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
