private and ConfidentialMember ofDeloitte Touche Tohmatsu Legal entity name 2006. All rights reserved.

Discussion Plan

Overview of State HIE Cooperative AgreementProgram

Role in HITECH and MU

Essential domains for statewide HIE planning,

implementation, evaluation

Current Status & Activities

Approved Plans


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State HIE CA Program: Overview

Fund sustainable expansion of HIE within andbetween states

Awards to state agencies or SDEs

Support provider meaningful use requirements

Statutorily-mandated State Plan requirement

Cooperative Agreement assistance instrument

Anticipates ONC involvement in performance of work


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FROM: Linder, Ma, Bates, Middleton, et al; Electronic Health Record Use and the Quality of Ambulatory Care in the United

States.

ARCH INTERN MED/VOL 167 (NO. 13), JULY 9, 2007.


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MU Objectives Supported by HIE 170.304(b) Generate/transmit permissible prescriptions

170.302(b) Implement drug-formulary checks 170.302(j) Medication reconciliation at encounters/transition of care

170.302(h) Incorporate structured/coded clinical lab results into EHR-S

170.304(i) Exchange key clinical info among providers/authorized entities

170.304 (h) Provide summary of care record for transitions/referrals

170.304(h) Clinical summaries to patient after each visit

170.304(f) Provide patients with copy of health info/discharge instructions

170.304(g) Provide patients with timely access to health info 170.302(k) Submit data to immunization registries

170.306(g) Submit reportable lab results to public health

170.302(l) Submit syndromic surveillance data to public health

170.304(j) Report ambulatory quality measures

170.302(i) Generate lists of patients by condition

170.302(m) Patient-specific health education resources


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Cooperative Agreement Awards

Based on CA/grant applicationRequirements in Federal Opportunity Announcement (FOA)

40/56 states/territories awarded February 2010

1 year Anniversary of HITECH

Remainder awarded March 2010

Total 56 states and territories: $547,703,438

Cooperative Agreement includes

Terms & Conditions

Milestones

Possible funds restriction pending remediation or milestoneachievement

Milestone for release of implementation funding

Approval of State Plan by HHS Secretary (ONC)


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State Plan

HITECH Sec 3013 requires State PlanActivities to facilitate HIE according to national standards

In public interest

c/w ONC strategic plan

Implementation activities (operational plan)

Elements as specified by HHS (as per FOA)

FOA defines State Plan

Strategic Plan

Address vision, goals, objectives, and strategies, to promote statewide HIE

Operational Plan Execution and implementation details of strategic plan


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Program/Plan Domains & HIE Services

Essential Domains for incremental progress

Governance

Finance (sustainability)

Technical Infrastructure

Operations (business & technical)

Legal & Policy (challenges & solutions)

HIE Servicese-eligibility & e-claims transactions

eRx and e-refill requests

Medication fill Hx and Rx fill status

Clinical lab e-orders and results e-deliveryClinical summary exchange (care coordination, patient engagement)

Quality Reporting

Public health e-reporting (immunizations, notifiable lab results)


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Governance

Collaborative, multi-stakeholder modelHITECH 3013(g) statutory consultation requirement

Sustain trust and participation

Resource allocationOversight & accountability

Provide transparency

State HIT Coordinator and rolePublic-Private Partnership ?


12/19 Deloitte Touche Tohmatsu 2006. All rights reserved.

Legal entity name 2006. All rights reserved.

Public Governance Models for HIE

From: Report to the State Alliance for eHealth, prepared by U. Mass Med School CHPR, NORC, and NGA Center for Best Practices


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Finance

Financial Sustainability beyond Program4-year period of CA Program (HITECH/ARRA) funding

Cost estimates

Staffing planProject plan

Risk analysis & mitigation strategies

Financial procedures and controlsCompliance with GAAP and OMB circulars

Required reporting


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Technology Infrastructure

Alignment with HHS interoperability standardsArchitecture

Reflects business/clinical requirements

Statewide HIE forProviders

Public Health

Patient engagement

Protects health dataNHIN alignment


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Business & Technical Operations

Leverage resources

Bandwidth

Workforce

HIOs/HIEs

EHR-S installations

Registries

Repositories

Reach all providers/geographies

Standard operating procedures

Project/Program Management


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Legal & Policy

HHS Privacy & Security Framework

Nationwide Privacy and Security Framework for Individually Identifiable HealthInformation [December 15, 2008]

Legal analyses

Statutory changes

Policies and Procedures

Trust Agreements

Oversight and enforcement


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Program Information Notice

Review

One-time investment

Concern with mandated provider participation

Clarify

State/SDE responsibilities

Roles of HIT Coordinator

Elements of S & O Plans (State Plan)

Focus

Operationally feasible plan to enable

eRx

Receipt of structured lab results

Sharing patient care summaries


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Status

Approved state plansCA, DE, MD, ME, NM, UT (__, __)

State HIE Toolkit website (MD, NM, UT)

State/SDE website (CA, ME, others)

Other plans: under reviewExamples

Discussion


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State HIE Update Barrows

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