Agenda Welcome, Introductions & HITOC Business Oregon Health - - PDF document

8/3/2017 1

Health Information Technology Oversight Council

August 3rd, 2017

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Agenda

• Welcome, Introductions & HITOC Business
• Oregon Health Policy Board Update
• HITOC HIT Strategic Plan – Milestone and key results

discussion (small group work)

• HIT Commons Update
• HITOC Future Workplan and Priorities
• HITOC September Report to OHPB
• Oregon HIT Program Updates
• Public Comment

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8/3/2017 2

OHPB Update

Karen Joplin, Board Liaison to HITOC Susan Otter, Director of HIT

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OHPB Action Plan for Health Refresh

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8/3/2017 3

Action Plan for Health: Vision

Health is foundational to human existence and quality

• f life. We believe the best way to achieve this is

through better health, better care, and lower costs for all Oregonians. This should be accomplished through Oregon’s coordinated care model, as demonstrated in local

• CCOs. To sustain this drive towards excellence, we

need to develop and ensure engagement of a workforce free of unnecessary administrative complexities.

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Action Plan for Health: Guiding Principles

• Access
• Innovation with Accountability
• Patient-Centered
• Health Equity
• Collaborative Partnerships
• Social Determinants of Health

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8/3/2017 4

Action Plan for Health: Foundational Strategies

• Pay for outcomes and value
• Shift focus upstream
• Improve health equity
• Increase access to health care
• Enhance care coordination
• Engage stakeholders and community partners
• Measure progress

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Focus area with specific HIT key actions called out in August Draft Action Plan

Action Plan for Health: Foundational Strategies and Focus Areas

8/3/2017 5

Action Plan for Health

• August 1st OHPB meeting – discussion and

implications for HITOC

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Strategic Plan General Feedback

Sean Carey, Lead Analyst

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8/3/2017 6

HIT Strategic Plan Key Results and Milestones

Sean Carey, Lead Analyst Marta Makarushka, Lead Analyst

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Milestone Discussion Framework

Action Plan for Health Foundational Strategies HIT Priorities Workplan Milestones

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8/3/2017 7

Key Priorities

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The Action Plan for Health: Foundational strategies Oregon’s HIT Priorities Oregon’s HIT Focus Areas and Workplan (2017-2020) Pay for outcomes and value Support alternative payment models HIT to support value based care and alternative payment models Support high-value data sources, including the social determinants

• f health

Spread health information exchange Implement core HIT infrastructure Develop shared governance for long-term HIT sustainability and alignment Shift focus upstream Support social determinants of health data and partners Improve health equity Increase access to health care Support integration of physical, behavioral and oral health Enhance care coordination Support sharing information and care coordination and Engage stakeholders and community partners Align across stakeholders and develop partnerships Measure progress Monitor and adapt to changing environment

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2017 2018 2019 2020+

Medicaid EHR Incentive Program (MEHRIP) Oregon Medicaid Meaningful Use TA Program (OMMUTAP) Common Credentialing Provider Directory Clinical Quality Metrics Registry HIE Onboarding Program CareAccord and Flat file directory for Direct secure messaging Network of Networks for HIE EDIE Utility and PreManage HIT Commons HIT Commons – New Projects Access to high-value data (e.g., POLST, PDMP, other public health registries) Implementation and launch Full operations Implementation and launch Live for CCO/ MEHRIP Potential expansion Transition to HIT Commons EDIE Utility pilot ends OHA- sponsored Statewide Medicaid subscription to PreManage Phase one provider onboarding through 2021 Phase two provider onboarding through 2021 Development, Launch CareAccord Operational – regular evaluation of effectiveness and value FFD transitions to Provider Directory Program continues until May 2019 Program continues until 2021 Launch PDMP gateway Offer gateway subscription statewide Ongoing pilots and initiatives to explore expanded access to high value data Implementation and launch Full operations

EHR adoption/use Develop HIT infrastructure High value data

Initial start-up under OHLC Transition to 501(c)(3) Planning

Shared Governance

Focus on HIE network of networks, PDMP gateway, adoption/spread of initiatives (e.g., Open Notes, etc.) Development Determine future priorities

Spread HIE and HIT for APMs

Planning, coordination and legal agreements Explore future infrastructure needs

8/3/2017 8

Milestones Development

Question is…“How will we know if we’re successful?”

• Looking for the essential milestones that signal

progress on broader efforts

• Should reflect current strategies and priorities
• Eye towards what can be reasonably measured

and/or reported on

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Types of Milestones for Consideration

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Initiation/ Launch Access, Availability Adoption and Use Value/ROI Achieved

• Programs/initiatives most likely to have milestones of

each type

• Some work unlikely to have milestones of each type
• Milestones cover both Oregon HIT Program and HIT

environment

• Most of the draft milestones are launch/access/

adoption

8/3/2017 9

Milestone Development Timeline

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• Develop initial

milestones

• Now
• Develop

metrics and methods to measure

• Determine

baseline data

• Late 2017- early 2018
• Data dashboards

to track progress

• Additional/

refined milestones to capture complexity

• 2018
• Today’s discussion intended to guide future

development

• Ongoing work expected to be iterative with HITOC

discussion

Proposed Key Results

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Creation of forum for culture and trust through an HIT Commons Development of the "network of networks" for statewide HIE Widespread use of EHRs Widespread access and participation in robust HIE, including:

• Care summaries
• Referrals
• Complex care

coordination

• Alerting

Widespread access to

• utside organization

data for APMs Widespread access and use of HIT that supports:

• Risk stratification
• Population health

measurement

• CQM reporting

and use Advance provider data alignment through provider directory and common credentialing Patients access health info through a patient portal Patients engage care team through HIT

Cross-cutting Goal 1 Goal 2 Goal 3

8/3/2017 10

Small Group Discussion

• Proposed Key Results

– Are these the right Key Results for each goal? Can they point to our overall progress on efforts?

• Draft Milestones:

– Are they the right essential milestones? Do they point to success on the key results? – Any suggested additions or deletions? – What data sources might be available to help us measure progress towards our goals? Do your organizations have data they would be willing to share?

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8/3/2017 11

HITOC Discussion

• Small group report out
• Discussion
• Takeaways and next steps

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HIT Commons Update

Susan Otter Laureen O’Brien, OHLC

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8/3/2017 12

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• Establish a stakeholder-led, neutral governance and

decision-making process for investing in HIT efforts

• Leverage opportunities for shared funding of efforts

with statewide impact

• Coordinate efforts to enable a network of networks for

HIE

• Facilitate access to high-value data (e.g., PDMP)
• Support core infrastructure needed for care

coordination and alternative payment models

Why pursue an HIT Commons? Key Opportunities and Objectives

24 |

• Achieve HIT goals more effectively with critical mass –
• Coordinate and support shared interests of health care

stakeholders and OHA to meet the vision of a transformed health delivery system optimized by HIT

• Support cooperation and data sharing to improve care for all

Oregonians

• Accelerate adoption and spread of HIT initiatives
• Stakeholder led process allows those closest to the work

ability to govern and direct efforts

• Shared equitable funding supports entities that face

resource barriers to “raise all boats”

• Maximize Oregon’s share of state and federal resources to

advance HIT optimized health care

Anticipated Benefits of an HIT Commons

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Building an HIT Commons Business Plan

• Goal: Build an HIT Commons model to accelerate Oregon’s

progress toward an HIT-optimized health care delivery system

• Build on the success of EDIE/PreManage Governance model
• OHA grant to OHLC, joint team to staff effort
• Sensing Sessions:
• Staff-led discussions with advisory committees and individual

stakeholders to gather themes, over 50 organizations represented

• HIT Commons Interim Advisory Group: Limited duration, interim

committee to lead evaluation & merit of Public/Private partnership to govern statewide HIT/HIE efforts

• 3-4 meetings, May 3, May 24, August 2, TBD

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• Initially expand on EDIE governance model,

Leverage OHLC as fiscal agent and management staff Proposed approach:

Interim Advisory Group continues to meet to nominate the new HIT Commons Board to serve staggered three-year terms

Representative board positions mirror EDIE Utility with some

• additions. Geographical diversity, positional (e.g., technical,
• perational, etc.) diversity, consumer representation.
• Eventually establish new 501(c)(3) after successful launch

Recommendations: HIT Management Structure

• Hospitals/health systems
• Health plans/CCOs
• Physicians
• Provider representatives (BH,

dental, public health/county)

• Hospital association
• OHA
• At-large community members

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27 |

HIT Commons Umbrella Structure

HIT Commons Governing Board Fiscal Agent and Management Staff Committees and Projects Funders and Participants

EDIE PDMP

Gateway

HIE

Network

• f

Networks

Admin Sim Health Plans CCOs Hospitals Providers OHA HIT

Adoption and Spread

Potential Health IT Governance “Galaxy”

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HITOC

PDAC CCAG HCOP HIT Commons

EDIE Utility Network

• f

Networks PDMP Gateway Funding Other Efforts

Public Advisory and Oversight Bodies

OHIT (OHA)

Policy Board

Exec Steering

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• Initial scope and process for adding new projects
• RACI needed on each initiative to clarify role(s) of the Commons and

ensure alignment with OHA and other partners

• Criteria/process for adding new projects, maintaining independence

for adopting new projects

• Further definition about how ideas come to HIT Commons for

consideration

• Funding model: Two components for Commons administration and

initiative-specific costs:

Available OHA/Medicaid HITECH funds for Medicaid share of development and implementation; and, Dues built on the current EDIE dues structure spreading costs across participants

• Initial OHLC funding for start up (OHLC Board 8/1/17)

Proposed HIT Commons Initiatives and Funding

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• Measures will need to be at two levels

Overarching governance effectiveness Implementation and adoption for each initiative

• Examples of potential governance measures (to be defined by

the new board):

HIT Commons projects are statewide in nature or have broad impact

• n health care delivery

Oregon health care stakeholders are aware and feel represented by HIT Commons HIT Commons projects advance HITOC stated goals HIT Commons projects have clear value propositions (Financial ROI, measurable in quality, care delivery, experience of care)

HIT Commons Success Measures

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• August
• OHLC Board – 8/1
• HIT Commons Interim Advisory Group – 8/2
• EDIE Governance Board – 8/2
• HITOC - 8/3
• OHA processes underway to ensure state participation in HIT

Commons (procurement, contracting, CMS review)

• September
• OHLC development work with management subcontractor begins
• Interim advisory group meets regarding HIT Commons

nominations and charter

• January
• Transition to new HIT Commons board

Next Steps

HITOC Future Workplan and Priorities

Sean Carey, Lead Analyst

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8/3/2017 17

High Level HITOC Work Plan

2017 2018-2020

Policy Topics

• Interoperability
• Behavioral Health Information

Sharing

• Other Policy Board or HITOC-

identified Topics

• Support for behavioral health information sharing
• Patient access, consent, and specially protected information
• Data sharing needs related to social determinants of health

(SDoH)

• New priorities as determined by OHPB and HITOC

Strategic Planning

• Complete update to strategic

plan

• Develop behavioral health HIT

workplan for the Behavioral Health Collaborative

• Review and update strategic plan annually
• Development or endorsement of strategies to support network
• f networks for HIE and HIT for Alternative Payment Methods

(APMs)

• Support HIT Commons and determine appropriate oversight

and reporting roles

Oversight

• Oregon HIT Program (e.g. Provider Directory, Common Credentialing, Clinical Quality Metrics

Registry, HIE Onboarding Program, etc.)

• Behavioral Health Collaborative – HIT workplan
• Advance data-driven measurement and milestones for HIT oversight

HIT Environment

• Behavioral health scan
• Develop additional capacity for ongoing environmental

scanning, with focus on new priorities (e.g., Long Term Services and Supports, SDoH, APMs, etc.)

Reporting

• Legislative Report in Summer

2017

• OHPB Report in Sept 2017
• Annual reports to legislature and OHPB
• Explore opportunities to create dashboards to measure

statewide progress

Federal Policy

• Federal Law/Policy Considerations (e.g. ACA, MACRA, 21st Century Cures Act, ONC initiatives,

Meaningful Use, privacy and security requirements (42 CFR part 2, etc.))

Priorities and Urgency (Discussion)

• Policy Work

– Support for behavioral health information sharing – Patient access, consent, and specially protected information – Data sharing needs related to social determinants of health (SDoH)

• Strategic Development

– Development or endorsement of strategies to support network of networks for HIE and HIT for Alternative Payment Methods (APMs) – Support HIT Commons and determine appropriate oversight and reporting roles

• Monitoring and Oversight

– Oregon HIT Program (eg., Provider Directory, Common Credentialing, CQMR)

• HIT Environment and Reporting

– Explore opportunities to create dashboards to measure statewide progress

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8/3/2017 18

HITOC September Report to the Oregon Health Policy Board

Susan Otter, Director of HIT

HITOC relationship to the Board

• The Board is responsible for

– chartering HITOC and setting priorities, appointing members, and determining terms – considers HITOC recommendations and takes action as appropriate

• HITOC is responsible to:

– Make recommendations to the Board related to HIT to promote health system transformation – Regularly review and report to the Board on:

• Status of the Oregon Health IT program
• Efforts of local, regional, and statewide organizations to

participate in health IT systems

• Adoption and use of health IT

– Advise on federal changes that impact HIT

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8/3/2017 19

Current Scope for HITOC Report

• HITOC report to OHPB: September 12

– High-level update on HIT efforts in Oregon – Progress on 2015-17 HITOC workplan – Focus on OHPB endorsement/approval of:

• Updated Strategic Plan: new recommendations:

– Network of networks approach to statewide HIE – HIT Commons

• 2018-2020 HITOC workplan and priorities

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2015-2017 HITOC Workplan

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Policy Topics

• Improving Interoperability across HIT/HIE investments in Oregon
• Behavioral Health information sharing
• Update Oregon HIT Strategic Plan

Oregon HIT Program

• Programs and Services
• Partnerships/Collaboratives
• Initiatives and Pilots

Health IT Environment

• Board Reporting Format Finalized
• HIT Metrics and Dashboard Development
• Monitoring EHR Incentive Program
• Monitoring HIE efforts (e.g. HIT/HIE Community & Organizational Panel)
• Behavioral Health Provider Survey (anticipated)

Federal Law and Policy

• Meaningful Use Stage 3 and other relevant federal rules and policies
• ONC Interoperability Roadmap
• ONC Standards Advisory

8/3/2017 20

Next steps

• Next steps:

– Develop report presentation with OHPB liaison and HITOC chair/ vice chair; – OHA, HITOC chair and/or vice chair will deliver report

• HITOC action needed – either

– convene briefly to review/approve report to OHPB – Approve topics for report and designate HITOC chair/vice- chair to work with staff further to finalize report

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Oregon HIT Program Updates

Susan Otter Director of HIT

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8/3/2017 21

Public Comment

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Next Meeting

Special Place, Date and Time! Joint meeting HITOC and HIT/HIE Community and Organizational Panel (HCOP)

• October 12th, 1 – 5pm
• Portland State Office Building

800 NE Oregon St, Room 1E, Portland

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