Provider Directory Advisory Group August 2015 Agenda Welcome, - - PowerPoint PPT Presentation

Provider Directory Advisory Group August 2015

Agenda

• Welcome, introductions, and agenda review
• Review procurement timeline
• Review ranking of uses across groups
• Rank justification exercise (HIE and Delivery only)
• Review materials and homework instructions
• Questions

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HIT Portfolio Milestone Timeline

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The provider directory (PD) is part of a package of Health IT (HIT) services procured under a contract amendment that extends prime services. Other HIT services include Common Credentialing (CC) and the Clinical Quality Metrics Registry (CQMR) *Tentative until a Prime Contractor has been brought onboard, implementation dates will be

formalized as individual solutions are contracted for. 2015 2017 10 /1/2015 1/1/2016 4/1/2016 7/1/2016 10 /1 /2016 1/1/2017 4/1/2017 QA vendor

• nboard

Complete use cases and requirements CQMR implementation complete* CC implementation complete* PD implementation complete* Prime contractor starts CC vendor selected CQMR vendor selected PD vendor selected Special Procurement Notice posted on ORPIN

Q3 Q 4 Q 1 Q 2 Q 3 Q 4 Q 1 Q2

Ranking across groups calculation

Ranking Weight X 0.55 1 1 2 0.9 3 0.8 4 0.7 5 0.6 6 0.5

Note: while we attempted to score and rank across groups, there were inconsistencies in how the groups ranked items. This should only be used as a guide.

Weight scores from groups were added across uses to develop totals

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Core

• 1: Integrate CC

data

• 2: Integrate HPD

directories

• 3: Integrate State

Data

• 4- Integrate HIE

flat files

• 22/23: Report

inaccurate data Class 1 (rating 2

• r higher)
• 14: Contact info/

Care Coordination

• 15: Local query

contact info

• 16: federated

contact info

• 8: PD Validation

Class 2 (rating 1

• r higher)
• 6: HIE address

search

• 21: System of

record (add/edit/delete)

• 11: Source of

payer info

• 20: Network

adequacy

• 17: In network

search Class 3 (rating < 1)

• 19: Performance

analytics

• 13: Outcomes

and intervention

• 24: Analytics

extract

• 18: Practice

location analytics

• 12: Privileging

info

• 7: HIE for MU
• 5: GIS
• 10: Medicaid

EHR audit

• 9: Accepting new

patients

• 25: Integrate

authoritative sources

Ranking across all groups

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Rank Justification exercises – HIE and Delivery

HIE

• 2 - Referrals/care

coordination (Use 14)

• 4 –Local query

contact info (Use 15)

• 4- federated contact

info (Use 16)

• 5 - Meet HIE

requirements for meaningful use (Use 7) Delivery

• Network Adequacy

(Use 20)

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HIE: Top ranked uses

Rank Use Use # Class 1 HIE address search 6 2 2 Contact Info/Care Coordination (find providers) 14 1 3

• Outcomes and intervention,

Performance measure analytics X 3 4 Local query contact info Federated contact info 15 16 1 1 5 Meet HIE requirements for meaningful use 7 3

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Analytics: top ranked uses

Rank Use Use # Class 1 Analytics extract 24 3 3 Performance analytics Outcomes and intervention Practice location analytics 19 13 18 3 4 Source for payer info 11 2 5 Source for privileging info 12 3

State sources of data and integrating HIE flat file sources were also top ranked but are now considered core uses

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Plans: Top ranked uses

Rank Use Use # Class 1 Validate Source 8 1 2 Local query contact info 15 1 3 System of record (add/edit/delete) 21 2 4 Network adequacy 20 2 5 Contact info/care coordination 14 1 6 Federated contact info 16 1

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Delivery: Top ranked uses

Rank Use Use # Class 1 Validate Source Contact info/care coordination Local query contact info Federated contact info 8 14 15 16 1 1 In network search System of record (add/edit/delete) 17 21 2 2 HIE Address search 6 2 3 Source for payer info 11 2 4 Network adequacy 20 2

State sources of data and integrating HIE flat file sources were also top ranked but are now considered core uses

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PDAG assignments

• Uses (“what use cases”) wording review
• Classification of data elements for:

– Inclusion in the provider directory – Degree of accuracy

• Ranking of state data sources
• Plans and Delivery – review Provider Directory standards and

requirements matrix

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Uses wording review

The purpose of this exercise is to check our understanding of the uses. Each use that was numerically ranked needs to be reviewed and are listed on separate tabs in your Excel workbook. The following needs to be reviewed for each use: 1. Does the use case wording make sense? 2. Is the depiction of the likely users associated with the use accurate? 3. Do the preconditions (assumptions, precursor uses, and affiliated uses) make sense? 4. Do the expected results make sense? 5. The total score is based on a scale from 0-4 and represents the calculated ranking across all PDAG groups. Your thoughts?

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Uses wording exercise sample

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Data Elements Classification

• The purpose of this exercise is to understand which data

elements are essential to be in the provider directory as well as the degree of accuracy for those elements.

• Data elements on this sheet were taken primarily from the

IHE-HPD Provider Directory standard and fields from the Oregon Common Credentialing application

• Elements that come from Common Credentialing and HPD

provider directories are marked with an “x” in the table

• Elements that are primary source verified (PSV) are also

identified

• Data elements that are not in either source are also listed
• Answers to the following is needed (based on your

perspective and uses of the provider directory):

– Which elements need to be included in the provider directory (rank as must have, nice to have, not needed)? – What is the level of accuracy needed for the data element (rank as high, medium, and low)?

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Data elements exercise sample

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State Source Ranking

• The purpose of this exercise is to understand the use of

state data and prioritization of the data sources.

• State sources listed are ones that have been identified

by stakeholders.

• The following is needed for each of the 10 sources:

– What data do you expect/need to get from this source – What is it going to be used for? – Rank each source – from 1-10

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State data source exercise sample

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Provider directory regulations (plans and delivery)

• The purpose of this exercise is to obtain PDAG’s identification
• f various provider directory regulations and standards that

we (OHA) will research and analyze.

• We are trying to understand the various standards that the

provider directory will need to meet in order for the provider directory to be a trusted source of information.

• This list was developed from common credentialing regulatory

and accrediting bodies, with a few additions for provider directory.

• The following is needed:

– Review regulatory and accrediting bodies that are listed. Do any need to be added? Do any need to be removed? Are any questionable? – Review Provider directory processes/data. Do these make sense? Are there any that need to be added? – Any other comments

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Provider directory regulations exercise sample

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Next steps

• Please have workbooks to Karen by September 9th
• If you need any help, please reach out to us
• We will be following up with groups and scheduling check-ins if

needed

• Next month, CA-HIE demo!
• October meeting – shift to October 21st?

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