Health Information Technology Oversight Council October 6, 2016 1 - - PowerPoint PPT Presentation
Health Information Technology Oversight Council October 6, 2016 1 Agenda 12:30 Welcome, Introduction and HITOC Business 12:35 HITOC Membership Recruitment 12:45 The Regional Information Health Collaborative 1:20
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Name Title Organizational Affiliation Location Term Maili Boynay IS Director Ambulatory Community Systems Legacy Health Portland, OR 3 Robert (Bob) Brown* (vice-chair) Retired Advocate Allies for Healthier Oregon Portland, OR 2 Erick Doolen (chair) COO PacificSource Springfield, OR 4 Chuck Fischer IT Director Advantage Dental Redmond, OR 3 Valerie Fong, RN CNIO Providence Health & Services Portland, OR 2 Charles (Bud) Garrison Director, Clinical Informatics Oregon Health & Science University Portland, OR 4 Brandon Gatke CIO Cascadia Behavioral Healthcare Portland, OR 3 Amy Henninger, MD Site Medical Director Multnomah County Health Department Portland, OR 2 Mark Hetz CIO Asante Health System Medford, OR 4 Sonney Sapra CIO Tuality Healthcare Hillsboro, OR 3 Greg Van Pelt President Oregon Health Leadership Council Portland, OR 2
Gaps to fill:
*Bob Brown will be stepping down when a replacement is found
Kim Whitley, VP/COO, Samaritan Health Plans Klint Peterson, Project Manager, IHN-CCO Regional Health Information Collaborative
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RHIC EHR 1 EHR 2 EHR 3
Susan Otter Director of Health IT Sean Carey HITOC Policy Analyst
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Step in the process Status Timeframe Goals (confirm) Completed December 2015 Aims/objectives Completed December 2015 State’s role / Principles Initial discussion Summer 2016 Prioritizing objectives and
Fall 2016 Assess environment:
Ongoing Ongoing Define/refine strategies:
End of 2016/2017 Roadmap/Final Plan 2017
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User Stories
state
Debrief Questions
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Implantable Device(s)
* OHA Identified Minimum Data Element ** OHA also identified the following minimum data elements:
HITOC Member Survey | N=9
Importance Rating Low Medium High Highest High or Highest
Medications*
4 5 9
Medication Allergies*
1 2 6 8
Diagnoses
1 4 4 8
Discharge Summary
1 4 4 8
Allergies
1 5 3 8
Laboratory Value(s)/Result(s)*
1 5 3 8
POLST Registry (Physician Orders for Life-Sustaining Treatment)
1 5 3 8
Advance Directives
1 1 4 3 7
Imaging results
1 1 5 2 7
Medication History
2 6 1 7
Prescription Drug Monitoring Program (PDMP) (i.e. opioid prescription history)
2 6 1 7
Hospital Event (ADT)
1 1 2 4 6
Social Determinants (e.g. food/ housing instability, ACE score, income)
3 3 3 6
Problem list*
1 2 3 3 6
Vital Signs*
3 4 1 5
Care plan*
4 4 1 5
Procedures*
4 4 1 5
Behavioral Health Plan
3 5 5
Referrals
4 5 5
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*ONC- Identified Near-term Priority Data Domain
User Stories
state
Debrief Questions
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Health Information Exchange Bright Spots, Gaps, and Opportunities
Current health information exchange platforms Type Examples Level of information able to be shared Intra-system Sharing Kaiser, Legacy, Providence High Preferred Provider Networks (sharing EHR) Legacy, Providence High Association Networks IPAs High Intra-vendor Sharing EpicCareEverywhere High Collaboratives/ Integration Commonwell, Carequality Medium - High HIE JHIE, RHIC Medium - High Direct Secure Messaging CareAccord, DSM within EHRs Low - Medium Payer-based CCOs, BCBS claims-level: High case management: Low- Medium Subscription-based EDIE/ PreManage Low - Medium Personal Health Records Humetrix, Medyear, caresync Medium - High Public Health Registries Syndromic surveillance, PDMP Low - Medium
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This matrix is illustrative, not exhaustive.
Gap Dimension Highlighted Examples of Largest Gaps Impact/Importance Examples Availability of Resources Critical access hospitals, high Medicaid members, nonprofits, behavioral health, long-term services and supports Organizations may be limited by low/negative margins or business models that preclude IT investment Urban-rural Small/solo practitioners, specialty/complex care Rural areas more likely to have one dominant system/network which creates both opportunities and gaps; rural trading partners likely to be outside of local area Eligible-provider Behavioral health, LTSS, social services, corrections, EMS EP status directly tied to incentive payment availability Practice size Small/solo practitioners, independent specialists Organizations may lack scale to achieve efficiencies from IT adoption/use Patient acuity Less sick/privately insured patients less likely to be affected/ interested Higher acuity patients typically involve substantially more organizations but receive higher attention from Medicaid/ payers; low acuity patients may have lower coordination needs but also receive much less support Types of data shared Complex/unstructured data, setting- specific data formats and definitions More complex/less structured data typically more difficult to exchange but likely to have higher value
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This matrix of gap dimensions follows from the August 2016 HITOC discussion of HIE gaps. It is illustrative, not exhaustive.
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Governance Entity CareAccord Provider Directory TBD (MPI, query, etc.) ADT/ Hospital Notifications Regional HIE Shared Funding (including HIE Onboarding Funding) Shared Principles, Policies, Agreements Hospital Behavioral health Corrections LTC Clinic PDMP (Gateway) CCO Shared Accountability (Oversight and Reporting) Large Health System Clinic EMS CCO Hospital Behavioral health Hosted EHR or
Hospital Clinic Shared Services
The diagram is highly simplified, not exhaustive, and represents HIE relationships to a governance entity and not necessarily between each other
Stakeholders OHA/ State
Susan Otter Director of Health IT Sean Carey HITOC Policy Analyst
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Step in the process Status Timeframe Goals (confirm) Completed December 2015 Aims/objectives Completed December 2015 State’s role / Principles Initial discussion Summer 2016 Prioritizing objectives and
Fall 2016 Assess environment:
Ongoing Ongoing Define/refine strategies:
End of 2016/2017 Roadmap/Final Plan 2017
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Potential March Meeting/ Retreat
2016 2017
governance model to:
– connect existing HIT systems, – support statewide HIT solutions, and – guide future investments to provide HIT solutions that support the health
stakeholders
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Environmental Scan
HIT Strategic Plan
Roadmap
Federal and State Processes
State Medicaid HIT Plan
HIT Strategies and Activities
Reporting
Kristin Bork Lead Policy Analyst
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Oregon intends to explore using new federal funds to: 1. Support care coordination across Medicaid providers, including supporting proposed housing and corrections initiatives in Oregon’s proposed 1115 waiver demonstration by – supporting the costs of an HIE entity (e.g., regional HIEs) to
2. Support Oregon’s Medicaid providers, with or without an EHR, including: – behavioral health, long-term care, corrections, and other social services, to connect to HIE entities. 3. Ensure HIE entities in Oregon are able to support OHA’s Medicaid
eligible for funding
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advisory to HITOC, HCOP, etc.)
groups, including – HITOC and OHPB – HITAG (CCO HIT Advisory Group) – HITOC’s HCOP (HIT/ HIE Community and Organizational Panel)
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(RFP)
that HITOC is developing
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landscape; prioritization within this context
eligible for support; further delineation of definition of what health information exchange will mean in this context
support under the HIE Onboarding Program; fleshing out a fuller definition of what a network of networks might mean in Oregon
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Name/Title Organization
Maili Boynay, IT Director Legacy Bud Garrison, Dir. of Clinical Informatics OHSU Brandon Gatke, CIO Cascadia Behavioral Health Mark Hetz, CIO Asante Linda Mann, Dir. of Community Outreach Capitol Dental Care Sonney Sapra, CIO Tuality Healthcare Gina Seufert, VP Physician & Clinic Services Tillamook Adventist Kim Whitley, VP/COO IHN CCO Andy Zechnich, MD Providence Additional Recruiting Underway LTSS, Tribes, supported housing, HIE, and additional behavioral health representation
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Sean Carey HITOC Policy Analyst
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data through an HIT system
2017
gateway solution, Appriss PMP Gateway
Appriss to provide the gateway service ($50/ provider/ year, with volume discounts)
to ED physicians and JHIE using federal grant funding
between EDIE and the PDMP
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– Accountability for delivering HIT Portfolio Solutions – Project and risk management – Technical requirements, architectural roadmap and implementation design for the integration of HIT Solutions – Systems integration of the HIT Solutions while maintaining privacy and security – Prime contractor for best-vendor solutions (subs) and ongoing
– Successful adoption of each HIT Solution (including outreach, change management and end user training) – Integration of three new individual HIT Solutions: Common Credentialing (CC), Provider Directory (PD), and Clinical Quality Metrics Registry (CQMR)
– Common Credentialing
– Provider Directory
– Clinical Quality Metrics Registry
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Next Meeting: Thursday December 1, 2016 Location: Transformation Center Training Room 421 SW Oak St, Suite 775, Portland
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