Digital Bridge Governance Principles Transparency: Stakeholders will have Utility: The governance body will prioritize • • visibility into the governance body’s work use of existing information technology and opportunities to provide input. standards and infrastructure as it pursues shared and realistic goals that benefit all Respect for Process: Governance body • parties. members will adhere to an agreed upon decision-making process. Members will Representativeness: Governance body • observe delineated and agreed upon roles members will represent their broader field and responsibilities. and be responsive to the goals of the Digital Bridge partnership. Outreach: The governance body can solicit • opinions and presentations from Trust: Governance body members will • stakeholders to inform its decision-making. honor commitments made to the Digital Bridge effort. FOR DISCUSSION USE ONLY – January 4 th , 2018
Digital Bridge Strategic Roadmap Milestones & Critical Activities PHASE III (2017) PHASE IV (2018-2019) PHASE V (2020-2021) PHASE VI (2022-2023) Jun Aug Nov Jan Aug Apr Dec Jan Nov Dec Jan Jan High Use case 2 Wave 1 – Wave 2 – Test launched Wave 1 – Test Production Operating implementation implementation model Wave 1 legal complete complete Wave 2 legal implemented agreements signed Use case 3 agreements signed launched Governance Wave 2 - Implement long by-laws Production term technical drafted architecture eCR legal agreement Operating model Governance templates developed self- sustaining Develop and Recommend Body changes Reportability recommend long long-term implemented Response (RR) funding modal term technical Published By-laws approved Develop long architecture by Governance term legal Digital Bridge Body strategy Implement Funding Model communications new funding 100% in effect plan-V2 Template for model Infrastructure for Legal agreement Complexity eCR legal new use cases Use case templates developed agreements criteria agreed for new use cases Digital Bridge upon recruitment strategies & Begin Technical marketing Evaluate Architecture funding model Stand up Evaluation technical Legal agreement Legend Concept of operations templates developed for Operations workgroup Operations Establish Digital developed subsequent use cases Bridge success Funding Establish stories communications Technical Infrastructure Governance body advisory group 7 sites up approves long term Legal and running Governance technical architecture Users & Use Cases body approves Marketing Reporting on use case 3 Governance Communications materials for five conditions ody approves funders use case 2 Critical Path Low Identify Other Milestones Operating model funders approved by governance body *** General Notes: (1) Complexity is used as a rough proxy for the needed resources and effort to complete a milestone, (2) Overall timeline and milestones are subject to change depending on project dependencies. FOR DISCUSSION USE ONLY – January 4 th , 2018
Governance Body Meeting Thursday, January 4, 2018 12:00 – 1:30 PM ET This meeting will be recorded for note-taking purposes only FOR DISCUSSION USE ONLY – January 4 th , 2018
FOR DISCUSSION USE ONLY – January 4 th , 2018
Meeting Agenda Time Agenda Item Purpose: 12:00 PM Call to Order – John Lumpkin The purpose of this meeting is to work toward a common vision for exchanging actionable information between 12:04 PM Agenda Review and Approval – John Lumpkin public health and health care. Objectives: 12:05 PM Scalability Assessment Update By the end of this meeting, the governance body will have: • Jim Jellison 1. Identified the status of the Digital Bridge eCR scalability assessment work 12:10 PM In-person Meeting Preparation 2. Identified framework and objectives for the in-person Charlie Ishikawa • meeting 3. Identified draft Digital Bridge sustainability plan’s 12:20 PM Digital Bridge Strategy essential elements for in-person meeting discussion Alana Cheeks-Lomax, Ben Stratton • Materials: remaining Announcements – Charlie Ishikawa 1. Draft Digital Bridge sustainability plan one pager 2. Meeting slide deck 1:30 PM Adjournment – John Lumpkin FOR DISCUSSION USE ONLY – January 4 th , 2018
Scalability Assessment Update Jim Jellison FOR DISCUSSION USE ONLY – January 4 th , 2018
eCR Scalability Assessment • Objective: Identify possible modifications to the current Digital Bridge electronic case reporting (eCR) approach that may improve scalability from legal and regulatory perspective for future implementations. • Purpose: • Summarize scalability issues and describe approach for identifying possible modifications. • Facilitate the governance body’s prioritization of modification options. • Take a proactive role in addressing potential privacy breaches for patients.
Why Perform this Assessment • The current eCR approach may include features hindering nationwide adoption of eCR. • Decision support intermediary (DSI) acting as business associate (BA) of providers entails • Privacy breach (HIPAA) risks inherent to role of BA • Administrative costs of managing business associate agreements (BAAs) • Alternatively, DSI acting as agent of public health may entail legal risks associated with scenario of DSI receiving case reports ultimately determined to be non-reportable. • Also, patient privacy advocates may perceive privacy breaches. • Motion passed on Oct. 5 Digital Bridge governance body meeting: • “The Digital Bridge governance body states that a key design objective for any future eCR approach is to improve the scalability of the eCR solution through modifications to the current DB eCR approach and directs the PMO to immediately begin work to identify possibilities.” • Please note: the initial eCR implementations are underway; this assessment is intended for future implementations FOR DISCUSSION USE ONLY
Preliminary Findings (Stakeholder Input Ongoing) Current eCR Approach Scalability Issue(s) Potential Modification(s) Responses 1. DSI acts as BA of provider (or HIE) • Inherent privacy breach risks DSI acts as agent of public health • Public health agencies may not delegate sending case report associated with role of BA; authority authority to DSI; • Administrative costs of BAAs; • DSI taking on BA’s risks could be “selling point” for eCR; • Administrative costs of BAAs mitigated through trusted exchange frameworks 2. Two levels of case adjudication logic: HIPAA risks associated with DSI distributes both primary and • Primary case adjudication logic (RCTC provider reporting non-reportable secondary case adjudication logic “trigger codes”) based on “reasonable • Primary logic that is nationally consistent and implemented in conditions to DSI (i.e., primary for implementation at EHR, HIE suspicion” of reportable case; case adjudication logic may “over provider’s EHR (i.e., “trigger • At present, not technically feasible to codes”, “RCTC”) report” to DSI) (or) distribute both primary and secondary case • Secondary logic that is adjudication logic to EHRs, HIEs; Provider sends de-identified case jurisdiction-specific and • At present, insufficient resources to re- implemented in DSI (i.e., report to DSI for secondary case engineer DSI for de-identified case reports adjudication, then sends identified “RCKMS”) case report as indicated by adjudication 3. Emphasis on primary case Some potential implementers Case adjudication (primary or At present, not technically feasible to distribute adjudication and case report may be motivated to implement secondary) and case report both primary and secondary case adjudication construction at point of care (i.e., in case adjudication and case construction is implementable in logic to EHRs, HIEs EHR) report construction in an HIE (or EHRs or HIEs (or environments similar) environment accessible to EHRs and HIEs) FOR DISCUSSION USE ONLY – January 2018
Next Steps • Legal and regulatory workgroup • Jan. 10 • Explore “reasonable suspicion” concept associated with primary case adjudication logic • Prepare scalability issue brief in advance of Jan. 24-25 meeting • Jan. 24-25 in-person meeting • Consensus on: • Scalability issues • Paths towards addressing any issues FOR DISCUSSION USE ONLY – January 2018
Preparation | January 2018 In-Person Meeting Charlie Ishikawa FOR DISCUSSION USE ONLY – January 4 th , 2018
Recommend
More recommend
