NYeC Monthly Association Call Kick-Off Valerie Grey Executive - - PowerPoint PPT Presentation

NYeC Monthly Association Call Kick-Off

Valerie Grey Executive Director October 12, 2018

Agenda

Time Topic

9:30 - 9:40am Welcome, Introductions & Purpose 9:40 - 10:15am NYeC and SHIN-NY: Review & Updates

• General SHIN-NY Progress Update
• Roadmap Strategies
• Other Updates

10:15 - 10:45am Association Roundtable (to include report-outs, updates, and other issues to raise)

• Behavioral Health
• Clinics
• Health Plans
• Home Care
• Hospice
• Hospitals
• Nursing Homes
• Providers

10:45 - 11:00am Action Items & Next Steps

2

Welcome, Introductions & Purpose

• Background:
• Importance of a continuous statewide feedback loop became apparent during the development
• f the SHIN-NY 2020 Roadmap
• NYeC is currently forming six Advisory Groups: Provider, Health Plan, CBO/VBC, Consumers,

Technology & Innovation, and Quality Measurement

• NYeC establishing ongoing, regular contact with our association partners via a monthly call
• Purpose:
• To help advise us on the intersection of patient care, transformation, and workflow with HIE and

HIT, and how that can be harnessed to transform the healthcare system and improve health

• utcomes and provider experience
• Focus:
• Updates, hot topic developments, challenges and opportunities for collective advocacy
• Advisory Group Updates once they are fully operational
• Associations should use this space to raise HIT/HIE issues and concerns to NYeC

Monthly Association Call Kick-Off

4

NYeC and SHIN-NY: Review & Updates

6

Roles and Responsibilities

QEs DOH

• Exercise overall authority for

the SHIN-NY (funding, regulation, laws, policy guidance, QE certification requirements,etc.)

• Serve as a partner with the

privatesector

• Utilize state levers to

promote SHIN-NY

NYeC

• Provide thought leadership

and statewide management to advance, align, integrate, and advocate

• Facilitate and propose policy,

technical standards, functionality, business

• perations, and innovation
• Oversee delivery of QE core

services through performance-based contracts

• Connect QEs statewide and

meet performance goals

• Partner with DOH and NYeC

to provide thought leadership

• Deliver core SHIN-NY services
• Meet performance goals and

comply with State requirements

• Directly support healthcare

reform initiatives, care models, and innovation

• If desired, offer enhanced

services for additional fees

7

SHIN-NY Governance

Department of Health

Board may formally propose statewide policy guidance to

• DOH. DOH may

accept or reject proposed statewide policy guidance at its sole discretion.

NYeC Board STATEWIDE COLLABORATION PROCESS

• Facilitates a transparent and robust

governance process to prioritize and drive consensus on policy development, implementation approaches, and operation support services.

• Provides a functional structure to

convene stakeholders and coordinate the implementation and

• peration of New York’s health

information infrastructure.

• Provides support (thought

leadership, project management, staff, tools and other resources) to streamline, coordinate and document activities.

*VBC: Value-based care

Business Operations Committee (BOC) Planning & Operations Technical Implementation Provider Advisory Group Consumer Advisory Group Health Plan Advisory Group SHIN-NY 2020 Roadmap additional groups to inform & provide feedback to NYeC staff & Board Special teams as needed Policy Committee

Committees may develop and approve recommendations on policies, technical standards and SHIN-NY services. Recommendations may be submitted for approval to the Board.

VBC* & CBO Workgroup Technology Advisory Group

Quality Measurement Workgroup

Monthly Association Calls

Strong Foundation

• Performance-Based Contracts
• Ambitious targets for participation, consent, data quality*
• Enhanced Security

Value Based Care

• Additional data & services & participants
• Enhanced functionality & integration
• Policy changes including consent

Innovation

• Leverage market developments
• Discrete data via FHIR
• Patient engagement

Efficiency

• New QE payment methodology
• Standardization, shared services, mergers
• Wire once ability

Advocacy

• Federal and State funding, policy, legislation
• EHR vendors
• Feedback via 6 new advisory groups

8

1 2 3 4 5

9

SHIN-NY: Current Statistics

As of September 30, 2018

Metrics 2020 Goal QE Average (of 8 QEs) Low (of 8 QEs) High (of 8 QEs)

Participating hospitals 100% 100% 98% 100% Participating skilled D&TCs, FQHCs, nursing facilities, home care, hospice 70% 78% 60% 93% Participating physicians 70% 68% 52% 91% Unique patient consent for at least one provider 85% 85% 54% 111%~ New data format and fields for hospitals 100% 32% 0% 83% New data format and fields for other regulated entities (ORE)** 70% 15% 0% 34% New data format and fields for physicians 70% 19% 0% 43%

~QE consent rates may exceed 100% if the consent rate exceeds their market share of participants

SHIN-NY Performance Based Contracting (PBC)

Performance Based Contracting

Core Allocation Dedicated Funding High Gap Closure Pool Interoperability & Innovation Pool Performance Payments

10

11

Ambitious Statewide Goals

Used in Performance-Based Contracting

• Adoption:
• 100% participation by hospitals
• 70% participation by other provider types
• 100% full data contribution by hospitals
• 70% full data contribution by other provider types
• Consent:
• 85% of patients provide consent to at least one provider
• SHIN-NY Utilization
• Enterprise Availability
• Customer Satisfaction
• All QEs and NYeC must obtain HITRUST certification

Performance payments 2018 - 2020 Pay-for-reporting for 2018 while work done on measures Performance payments start for these metrics in 2019 and 2020 Share of overall funding allocated to performance will increase over time

Gateway Vendor Hub Connections eConsent

Healthix

eConsent

NYCIG

Subsidy to temporarily reduce

• r eliminate

provider connection fees charged by QEs

HGC QEs

12

High Gap Closure Program

Focused on Participation & Consent Downstate

• The Data Exchange Incentive Program (DEIP) provides up to

$13,000 financial incentive payment to eligible providers to help

• ffset costs related to connecting to their QE and the SHIN-NY
• DEIP 2-year extension was approved
• DEIP eligibility being expanded to EMS and Pharmacy
• EMS target – Fall 2018
• Pharmacy target – Late 2018
• NYeC is working with NYS and stakeholders on defining the data

that would be required as a condition of DEIP funding

• Potential expansion to include labs as eligible participants

13

Data Exchange Incentive Program – Good News!

14

Supporting Value Based Care

Up to 3 enhanced functionality projects, examples include:

• Medication fills
• Quality measurement reporting
• Standardized data formats
• Medical claims (via APD)
• eMOLST
• Registries
• Social determinants of health

Up to 3 additional data & services projects, examples include:

• Single sign-on for Health Commerce

System (I-STOP, others)

• Smarter, actionable alerts
• MACRA/MIPS compliance
• Care plan exchange
• Additional EHR integration
• Patient-centered data home
• Basic alerts available to

those with treating relationships without written consent

• Incorporation of SHIN-NY

consent with other forms

• Exploration of opt-out
• Data governance
• Others

Screening for Clinical Depression and Follow- Up (CDF): Non-HEDIS Controlling High Blood Pressure (CBP): HEDIS Comprehensive Diabetes Care (CDC): HEDIS Viral Load Suppression (VLS): Non-HEDIS Prenatal and Post Partum Care* (PPC): HEDIS Childhood Immunization Status (CIS): HEDIS Lead Screening in Children (LSC): HEDIS

• 25 DSRIP Performing Provider Systems (PPSs)

selected projects and each project has performance metrics, 7 of which are measures are obtained via medical record data

• QEs will examine their data and help

supplement medical record information

• btained by NYS DSRIP medical record review

contractors

• Example: When HealtheConnections assisted

earlier this year, the additional information reduced HbA1C poor control from 61.4% to 36.4% (lower rate is better)

15

SHIN-NY Helping PPSs!

QEs Assisting with DSRIP Medical Record Review

• 4 QEs* will to support regional oversight

and management committees (ROMCs), NYS PCMH practices and health plans with data contribution and data quality

• Goal is to develop the capability to support

quality measurement and transformation activities:

• Calculating quality measures for NYS PCMH

practices to use for ongoing monitoring and quality improvement

• Delivery of data to health plans to use in

measurement of NYS PCMH practices

• A critical activity for all pilot participants

will be to share detailed documentation:

• Will be used to inform consensus building and

SHIN-NY quality measurement governance, including standardization

16

SHIN-NY Helping ROMCs with NYS PCMH!

QE Quality Measurement Pilots

* HEALTHeLINK, HealtheConnections, Hixny, Healthix/Bronx RHIO

17

I-STOP EHR Integration Pilot

• Prescribers must consult I-STOP when writing prescriptions for certain controlled

substances

• I-STOP is a stand alone system that is not connected to EHRs or SHIN-NY
• Clinician workflow improves if integrated with HER
• NYeC, working in partnership with DOH’s various divisions, issued an RFA for a QE

pilot to work with a health system to integrate I-STOP with their EHR

• Rochester RHIO’s proposal with Rochester Regional was selected
• Goal will be to test current NYS I-STOP specs to integrate Rochester’s EPIC EHR with

I-STOP and see if the specs are scalable

• Also exploring use of FHIR standards for future integration

18

Social Determinants of Health

• NYeC presented a poster on

SHIN-NY opportunities for Social Determinants of Health at the DOH Summit

• NYeC is funding a Rochester RHIO

pilot that will do a deep-dive legal analysis for sharing of social determinants of health data

19

Enabling Interoperability, Innovations & Wiring Once

Cross QE data sharing to support analytics

Bronx

Combining commercial claims with QE clinical data for quality measures and more

HEALTHe-LINK

Multiple Wegmans pharmacy sites cross QE borders with one HealtheConnections connection

Healthe- Connections

20

Advocacy

• Academic studies
• Consistent messaging
• Consumer education
• New Advisory Groups
• Strong advocacy with

Executive and Legislature Aggressive collective work with EHR vendors on issues including:

• CCD/C-CDA, certified EHRs,

prioritization of QE participants, responsiveness to development

• f gateways and inconsistent

pricing, and charging for HIE connections

• Participate and influence federal

discussions

• Val Grey was appointed by Senator

Schumer to serve on Federal HIT Advisory Committee (HITAC)

• Collaborate with other states and

regional HIEs

• Promote statewide standards

Value, Policy & Funding EHR Vendors Interoperability & Standards

21

NYeC Federal Work

NYeC provided extensive comments on proposed National HIE Network (TEFCA), New MU Rules (PI), and others

• Traditional non-Meaningful Use provider types are vital and need support
• Phase-in future interoperability requirements over time, moving initially from incentives to a firm requirement
• Incentivize health plan participation
• Consider providing extra points on Medicare Advantage star ratings to health plans participating in health information

exchange networks

• Support better medication management for patients through medication fill data
• Explore all federal levers, including Part D and other, to ensure HIEs and participating providers have timely access to

medication fill data for their patients

• Recognize mature HIEs ensure that information is not blocked
• Active participation in HIEs, as designated by the Medicaid agency in each state, should serve as evidence that

information blocking is not occurring, especially since TEFCA will take time

• Consider requiring hospitals to share admission, discharge and transfer (ADT) data with other

providers

• New York hospitals already do this and this data has proven very valuable to care teams
• Do more to modernize data sharing under Part 2
• This is needed to truly address the opioid crisis and actually integrate physical and behavioral health
• Continue to set minimum set of information for exchange

22

NYeC Feedback

On CMS Promoting Interoperability RFIs

• Interest in sharing best practices for how to leverage the SHIN-NY to

increase awareness and support providers generally

• Initiated discussion regarding the value SHIN-NY offers to providers and

the contribution of each core service

• Discussion of need to prioritize value-based care support mechanisms

such as medication fill data, social determinants, I-STOP integration, and quality measurement

• Recognition that patient engagement remains challenging but there are
• pportunities worth exploring such as open APIs and EHRs in

iPhones/mobile devices

NYeC Provider Advisory Group

Kick-Off Meeting Highlights

23

NYeC EHR Vendor Advocacy Strategy 2018-2019

Understand vendor support of NYS data exchange EHR Vendor Assessment

• Assessment criteria will demonstrate how EHRs’ functionality and other characteristics align with NYS data exchange needs
• Leverage Salesforce aggregate reports to populate assessment for hospitals, articled facilities, and physician practices and identify

vendors to assess

Understand common challenges related to HIE Stakeholder Engagement

• QE survey to collect information and affirm assessment criteria
• Association and NYeC’s Provider Advisory Group discussions to assess criteria on behalf of providers
• Use qualitative data to further refine strategies and advocacy opportunities

Identify workable, interoperable solutions for providers across all sectors EHR Vendor Engagement

• Drive vendor compliance with DEIP and SHIN-NY Connections Initiative (SCI) requirements to entitle providers to incentive funds

and support Participation and Contribution goals

• Educate vendors and their customers on the SHIN-NY
• Coordinate with vendors to understand feasibility, pricing variation, challenges, etc.

24

Association Roundtable

• We want to encourage dialogue, and ensure a meaningful feedback loop
• Each month, we will dedicate a significant portion of this call to

association sharing

• This is an opportunity for you to discuss HIT/HIE related updates

impacting your members, and opportunities for us to support shared goals and address related needs throughout the provider and plan communities

Let’s Hear From You!

26

• Behavioral Health
• MHANYS
• NYS Council for Community Behavioral Healthcare
• Clinics
• CHCANYS
• Health Plans
• Coalition of NYS PHPs
• HPA
• NYS Conference of BC and BS Plans
• Home Care
• HCA
• NYSHCP
• Hospice
• HPCANYS
• Hospitals
• GNYHA
• HANYS
• Iroquois
• Nursing Homes
• Leading Age NY
• NYSHFA
• Providers
• ACP
• MSSNY
• NPA
• NYSAFP

Let’s Hear From You!

Association Updates, Concerns and Issues to Raise

27

Action Items & Next Steps

Upcoming Association Calls

November 9 10am December 14 10am

29

40 Worth Street, 5th Floor New York, New York 10013 80 South Swan Street, 29th Floor Albany, New York 12210