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The Massachusetts
eHealth Institute
MeHI is designated state agency for:
  Coordinating health care innovation,
technology and competitiveness
  Acceleratin...
2013	
   2014	
   2015	
   2016	
   2017	
  
Meaningful	
  Use	
  Stage	
  2	
  Repor4ng	
  Starts	
  
October	
  2013	
  ...
4
Massachusetts EHR Adoption
©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  89% of Massachus...
5
Meaningful Use in Massachusetts
©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
6
Massachusetts EHR Incentive Payments
©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
7
MeHI | How We Help
Awareness Education Qualify Engage Implement Optimize
ImpactAdoptMotivate
Communications
  Webinar S...
8
Massachusetts Health Information HIway
  A collaboration between EOHHS and MeHI to deploy a secure
statewide health inf...
Health Information Exchange Progress
9 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Coordinat...
10
Introducing Massachusetts Success Stories
  Baystate Health, Inc.
–  Joel L. Vengco
Vice President & Chief Information...
Coordinating and
Improving Care through
the Mass HIway
Sean Kennedy
Mass eHealth Institute
Director, Health Information Ex...
Agenda
  Health Information Exchange 101
  Overview of the Statewide HIE - the Mass HIway
  Introduction to the Last Mi...
Health Information Exchange 101
14 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Health Information Exchange 101
1.  Patient n...
Mass HIway Overview
Benefits
Governance
Security + Privacy
Roadmap
Services
16 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Mass HIway | Hub for Health Information Excha...
17 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Governance and Advisory Groups
Consumer
Advis...
Mass HIway | ‘Trust Fabric’
  The Mass HIway ‘trust fabric’ is achieved through the
combination of technical security sta...
PHASE 2
Registries + Query Exchange
PHASE 1
Information Highway
2012-2013
•  State assumes HISP role
•  ‘Directed’ exchang...
HIway Services
EHR
Connect directly
..................................................
Connect with local
gateway
...........
Mass HIway | Last Mile Program
Mission
Goals
Environment
Approach & Initiatives
22 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Last Mile Program | Mission
Grow adoption of ...
23 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Last Mile Program | Goals
Connect and Integra...
Barriers Incentives
EHR technology interfaces & product timelines Meaningful Use
Consumer on-ramps & workflows HIway Imple...
Impact
Healthcare
AdoptionConnection
Outreach - Education
HIway Interface
Grant Program
Implementation & Support
HIway Imp...
Mass HIway | Get Connected
26 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
27 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
Connection | Pricing
Annual Services Fee
Tier...
HIway Use Case Examples
Use Case Scenario 1.1/1.2 – Referral
29
Patient Scenario
1.  Patient sees PCP
2.  PCP’s plan includes a referral to a
Card...
Use Case Scenario 2.1/2.2 – Hospital Referral
30
Patient Scenario
1.  Patient sees PCP or specialist
2.  Treatment plan in...
Use Case Scenario 3.1 – ED Notification
31
Patient Scenario
1.  Patient presents at ED
2.  Patient is treated and released...
Use Case Scenario 3.2/3.3 – Discharge Summary
32
Patient Scenario
1.  Patient is discharged from hospital to
the care of a...
Use Case Scenario 1.1/1.2 – Referral
33
XYZ Hospital
1.  Patient admitted to XYZ ED
2.  Treatment plan calls for a tertiar...
Massachusetts eHealth Institute
617-371-3999
617-725-8938 (fax)
info@maehi.org
Twitter - @massehealth
MeHI Community - www...
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MeHI Regional Health IT Meetings - Springfield, MA - Sept, 2013

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Presentation from the Massachusetts eHealth Institute Regional Health IT meeting in Springfield, MA in September, 2013.

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Transcript of "MeHI Regional Health IT Meetings - Springfield, MA - Sept, 2013"

  1. 1. The Massachusetts eHealth Institute
  2. 2. MeHI is designated state agency for:   Coordinating health care innovation, technology and competitiveness   Accelerating the adoption of health information technologies   Promoting health IT to improve the safety, quality and efficiency of health care in Massachusetts   Advancing the dissemination of electronic health records systems in all health care provider settings   Connecting providers through the statewide HIE   Managing HIE and REC grants from Office of National Coordinator MeHI is a division of the Massachusetts Technology Collaborative, a public economic development agency 2 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. MeHI Overview
  3. 3. 2013   2014   2015   2016   2017   Meaningful  Use  Stage  2  Repor4ng  Starts   October  2013   Massachusetts Healthcare IT Drivers   Meaningful Use Stage 2 requires use of an HIE, starts in October 2013   Federal HITECH Grants supporting EHR and HIE adoption   Physician Licensing Requirement Starts - January 2015 –  Massachusetts requires physicians to be proficient in the use of health information technology as a condition of licensure. Proficiency, at a minimum, means demonstrating the skills related to the “meaningful use” requirements.   All Providers on EHRs and the HIE - January 2017 –  All providers (not just physicians) in the Commonwealth shall implement fully interoperable electronic health records systems that connect through the statewide health information exchange Physician  License  Requirement  Starts   January  2015   All  Provider  Requirement   January  2017   3 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  4. 4. 4 Massachusetts EHR Adoption ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.   89% of Massachusetts physicians are using an EHR/EMR system ranking us #1 in the US.*   56% of eligible healthcare providers in Massachusetts have received Meaningful Use payments ranking us #2 in the U.S.**   62% of Massachusetts office-based providers have adopted an EHR system ranking us #4 in the U.S.**   89% of non-federal acute care hospitals in Massachusetts have a certified EHR system ranking us in the Top 12 states*** *Hsiao CJ, Hing E. Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001–2012. NCHS data brief, no 111. Hyattsville, MD: National Center for Health Statistics. 2012. Hyattsville, MD; National Center for Health Statistics, 2012. **CMS Health IT Dashboards. http://dashboard.healthit.gov ***ONC Data Brief. No. 9. March 2013: Adoption of Electronic Health Record Systems among U.S. Non-federal Acute Care Hospitals 2008-2012.
  5. 5. 5 Meaningful Use in Massachusetts ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  6. 6. 6 Massachusetts EHR Incentive Payments ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  7. 7. 7 MeHI | How We Help Awareness Education Qualify Engage Implement Optimize ImpactAdoptMotivate Communications   Webinar Series   Regional Meeting Series   HIway Newsletter   EU-US Conference October 22-23 Regional Extension Center   Recruiting a few new providers   Helping providers get to Meaningful Use Medicaid EHR Incentive Program   Processing 2013 MU applications HIE Last Mile Program   HIway Implementation Grants   HIway Vendor Grants eHealth Economic Development   eHealth Firm Listing (>150 firms in MA)   Workforce Planning Provider and Consumer Research
  8. 8. 8 Massachusetts Health Information HIway   A collaboration between EOHHS and MeHI to deploy a secure statewide health information exchange.   EOHHS leads infrastructure development and operation   MeHI leads the Last Mile Program: –  Connection and adoption –  Demonstrate measurable improvements in care quality, population health and health care costs –  Catalyze innovation   Funded through ONC and CMS with state matches – sustained through private sector contributions ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  9. 9. Health Information Exchange Progress 9 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Coordination of care for elderly psychiatric patients Pre-hospital transport care coordination for homeless Referrals from specialty care to home health Care management for Heart Failure patients Decision support through 2-way exchange of data Discharge summaries from acute care to SNF and Home Health
  10. 10. 10 Introducing Massachusetts Success Stories   Baystate Health, Inc. –  Joel L. Vengco Vice President & Chief Information Officer   Holyoke Medical Center –  Carl R. Cameron Chief Information & Analytics Officer ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  11. 11. Coordinating and Improving Care through the Mass HIway Sean Kennedy Mass eHealth Institute Director, Health Information Exchange
  12. 12. Agenda   Health Information Exchange 101   Overview of the Statewide HIE - the Mass HIway   Introduction to the Last Mile Program   Example Use Cases   Questions 12 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  13. 13. Health Information Exchange 101
  14. 14. 14 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Health Information Exchange 101 1.  Patient name 2.  Sex 3.  Date of birth 4.  Race ** 5.  Ethnicity ** 6.  Preferred language 7.  Care team member(s) 8.  Allergies ** 9.  Medications ** 10.  Care plan 11.  Problems ** 12.  Laboratory test(s) ** 13.  Laboratory value(s)/result(s) ** 14.  Procedures ** 15.  Smoking status ** 16.  Vital signs NOTE: Data requirements marked with a double asterisk (**) also have a defined vocabulary which must be used.   Electronic sharing of health information among varied healthcare systems – while maintaining meaning   HIE Model Types o  “Push” vs. “pull” (query) -  Consent implications   Content standards o  Create and display capabilities (C-CDA, CCD/C32 or CCR) o  Common MU data set (data frequently exchanged)   Transport standards o  Transmit and receive capabilities   Health Information Service Provider o  Certificate discovery, message delivery, Direct address provisioning   The MA state-wide HIE o  The Mass HIway
  15. 15. Mass HIway Overview Benefits Governance Security + Privacy Roadmap Services
  16. 16. 16 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Mass HIway | Hub for Health Information Exchange The Mass HIway enables the secure electronic exchange of health information among diverse participants in the Commonwealth: The Benefits of HIE Improve & streamline care coordination Fewer medical errors/improved patient safety Reduce duplication Supports achieving Meaningful Use Reduce costs throughout the care delivery system Ease & improve public health reporting & analytics Foundation for Accountable Care Organizations & value-based healthcare models Public Health Ambulatory Care Long-term Post-Acute Care Acute & Post-acute Care Payer Pharmacy Labs Patient Mass HIway
  17. 17. 17 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Governance and Advisory Groups Consumer Advisory Group Provider Advisory Group Technology Advisory Group Legal & Policy Advisory Group HIT Council
  18. 18. Mass HIway | ‘Trust Fabric’   The Mass HIway ‘trust fabric’ is achieved through the combination of technical security standards + legal policies to which all participants agree. 18 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. SECURITY Encryption Authentication PRIVACY Participation Packet Patient Consent TRUST
  19. 19. PHASE 2 Registries + Query Exchange PHASE 1 Information Highway 2012-2013 •  State assumes HISP role •  ‘Directed’ exchange of electronic health information •  Provider can ‘push’ health information to another provider 2013-2014 •  Query-based exchanged enabled (Master Person Index, Relationship listing service, Consent database) •  Development of DPH registries, analytical repositories •  Patient-directed exchange 19 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Mass HIway | Roadmap
  20. 20. HIway Services EHR Connect directly .................................................. Connect with local gateway .................................................. Connect through LAND (Local Application for Network Distribution) .................................................. Browser access to webmail inbox .................................................. CONNECTION OPTIONS Participant directory Certificate repository Secure messaging Message Transformation Secure web mail User Types Physician Practice Hospital Long-term Care Other Providers Public Health Health Plans Labs & Imaging Centers 20 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Mass HIway | Connection Options & Services
  21. 21. Mass HIway | Last Mile Program Mission Goals Environment Approach & Initiatives
  22. 22. 22 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Last Mile Program | Mission Grow adoption of the Mass HIway by all eligible participants, while catalyzing innovation ultimately demonstrating measurable improvements in care quality, population health and health care costs
  23. 23. 23 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Last Mile Program | Goals Connect and Integrate Connect participants to and enable integration with the Mass HIway by all eligible participants Maximize Adoption Optimize Mass HIway services and grow utilization Impact Healthcare Demonstrate measurable improvements in care quality (better care), population health (healthy people and communities) and health care costs (affordable care) GOAL 1 GOAL 2 GOAL 3
  24. 24. Barriers Incentives EHR technology interfaces & product timelines Meaningful Use Consumer on-ramps & workflows HIway Implementation Grants Consent infrastructure HIway Interface Grants Evolving HIway infrastructure Evolving policies (consent, HISP-HISP) HIway awareness Enablers Penalties Chapter 224 – force of law to require connectivity (patients, providers, etc) Chapter 224 – Penalties for non-participation in HIE (1/1/2017) Pioneer Accountable Care Organizations (ACOs) CMS readmission penalty Community-based care transition programs BORIM – meaningful use licensure (1/1/2015) Patient Centered Medical Home (PCHM) Mergers & Acquisitions Innovation & outcome funding 24 Last Mile Program | Our Environment ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  25. 25. Impact Healthcare AdoptionConnection Outreach - Education HIway Interface Grant Program Implementation & Support HIway Implementation Grant Program Community of Practice 25 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Last Mile Program | Initiatives
  26. 26. Mass HIway | Get Connected 26 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  27. 27. 27 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Connection | Pricing Annual Services Fee Tier Category One-time Setup Fee LAND HIE Services (per node) Direct (XDR/SOAP or SMTP/SMIME) HIE Services (per node) Direct Webmail HIE Services (per user) Tier 1 Large hospitals $2,500 $27,500 $15,000 $240 Health Plans $2,500 $27,500 $15,000 $240 Multi-entity HIE $2,500 $27,500 $15,000 $240 Tier 2 Small hospitals $1,000 $15,000 $10,000 $240 Large ambulatory practices (50+) $1,000 $15,000 $10,000 $240 Large TLCs $1,000 $15,000 $10,000 $240 ASCs $1,000 $15,000 $10,000 $240 Non-profit affiliates $1,000 $15,000 $10,000 $240 Tier 3 Small LTC $500 $4,500 $2,500 $120 Large behavioral health $500 $4,500 $2,500 $120 Large home health $500 $4,500 $2,500 $120 Large FQHCs (10-49) $500 $4,500 $2,500 $120 Medium ambulatory practices (10-49) $500 $4,500 $2,500 $120 Tier 4 Small behavioral health $25 $250 $175 $60 Small home health $25 $250 $175 $60 Small FQHCs (3-9) $25 $250 $175 $60 Small ambulatory practices (3-9) $25 $250 $175 $60 Tier 5 Small ambulatory practices (1-2) $25 $60 $60 $60
  28. 28. HIway Use Case Examples
  29. 29. Use Case Scenario 1.1/1.2 – Referral 29 Patient Scenario 1.  Patient sees PCP 2.  PCP’s plan includes a referral to a Cardiac specialist 3.  Referral to specialist is authorized and generated via Direct with a summary of care document 4.  Referral and summary of care is sent via HIway to Cardiac specialist Specialist A.  Receives Direct message with summary of care document B.  Provides necessary care C.  Generates a consult note for delivery to PCP D.  Consult note is attached to a Direct message and sent via the HIway to PCP Referral Consult NotePCP Specialist ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  30. 30. Use Case Scenario 2.1/2.2 – Hospital Referral 30 Patient Scenario 1.  Patient sees PCP or specialist 2.  Treatment plan includes a referral to a local hospital 3.  Referral to hospital is authorized and generated via Direct with a summary of care document 4.  Referral is sent via HIway to hospital Hospital A.  Receives Direct message with summary of care document B.  Provides necessary care C.  Generates an admission notification and summary of care document D.  Admission notification sent via HIway to PCP and/or specialist PCP Specialist ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  31. 31. Use Case Scenario 3.1 – ED Notification 31 Patient Scenario 1.  Patient presents at ED 2.  Patient is treated and released Hospital A.  Provides necessary care B.  Generates an admission notification and summary of care document C.  Admission notification sent via HIway to PCP and/or specialist PCP Referring Physician ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  32. 32. Use Case Scenario 3.2/3.3 – Discharge Summary 32 Patient Scenario 1.  Patient is discharged from hospital to the care of a referring physician, PCP or other care setting Hospital A.  Provides necessary care B.  Generates a discharge summary and summary of care document C.  Discharge summary sent via HIway to referring physician, PCP, and/or other care setting Specialist PCP SNF ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  33. 33. Use Case Scenario 1.1/1.2 – Referral 33 XYZ Hospital 1.  Patient admitted to XYZ ED 2.  Treatment plan calls for a tertiary level of care 3.  Patient is referred to ABC hospital 4.  Referral and summary of care are generated via Direct message 5.  Direct message is sent via HIway to ABC hospital ABC Hospital A.  Patient is received at ABC hospital B.  ABC hospital receives referral and summary of care document C.  Provides necessary care D.  Generates a discharge summary and summary of care via Direct E.  Sends discharge summary and summary of care via HIway to XYZ hospital XYZ Hospital ABC Hospital ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential.
  34. 34. Massachusetts eHealth Institute 617-371-3999 617-725-8938 (fax) info@maehi.org Twitter - @massehealth MeHI Community - www.thehitcommunity.org/mehi/ www.mehi.masstech.org Mass HIway Last Mile Program 1.855.MA-HIWAY (1.855.624.4929) Option 1 MassHIway@masstech.org mehi.masstech.org/what-we-do 34 ©2013 Massachusetts eHealth Institute. All Rights Reserved. Confidential. Connect with MeHI & Last Mile
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