The document outlines an agenda and proposed next steps for the Information Exchange Workgroup. Key points include: - Establishing two task forces focused on provider directories and public health transactions. - Developing work plans and timelines for each task force to assess current issues, identify barriers, and make recommendations. - Prioritizing initial areas like laboratory results, electronic prescribing, and patient summary exchange in relation to Meaningful Use. - Coordinating activities with the HIT Policy Committee and ensuring alignment with other national health IT initiatives. The workgroup aims to address specific challenges to information exchange and make policy recommendations to facilitate interoperability goals.

1. HIT Policy Committee
Information Exchange Workgroup Meeting
August 26, 2010

2. Agenda
• Review of presentation to Policy Committee
• Workgroup priorities and activities for remainder of
2010
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3. HIT Policy Committee
Information Exchange Workgroup
Proposed Next Steps
Micky Tripathi, Chair
David Lansky, Co-Chair
August 19, 2010

4. Information Exchange Workgroup
Chairs:
• Micky Tripathi MA eHealth Collaborative
Co-Chair:
• David Lansky Pacific Business Group on Health
Members:
• Judy Faulkner Epic • Jonah Frohlich California Health & Human Services
• Connie W. Delaney University of Minnesota, Nursing • Steven Stack AMA
• Gayle Harrell • George Hripcsak Columbia University
• Michael Klag Johns Hopkins School of Public Health • Seth Foldy DHS, Wisconsin
• Deven McGraw Center for Democracy & Technology • Jim Buehl CDC
• Latanya Sweeney Carnegie Mellon University • Jessica Kahn CMS
• Charles Kennedy WellPoint, Inc. • Walter Suarez Kaiser Permanente
• Paul Egerman • David A. Ross PHII
• James Golden Minnesota Department of Health • Hunt Blair Vermont Medicaid
• Dave Goetz Dept. of Finance and Administration, TN • George Oestreich Missouri Medicaid
• Dianne Hasselman Center for Health Care Strategies
• Donna Frescatore NY State Health
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5. Charge to the IE Workgroup
• Breakthrough areas where policy barriers prevent providers and/or states from
being effective enablers of broader and deeper health exchange
– Specific clinical transactions already identified as important to meaningful
use
– Critical issues that get unearthed by the over $1.5 billion programs in state-
level HIE, RECs, Beacons, and NHIN Direct
• IE WG will also act as conduit for state-level policy issues that need HITPC
attention
– For issues in IE WG charter, Identify and recommend solutions to such
issues to HITPC
– For issues outside of IE WG charter, navigate to most appropriate HITPC
WG(s) and facilitate/coordinate as necessary

6. Scope and Approach
Focus areas Evaluative framework Policy levers
MU transactions 1. Is the transaction or service
• Labs (Round 2) universally and affordably
available in the market today?
• eRX (Round 2)
2. If not, where are the gaps and
• Public health what market and/or policy
• Administrative transactions barriers have created and are
perpetuating these gaps?
• Summary exchange
3. What market correcting or
• Quality measurement and
reinforcing actions could be
reporting
taken to eliminate identified
• Patient-facing applications service gaps?
4. Which transactions might
Emerging issues require more assertive role for
government, and how might
• Barriers to directed exchange:
state and federal policies be
Provider directories
orchestrated to complement
• Coordination with state public market solutions and catalyze
health agencies removal of service gaps?
• Coordination with Medicaid
programs

7. Proposed Task Forces
1. Provider Directories
• How can we work to ensure interoperability and access across provider directories being created under
the State HIE Cooperative Agreement Program?
• How can we leverage existing directories (i.e. immunization registries, SureScripts, Federation of State
Medical Boards etc) in the creation of an authoritative directory?
• How can we promote economies in directory development across states/regions?
• Who has responsibility for directory maintenance and data management?
• What entity will have governance (ownership) of statewide directories?
• What policies are needed for different directory models: central repositories and federated record locators
• What business models will support authoritative directories? How will sustainability be achieved?
• How do you maintain up-to-date information on providers? What will incentivize providers to update their
information whenever it changes?
• How do public health and Medicaid uses affect directory design?
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8. Proposed Task Forces
2. Public Health
• How to leverage provider directories for public health communications and alerts?
• How to leverage public health provider directories for HIE?
• How can we promote economies in public health interoperability development across states/regions?
• What are best ways to manage tension between declining budgets in state public agencies and increasing
demand for public health capabilities driven by MU requirements?
• Implementation of public health MU reporting and data exchange requirements.
• Harmonization of state and federal public health reporting requirements.
• Need to ensure we harmonize the standards used in NHIN Direct and public health reporting systems
(e.g., PHIN).
• Public health agencies have limited capability and funding to update their data collection systems. Can we
establish a universal HIE migration path for public health so every state and local agency does not have to
reinvent the wheel?
• Can we utilize ONC adopted standards for EHRs to facilitate this evolution?
• What policies and resources can be employed to enable increased uniformity in public health data
platforms (health care providers have EHR certification, what can be done for public health)?
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9. Next Steps
• For Sep 14 HITPC meeting
– Work plan and deliverables for each task force
– Identification of next set of focus areas
• For Oct 20 HITPC meeting
– Provider directories recommendations
– Perspectives on key public health issues (align with MU
Workgroup)
– Identification of emerging state-level implementation issues
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10. Agenda
• Review of presentation to Policy Committee
• Workgroup priorities and activities for remainder of
2010
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11. Task force membership (volunteers to date)
Provider directories Public health
• Paul Egerman • Jim Buehler
• Seth Foldy • Seth Foldy
• Jonah Frolich • Jonah Frolich
• James Golden • George Hripcsak
• Dave Goetz • Deven McGraw
• Blair Hunt • David Ross
• Steve Stack • Steve Stack
• Walter Suarez • Walter Suarez

12. High-level timeline
Sep Oct Nov
Provider directories
• Work plan completion
• Environmental scan
• Requirements assessment
• Identification of barriers
• Potential solutions
Public health transactions
• Work plan completion
• Environmental scan
• Requirements assessment
• Identification of barriers
• Potential solutions
IE Workgroup meetings
HITPC meetings
14 20 19

13. Next steps – for discussion
• Task forces
– Leadership and membership
– Work plan development
– Long-lead and ONC staff support items
• Long-lead items include hearings, surveys, joint meetings with other WGs, etc
• Beyond the task forces
– Issues in coordinating state-level activities
• Alignment of state laws with each other and with federal
• Barriers to aligning funding across states and across programs (eg, ONC, Medicaid,
public health, etc)
• What are possible approaches to better enable state coordination to drive market
behavior?
– Initial assessment of emerging State-Level HIE issues
– PIN priorities: Labs, eRX, and Patient Care Summary exchange
• eRX – is the current eRX infrastructure prepared to support medication management
requirements of MU?
• Labs – does lack of required standard for lab transactions pose barriers to MU
achievement?
• Patient care summary exchange – alignment of NHIN Direct availability and state-
level HIE requirements
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– Alignment with MU Workgroup, NHIN governance process, NHIN Direct, other?

14. Draft IE WG meeting agendas – for discussion
Meeting Focus
Early September • Review task force and IE WG work plans for
September HITPC meeting
• Prep for State-Level HIE Status meeting
Late September • Task force reports
• State-level HIE Status meeting
• NHIN Direct update
Early October • Review Provider Directory Task Force status and
recommendations
• Review status of Public Health Task Force findings
• Prep for October HITPC meeting
Late October • Discussion of Coordinating State-Level Initiatives
• PIN priorities
Early November • PIN priorities
• Other emergent issues