HIE

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HIE

  1. 1. State HIE Program Webinar January 5th, 2010 1
  2. 2. Agenda for State HIE Program Webinar • State HIE Program Updates and Q&A  20 min • NHIN Update, IFR Update and Q&A  40 min • State HIE Program Technical Assistance: Resources for Grantees Facilitated through the State HIE Leadership Forum  45 min o a. Overview o b. State-HIE Toolkit Overview and Demonstration o c. State HIE Planning – Using the Toolkit • Next Steps  15 min o a. Feedback o b. Release of Additional Modules o c. Listserv – Ongoing Forum Communication 2
  3. 3. Grants Programs High-Level Summary/Status 3
  4. 4. Agenda • A. Overview of Funding Opportunities  15 min o 1. Regional Extension Centers o 2. Beacon o 3. SHARP o 4. Workforce • B. HIE Overview and Resources Providing Guidance  5 min 4
  5. 5. Currently Available Funding Opportunities • Provide grants for the establishment of Health Information Technology Regional Extension Centers that will offer technical Health Information assistance, guidance and information on best practices to support and accelerate health care providers’ efforts to become Technology Extension meaningful users of Electronic Health Records (EHRs). Program (Cycle 2) • Application Deadline: Cycle 1: Full Applications – Due on November 3, 2009 Cycle 2: Preliminary Applications – Due on December 22, 2009; Full Applications - January 29, 2010 • Provide funding to communities to build and strengthen their Beacon Community health information technology (health IT) infrastructure and exchange capabilities to demonstrate the vision of meaningful Cooperative health IT. Agreement Program • Application Deadline: February 1, 2010 (Letter of Intent due January 8, 2010) • Fund research focused on achieving breakthrough advances to Strategic Health IT address well-documented problems that have impeded adoption: 1) Security of Health Information Technology; 2) Advanced Research Patient-Centered Cognitive Support; 3) Healthcare Application and Network Platform Architectures; and, 4) Secondary Use of Projects (SHARP) EHR Data. Program • Application Deadline: January 25, 2010 (Letter of Intent due January 8, 2010) 5
  6. 6. Currently Available Funding Opportunities • This funding opportunity, one component of the Health IT Workforce Program, will provide $10 million in grants to institutions of higher education (or consortia thereof) to support Curriculum health information technology (health IT) curriculum Development Centers development. • Application Deadline: January 14, 2010 (Letter of Intent due January 4, 2010) • This program, one component of the Health IT Workforce Community College Program, seeks to rapidly create health IT education and Consortia to Educate training programs at Community Colleges or expand existing programs. Community Colleges funded under this initiative will Health Information establish intensive, non-degree training programs that can be Technology completed in six months or less. • Application Deadline: January 22, 2010 (Letter of Intent due Professionals January 6, 2010) • The purpose of this program, one component of the Health IT Workforce Program, is to rapidly increase the availability of Program Assistance individuals qualified to serve in specific health information for University-Based technology professional roles requiring university-level training. Training • Application Deadline: January 25, 2010 (Letter of Intent due January 8, 2010) 6
  7. 7. Currently Available Funding Opportunities Competency • This funding opportunity, one component of the Health IT Workforce Program, will provide $6 million in grants to an Examination for institution of higher education (or consortia thereof) to support Individuals the development and initial administration of a set of health IT competency examinations. Completing Non- • Application Deadline: January 25, 2010 (Letter of Intent due Degree Training January 8, 2010) • These grant programs will support states and/or State Designated Entities (SDEs) in establishing health information *State Health exchange (HIE) capacity among health care providers and hospitals in their jurisdictions. Such efforts at the state level will Information establish and implement appropriate governance, policies, and Cooperative network services within the broader national framework to rapidly build capacity for connectivity between and among Agreement Program health care providers. State programs to promote HIE will help to realize the full potential of EHRs to improve the coordination, *Pending Award efficiency, and quality of care. • Awards expected in early 2010 7
  8. 8. REC – Application, Award Process, and Timeline 2009 2010 NOV DEC JAN FEB MAR Cycle One 11 Due Diligence 21 3 Full NGA Apps Issuance Objective Due Review Completion Cycle Two 18 22 6 29 15 Due Diligence 31 FOA Prelim Full Apps Apps Objective Updated Preliminary Due Review NGA App Due Completion Issuance Review Completion 8
  9. 9. REC Overview • The purpose of the Regional Centers is to furnish assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement and meaningfully use certified EHR technology to improve the quality and value of health care. • Priority shall be given to providers that are primary-care providers (physicians and/or other health care professionals with prescriptive privileges, such as physician assistants and nurse practitioners) in any of the following settings:  Individual and small group practices (ten or fewer professionals with prescriptive privileges) primarily focused on primary care;  Public and Critical Access Hospitals;  Community Health Centers and Rural Health Clinics; and  Other settings that predominantly serve uninsured, underinsured, and medically underserved populations. 9
  10. 10. Beacon, Sharp, and Workforce Timeline Key Steps and Anticipated Dates Letter Execution of FOA Full of Cooperative Released Application** Intent Agreements BEACON 12/02/2009 1/8/2010 1/1/2010 3/2010 SHARP 12/17/2009 1/8/2010 1/25/2010 3/2010 WORKFORCE Community College 11/25/2009 1/6/2010 1/22/2010 3/2010 WORKFORCE 12/15/2009 1/4/2010 1/14/2010 3/2010 Curriculum Development WORKFORCE 1/25/2010 University Training 12/17/2009 1/8/2010 3/2010 WORKFORCE 1/2010 Competency Examination 12/17/2009 1/2010 3/2010 **Applications which do not meet Completeness and Responsiveness criteria will not pass on to Objective Review. 10
  11. 11. Beacon Overview • Will provide funding to communities to build and strengthen their health IT infrastructure and exchange capabilities to demonstrate the vision of the future where hospitals, clinicians and patients are meaningful users of health IT, and together the community achieves measurable improvements in health care quality, safety, efficiency, and population health. • Awards will be made in the form of cooperative agreements to 15 qualified non-profit organizations or government entities representing geographic health care communities. • Beacon Communities will generate and disseminate valuable lessons learned that will be applicable to the rest of the nation’s communities as they strive to build and leverage their health IT infrastructure for healthcare improvement. • Will include $220 million in grants to build and strengthen health IT infrastructure and health information exchange capabilities, including strong privacy and security measures for data exchange, within 15 communities. An additional $15 million will be provided for technical assistance to the communities and to evaluate the success of the 11 program.
  12. 12. Beacon Overview (cont’d) 15 Communities 1. Extend existing (advanced) health IT and exchange infrastructure 2. Leverage this infrastructure to achieve specific and measurable healthcare improvements Demonstrate vision of the future where hospitals, clinicians and patients are meaningful users of health IT, and together the community achieves measurable improvements in health care quality, safety, efficiency, and population health 12
  13. 13. SHARP Overview • The purpose of the Strategic Health IT Advanced Research Projects (SHARP) Program is to fund research focused on achieving breakthrough advances to address well-documented problems that have impeded adoption of health IT and to accelerate progress towards achieving nationwide meaningful use of health IT in support of a high-performing, continuously- learning health care system. • ONC expects to award four cooperative agreements:  Security of Health Information Technology  Patient-Centered Cognitive Support  Healthcare Application and Network Platform Architectures  Secondary Use of EHR Data 13
  14. 14. Workforce Overview (cont’d) Curriculum Community Development College Centers Consortia Workforce Program Competency University-Based Development Training Testing • The Curriculum Development Centers program will provide $10 million in grants to institutions of higher education (or consortia thereof) to support health information technology curriculum development. • ONC plans to make up to 5 grant awards that will support curriculum development to enhance programs of workforce training primarily at community college level. • The materials developed under this program will be used by the member colleges of the five regional consortia as well as be available to institutions of higher education across the country. 14
  15. 15. Workforce Overview (cont’d) Curriculum Community Development College Centers Consortia Workforce Program Competency University-Based Development Training Testing • The Community College Consortia to Educate Health Information Technology Professionals in Health Care program seeks to rapidly create HIT academic programs at Community Colleges or expand existing ones. • Students will be able to complete training in one of six roles within six months or less. • Academic programs may be offered through traditional on-campus instruction or distance learning modalities, or combinations thereof. • It is expected that by the end of the two-year project period, collectively all of the Community Colleges participating in the program will have established training programs with the capacity to train at least 10,500 students annually to be part of the HIT workforce.  Anticipated training capacity of the consortium as a whole must average 150 students per member College.  Training at all consortium member Colleges will be expected to begin by September 30, 2010  Colleges should have a plan collaborate with regional extension centers and state health information exchange programs 15
  16. 16. Workforce Overview (cont’d) Curriculum Community Development College Centers Consortia Workforce Program Competency University- Development Based Training Testing • The purpose of the Information Technology Professionals in Health Care: Program of Assistance for University-Based Training grants is to rapidly increase the availability of individuals qualified to serve in specific health information technology professional roles requiring university-level training. Four-year colleges or universities are eligible to apply for funding under this program, which will emphasize programs that can be completed by the trainee in one year or less. • The six roles targeted by this funding opportunity are:  Clinician/Public Health Leader  Health Information Management and Exchange Specialist  Health Information Privacy and Security Specialist  Research and Development Scientist  Programmers and Software Engineer 16  Health IT Sub-specialist
  17. 17. Workforce Overview (cont’d) Curriculum Community Development College Centers Consortia Workforce Program Competency University-Based Development Training Testing • The Competency Examination for Individuals Completing Non-Degree Training program, one component of the workforce program, will provide $6 million in grants to an institution of higher education (or consortia thereof) to support the development and initial administration of a set of health IT competency examinations. • The examinations will assess basic competency for individuals trained through short-duration, non-degree health IT programs, and for members of the workforce with relevant experience or other types of training who are seeking to demonstrate their competency in certain health IT workforce roles integral to achieving meaningful use of electronic health information. 17
  18. 18. State HIE Program • Cooperative agreements will be awarded through the State Health Information Exchange Cooperative Agreement Program to states and qualified State Designated Entities (SDEs).  Objective: To develop and advance mechanisms for information sharing across the health care system.  A cooperative agreement is a partnership between the grant recipient and the Federal government.  States and SDEs will be required to match grant awards beginning in 2011. • Under these State cooperative agreements $564 million will be awarded to support efforts to achieve widespread and sustainable health information exchange (HIE) within and among states through the meaningful use of certified Electronic Health Records (EHRs).  The goal of meaningful use of EHRs is for health care providers to use this technology to improve the quality and efficiency of care. 18
  19. 19. State HIE Program (cont’d) • The grant programs will support states and/or SDEs in establishing in developing and implementing strategic and operational plans which address and facilitate HIE capacity among health care providers and hospitals in their jurisdiction. • Grant performance will be evaluated on a quarterly basis to determine if there is improved capability for providers to actively exchange healthcare data focusing specifically on electronic order and receipt of labs and test results as well as e-prescribing. • The respective state governments, federal government (complimentary grants programs) and private sector will all play important roles in advancing HIE among health care providers through the grant programs. 19
  20. 20. Aligning with Current & Future State HIE Guidance • Statewide Strategic and Operational Plans should be developed and implemented based upon evolving guidance. States will receive guidance from:  ONC  ONC – State HIE Team  Technical Assistance Providers (State HIE Toolkit, etc.)  CMS (Meaningful Use NPRM, etc.)  ONC FACA Committees (HIT Policy – NHIN Workgroup)  Other 20
  21. 21. Interim Final Rule and Notice of Proposed Rulemaking of Meaningful Use An Interim Final Rule (IFR) on an initial set of standards, implementation specifications, and certification criteria was issued on December 30, 2009, with a request for comments. The Centers for Medicare & Medicaid Services (CMS) also issued a Notice of Proposed Rulemaking (NPRM) on the definition of “meaningful use.” • In order for professionals and hospitals to be eligible to receive payments under the Medicare and Medicaid EHR incentive programs, provided through the Recovery Act, they must be able to demonstrate meaningful use of a certified EHR system. The IFR will become effective 30 days after publication and will be open for public comment for 60 days after publication. The final rule will be issued sometime in 2010. More information on the IFR can be found at: http://www.federalregister.gov/inspection.aspx#special Public comments can be made at: http://www.regulations.gov/search/Regs/home.html#home 21
  22. 22. Technical Architecture & the NHIN In Support of the State HIE Program 22
  23. 23. Agenda • A. Overview & Approach of the Nationwide Health Information Network (NHIN)  10 min o 1. Industry Engagement &The Evolution of the NHIN o 2. Governance for the NHIN o 3. Trust, the DURSA, & the NHIN o 4. Standards, Specifications, and Meaningful Use • B. Technical Architecture , NHIN, & State Health Information Exchange (HIE)  20 min o 1. Key Principles & Information Exchanges to be Considered by States o 2. Stakeholders Participating in HIE o 3. Services to be Provided by &/or Used by States o 4. Sharing Information with Current & Future NHIN Participants o 5. Alignment with Current & Future Technical Architecture & NHIN Guidance 23
  24. 24. Overview & Approach of the Nationwide Health Information Network (NHIN) 24
  25. 25. NHIN: An Overview • The Nationwide Health Information Network (NHIN) is a collection of standards, protocols, legal agreements, specifications, and services that enables the secure exchange of health information over the internet.  The NHIN provides a common platform for health information exchange across diverse entities to achieve the goals of the HITECH Act.  This enables health information to follow the consumer, be available for clinical decision making, and support use of healthcare information beyond direct patient care to improve public health. 25
  26. 26. NHIN: An Overview • In its initial pilot implementations, the NHIN provides a vehicle for large and/or technologically sophisticated organizations to securely exchange electronic health information on a common platform for HIE across diverse entities to achieve the goals of the HITECH Act.  Moving forward, the NHIN will accommodate uses ranging from simple local applications such as a healthcare provider communicating a prescription to a pharmacy, to complex interchanges involving nationwide participants and the attendant network facilities and tools, and/or to consumers seeking access to their health records from their local caregivers. 26
  27. 27. NHIN: Industry Engagement & Evolution • ONC will be engaged in diverse public discussions about the various possibilities NHIN  One important source of input is through Federal Advisory Committees, public meetings, and comments during formal rulemaking processes.  A NHIN Work Group (under the HIT Policy Committee) is being formed to offer recommendations on creating a policy and technical framework that allows the internet to be used for the secure and standards-based exchange of health information, in a way that is open to all and fosters innovation.  The new NHIN Work Group will hold discussions on how to use the internet to transform healthcare, including network security and access to health information.  At the inaugural meeting on November 20, the work group was charged with reviewing and refining the charge and initial activities, including: o Establishing an incremental approach that will generate immediate value (e.g., enable providers to achieve meaningful use) while creating the components that will be needed for more advanced information exchange (e.g., broadcast query). o Describing the governance mechanism required for above. o Providing recommendations to the HIT Policy and HIT Standards Committees. Activities of the HIT Policy Committee can be found at: http://healthit.hhs.gov/policycommittee 27
  28. 28. 28
  29. 29. NHIN: Current Governance • As part of the 2009 NHIN limited production pilots, the following interim governance structures were put in place to support information exchange across the NHIN during the formal rulemaking process:  The NHIN Technical Committee focuses on architectural and technical issues such as prioritization of new functionality and approval of new or modified technical requirements and specifications.  The NHIN Coordinating Committee has the authority to establish and maintain the set of policies and legal agreements and accountability measures for NHIN participants. The current governance mechanisms may be enhanced or modified based on recommendations from the HIT Policy Committee – NHIN Workgroup. 29
  30. 30. NHIN: Creating a “Fabric of Trust” • Those who might want to use the NHIN for simple exchanges of information may not require the rigorous agreements that have been established for the exchange of data during the limited production pilots. Therefore, even simple exchanges require:  The sender of information must be confident of the address of the recipient,  The receiver of the data is the intended recipient  The substance of the information has not been altered during transmission. Other users may have more extensive requirements to establish trust. • The NHIN will require a “fabric of trust” that can serve multiple users and can provide multiple layers to establish confidence.  A “lightweight” layer  Additional layers • A wide range of key stakeholders will need to be involved in drafting new, and revising existing, elements of the NHIN trust fabric (e.g. trust agreements, operating policies and 30 procedures, and Coordinating Committee processes.)
  31. 31. NHIN: DURSA – “A Fabric of Trust” • Data Use and Reciprocal Support Agreement (“DURSA”) – is a comprehensive, multi-party trust agreement.  The DURSA provides the legal framework governing participation in nationwide information exchange by requiring the signatories to abide by a common set of terms and conditions that establish the Participants’ obligations and the trust fabric to support the privacy, confidentiality and security of the health data that is exchanged. • Key terms and conditions of the DURSA are noted below:  Multi-Party Agreement  Participants in Production  Privacy and Security Obligations  Requests for Data Based on Permitted Purposes  Duty to Respond  Future Use of Data Received Through the NHIN  Duties of Requesting and Responding Participants. Each Participant has certain duties when acting as a requesting or responding Participant. o Breach Notification o Mandatory Non-Binding Dispute Resolution o Allocation of Liability Risk 31 o Applicable Law
  32. 32. NHIN: The Use of Standards • The NHIN references, leverages and utilizes approved standards.  The Health IT Standards Committee, a federal advisory committee is responsible for making recommendations to the National Coordinator for Health IT on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information.  The Health IT Standards Committee may be informed by standards harmonization entities, standards development organizations (SDOs), etc. To date The Health Information Technology Standards Panel (HITSP) has played a significant role in harmonizing standards. Their work can be referenced here: http://www.hitsp.org/ 32
  33. 33. NHIN: The Development & Utilization of Specifications • The NHIN specifications which must be implemented in an NHIN Gateway vary with the functionality an NHIN Participant wishes to support. NHIN Specification are developed in alignment with approved standards. • Entities are encouraged to implement the complete set, so that they may offer the full suite of NHIN services to members of its healthcare value chain. • The NHIN Specifications include:  Messaging, Security, and Privacy Foundation  Discovery Information Services  Information Services Profile To date The Health Information Technology Standards Panel (HITSP) has played a significant role in harmonizing standards. Their work can be referenced here: http://www.hitsp.org/ 33
  34. 34. NHIN: Aligning with Meaningful Use 2009 2011 2013 2015 HIT-Enabled Health Reform Meaningful Use Criteria HITECH Policies 2011 Meaningful Use Criteria (Capture/share data) 2013 Meaningful Use Criteria (Advanced care processes with 2015 Meaningful decision support) Use Criteria (Improved Outcomes) 34
  35. 35. Meaningful Use and Preliminary Rulemaking Timeline July August September Late 2010 and 2009 2009 2009 2009/Early Onward 2010 Rulemaking Preliminary Definition of MU Preliminary (HIT Policy Standards Committee) Identified to Support MU Work Begun to (HIT Standards Develop HHS Committee) Certification ONC IFRs & Criteria for MU CMS NPRMs (HIT Standards Released Committee) Regulations Written into Law and Executed 35
  36. 36. Status of Rulemaking • An Interim Final Rule (IFR) on an initial set of standards, implementation specifications, and certification criteria was issued on December 30, 2009, with a request for comments. • Represents the first step in an incremental approach to adopting standards, implementation specifications, and certification criteria to enhance the interoperability, functionality, utility, and security of health IT and to support its meaningful use. • The certification criteria adopted in this initial set establish the capabilities and related standards that certified electronic health record (EHR) technology will need to include in order to, at a minimum, support the achievement of the proposed meaningful use Stage 1 (beginning in 2011) by eligible professionals and eligible hospitals under the Medicare and Medicaid EHR incentive programs. • In a related announcement, the Centers for Medicare & Medicaid Services (CMS) also issued a Notice of Proposed Rulemaking (NPRM) on the definition of “meaningful use.” • In order for professionals and hospitals to be eligible to receive payments under the Medicare and Medicaid EHR incentive programs, provided through the Recovery Act, they must be able to demonstrate meaningful use of a certified EHR system. • The proposed standards and certification criteria in the IFR are fundamentally linked to and specifically designed to support the 2011 meaningful use criteria. 36
  37. 37. Technical Architecture, NHIN, and the State HIE Program 37
  38. 38. Technical Architecture: Key Principles • Statewide Strategic an Operational Plans are expected to provide a technical architecture that describes the interactions of stakeholders and technologies to achieve the state’s strategic health objectives. • Architecture the components of a complex system and the relationships and interactions among those components, whether they be parts of a house, objects in a software application, or elements of state health information exchanges. There are many “moving parts” encompassed within state HIE initiatives: • Exchanges of information among many different participants in the healthcare value chain;  Necessary technology infrastructure to facilitate these exchanges; and  Alignment to the national health IT agenda to ensure that these exchanges of health information are secure and interoperable. ONC realizes that States/SDEs may be at different levels of maturity and therefore is providing additional guidance in the State HIE Toolkit and other TA Initiatives. 38
  39. 39. Technical Architecture: Key Principles & Health Information Exchange (HIE) • The development of and evaluation of state technical architectures will be driven by well-defined principles that clearly advance the national health IT agenda, namely: • States/SDEs should ultimately advance the key tenets of the health reform agenda:  Improving quality of care and patient outcomes  Improving the cost-effectiveness of care  Enhancing the capabilities of public health • States/SDEs should advance key priority areas for the meaningful use of electronic health records. These key priority areas were originally defined by the HIT Policy Committee in July 2009 and it is anticipated that they will undergo review and update and will be written into law.  The priority areas which have been defined as short term (2011) include: o Electronic eligibility and claims transactions o Electronic prescribing and refill requests o Electronic clinical laboratory ordering and results delivery o Electronic public health reporting (i.e., immunizations, notifiable laboratory results) o Quality reporting o Prescription fill status and/or medication fill history o Clinical summary exchange for care coordination and patient engagement 39
  40. 40. Technical Architecture: Stakeholders Participating in HIE • States/SDEs should incorporate all key stakeholders within the state’s healthcare value chain, including non-governmental entities such as providers, health plans, labs and pharmacies, as well as agencies with health-related missions at all levels of government.  The architecture should also conform to national standards for health IT, and should facilitate participation in the NHIN. • The scope of health information exchange activities includes exchanges between health enterprises, both within a state (intra-state) and across states (inter-state).  “Health Enterprise” refers to an organization that maintains a common index of patients and their associated documents/data, encompasses participants that have established trust and business relationships, and have agreed to adhere to common standards. The scope of a health enterprise could be as small as a single practice, but it would also include large chains or delivery networks, existing jurisdictional HIEs/RHIOs, and state or county agencies. 40
  41. 41. Technical Architecture: Services to be Provided by and/or used by States • State technical architectures should describe what shared or common infrastructure they intend to supply to facilitate the information exchanges described above. At a minimum, state technical architectures must describe mechanisms to:  Provide or Participate in Location Services  Ensure Entities (Patients, Providers, etc.) are Discoverable  Provide services for trust, security and privacy  Integrate Medicaid Services  Integrate State-Level Registries 41
  42. 42. Sharing Information with Current and Future NHIN Participants • New users will soon be joining the existing NHIN activities  Includes states, SDEs or other recipients of Federal contracts to build and begin exchanging health information.  In addition, there are numerous Federal initiatives that will depend upon information exchange via the NHIN, including the CDC biosurveillance pilots, the Virtual Lifetime Electronic Record implemented by the DoD and the VA, and the Social Security Administration’s disability determination process. 42
  43. 43. Aligning with Current & Future Guidance • Grantees are highly encouraged to plan for and participate in the NHIN. • Grantees Statewide Strategic and Operational Plans are highly encouraged to address options for future NHIN participation.  This may include planning for and implementation of appropriate standards, specifications, technical architecture, trust agreements, etc. • Project Officers will evaluate Statewide Strategic and Operational Plans based upon evolving NHIN guidance. • States will receive guidance regarding the NHIN from:  ONC  ONC – State HIE Team  Technical Assistance Providers (State HIE Toolkit, etc.)  CMS (Regarding Meaningful Use)  ONC FACA Committees (HIT Policy – NHIN Workgroup) 43
  44. 44. Questions & Answers (If Time Permits) 44
  45. 45. Technical Assistance & Toolkit Overview 45
  46. 46. State HIE Program Technical Assistance Overview TA Goal: Support states in their efforts to build HIE capacity to support Meaningful Use TA Objectives:  Targeted to stages of development and responsive to state identified needs  Aligned to support HITECH - State HIE Program o Program goals o Milestones across states  Leveraging collaborative expertise and resources o ONC Program guidance, Project Officers, Regional Consultants o SLHIE Project T.A. Team (staff, consultants, other collaborators) o States and state-specific resources e.g. consultants
  47. 47. Organizing T.A. - Goals, Strategic Priorities
  48. 48. Distinctions about T.A. Services Assumptions State HIE T.A. Services • Most states will use hire • Targeting areas that states consultants either to help otherwise can’t address via develop Plans and/or to vendors, consultants execute on Plans. • Providing program level • States need additional guidance and direction source of guidance • Helping states address  Cross-cutting issues, barriers common issues  Comparative information • Facilitating flexible state about emerging best practices approaches, stages while  Objective source of guidance also ensuring that states are linked to State HIE Program “on the right road.” expectations
  49. 49. State HIE Program TA Services and Resources Will Address These Type Questions… • How do I get started (I don’t know what I need or who to choose to help)? • How do I pick a consultant/vendor? • What do I do to get ONC approval for my state plans? • What are the best practices across the states for implementing effective HIE across the domains, especially governance? • What are the best practices across states for overcoming a particular issue/barrier? • What is ONC’s position on a variety of issues? • What are the NHIN specs; what can we do with our architecture to become compliant (and not rely on the vendor’s word)? • Is the proposal received from this consultant/vendor in compliance with ONC guidelines?
  50. 50. State HIE Technical Assistance Services and Resources Virtual Programs Communications Toolkit Webinars Listserv Coaching Meetings Leadership Virtual/On-site Roundtable Training Consulting Discussions
  51. 51. Technical Assistance Consultations Include Do Not Include • Helping states identify • Directly meeting strategies and address milestones for the issues within and states across the five domains • Developing states’ • Supporting states to deliverables meet milestones and deliverables as required by cooperative agreements with ONC
  52. 52. Technical Assistance Consulting Activities Do Include…. • Provide recommended best practices as identified by SLHIE and other ONC projects e.g. HISPC, State Alliance, NHIN. etc • Assist to develop strategies to address issues, reach milestones or deliverables by:  Provide advice on direction or resolution of an issue  Analyze specific issues, suggest potential solutions  Synthesize different approaches and outline the alternatives  Identify case studies or other states’ efforts to resolve similar issues and bring these to attention where a state needs help
  53. 53. Technical Assistance Consulting Activities Do Not Include…. • Developing systems • Deploying technologies • Giving legal advice • Developing strategic and operational plans • Completing audits • Writing data sharing agreements • Producing for states any State HIE Cooperative Agreement Program deliverables or products
  54. 54. Anticipated Technical Assistance Topics Evolving Across Stages
  55. 55. State HIE Toolkit • Purpose  Resource to support state grantees to plan and lead activities to accomplish targeted milestones and expectations outlined in state plans and cooperative agreements • Design  Aligns with State HIE Program guidance (domains, general areas)  Modules offer education, decision-making support, practical tools  States have ready access, ability to customize use  Iterative, expanding content to provide access to emerging best practices, lessons learned in the field • Dissemination  Released in versions with ongoing updates  Available through Forum Web site and directly at http://www.statehieresources.org
  56. 56. Toolkit Beta Release • Toolkit Content o Initial modules focus on planning fundamentals • Next Version release o Additional set of modules planned January 31, 2010 • Feedback on Beta version o Enhancements, expanded resources will address feedback about states’ needs, priorities
  57. 57. Using the Toolkit • Tackling key fundamentals  Establishing governance  Organizing to address key planning priorities
  58. 58. Next Steps • State HIE Forum Participants  Sign up for Listserv through Toolkit or Forum Web site • SLHIE Project –  Will send Listserv request for feedback on the Toolkit  States respond with suggestions, resource requests, etc  Moderated communication will begin to circulate state inquiries, requests, resource sharing • Beginning in 2010  T.A. assessments and planning  Webinar series

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