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 – March 7th, 2019
Governance Body Meeting Thursday, March 7 th , 2019 12:00 P.M.– 1:00 P.M. ET This meeting will be recorded for note-taking purposes only 2 FOR DISCUSSION USE ONLY – March 7th, 2019
3 FOR DISCUSSION USE ONLY – March 7th, 2019
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 health care and public health. 12:03 PM Agenda review and approval – John Lumpkin 12:05 PM Consent agenda – John Lumpkin Consent Agenda • Workgroup updates 12:10 PM Risk log • Expansion of Pilot Conditions – Hepatitis C • eCR Implementation progress – Laura Conn • Jan 2019 in-person mtg: Executive meeting summary and suggested action items 12:25 PM Action – John Lumpkin • Risk Log eCR Transition – Bob Harmon / Michael Iademardo • Implementation progress update 12:40 PM Discussions – John Lumpkin • Transition management • Proposed Legal Frameworks for eCR services – John Loonsk For Action 12:55 PM Announcements – Charlie Ishikawa • eCR Transition Recommendations For Discussion 1:00 PM Adjournment – John Lumpkin • Proposed Legal Frameworks for eCR services 4 FOR DISCUSSION USE ONLY – March 7th, 2019
Consent Agenda | March 2019 John Lumpkin (Chair) FOR DISCUSSION USE ONLY – March 7th, 2019
Governance Meeting Consent Agenda Protocol March 2019 Consent Agenda Items 1. Pre-meeting: 1. Workgroup updates a. eCR Implementation Workgroup a. Chair places items that are believed to be b. Evaluation Committee non-controversial or routine c. Pilot Participation Workgroup b. Items should be received with sufficient review time d. Transition Workgroup e. Legal, Policy, and Regulatory Workgroup 2. Start of meeting: 2. Expansion of Pilot Conditions – Hepatitis C a. Chair asks if any member wishes to move an 3. In-person Meeting Executive Summary and item into regular discussion Suggested Actions b. All items left on the consent agenda are documented as approved by governance body c. Any item removed will be discussed during the meeting 6 FOR DISCUSSION USE ONLY – March 7th, 2019
Risk Log: eCR Implementation and Transition Progress Laura Conn and Kirsten Hagemann (eCR Implementation Taskforce Co-Chairs), Rob Brown and Jim Jellison (Digital Bridge PMO) FOR DISCUSSION USE ONLY – March 7th, 2019
Update: eCR Implementation Workgroup • Implementation Activities Hepatitis C • The Houston site went live on November 14, 2018 • The latest RCTC contains trigger codes to support • Hepatitis C Currently in parallel production • The Utah site went live on December 20, 2018 • All demonstration sites have the opportunity to add • Currently in parallel production on as a sixth condition • Remaining implementation sites will be participating in • RCKMS has been updated to accommodate this RCKMS training activities & authoring jurisdictional rules condition • AIMS connectivity and test planning activities are occurring with the New York site • IFH/ New York City & New York State Up Next • Digital Bridge Technical Specifications will be updated as new RKCMS authoring process is defined • California, Michigan, Kansas are actively working on their vendor/ provider development activities 8 Consent Agenda | Digital Bridge Governance Meeting | For Discussion Only FOR DISCUSSION USE ONLY – March 7, 2019
Digital Bridge eCR Implementation Timeline Estimate- 2019 DRAFT Jan 2019 Feb 2019 Mar 2019 Apr 2019 May 2019 June 2019 July 2019 Aug 2019 Sept 2019 Oct 2019 Nov 2019 Dec 2019 Michigan Site Michigan Site Production Connectivity/Onboarding/Testing California Site California Site Connectivity/Onboarding/Testing Production Kansas Site Potential Interested Implementation Sites: Kansas Site Connectivity/Onboarding/Testing Allscripts • Production Delaware • Health & Hospitals • New York City Site New York City Site Illinois • Connectivity/Onboarding/Testing Production Iowa • Kentucky • Anticipate discussion of Maryland • New York State New York State - PHA MDLand • how eCR onboarding will Connectivity/Onboardi Production Minnesota • ng/Testing be opened up as part of North Carolina • North Dakota • eCR transition Ohio • Pennsylvania • South Dakota • Tennessee • Note: Massachusetts site currently searching for provider to participate Wisconsin • Houston in production – 11/14/18 Utah in production 12/20/18 9 Today FOR DISCUSSION USE ONLY – March 7 , 2019
All Site Progress Summary Activities MI UT CA KS NYC MA NYS HOU Site Development Activities Onboarding End to End Testing Legal Readiness Completed In Progress Not Started 10 Not Currently Applicable FOR DISCUSSION USE ONLY – March 7 , 2019
Brief Update – Jim Jellison ECR TRANSITION MANAGEMENT 11 FOR DISCUSSION USE ONLY – March 7th, 2019
Action: eCR Transition Recommendations John Lumpkin (Chair) FOR DISCUSSION USE ONLY – March 7th, 2019
eCR Transition Recommendations Question charged to answer Organization Name Designation Representing • “Beyond demonstrating and evaluating eCR, what will Digital Bridge do for general eCR John Lumpkin – primary RWJF Member Sponsor Hilary Heishman – alternate adoption and to assure eCR sustainability?” Michael Iademarco - Co-chair CDC Bill Mac Kenzie – primary Member Sponsor Purpose Laura Conn – alternate • Share the workgroup's initial ideas with the Bob Harmon – Co-chair Cerner/Epic Member Vendors governance body and receive feedback to James Doyle – alternate finalize recommendations for endorsement and Kaiser Walter Suarez – primary implementation. Permanente Member Healthcare delivery Richard Paskach–alternate HealthPartners Mary Ann Cooney – primary ASTHO Member Public health Governance Action Schedule Mylynn Tufte – alternate 1. Preliminary posted on 1/7 Scott Becker – primary eCR operators and APHL Member Patina Zarcone – alternate public health 2. Discuss, modify and adopt by 1/23 – 1/24 Kathy Tuner – primary 3. Revised during Feb eCR operator and CSTE Jeff Engel – alternate Member public health 4. Penultimate delivered on 3/6 Meredith Lichtenstein – tertiary Vivian Singletary – primary PHII/Deloitte Andy Wiesenthal – alternate Observer PMO (PMO) John Stinn–alternate 13 FOR DISCUSSION USE ONLY – March 7th, 2019
Penultimate Report Change summary 1. Incorporates decisions made during the January in-person meeting 2. Adds ideas developed in breakout sessions (e.g., governance "lite" for scale-up) 3. Eliminates redundant and unnecessary discussions 4. Reduces over all page count 5. Focuses the Executive summary to one- page 14 FOR DISCUSSION USE ONLY – March 7th, 2019
Scale-up eCR Governance Group Relationship Purview Digital Bridge Independent Issues with broad, Digital Gov. Body nationwide or strategic Bridge Governance impact; legal, Body architecture, standards eCR Operations CDC Partner eCR knowledge products (trigger codes and logic), on-boarding guidance, operational Scale-up Governance priority setting eCR CoP CDC Partner Advance eCR adoption eCR eCR and use, contribute Community Operations of Practice Group expertise and perspective to 15 FOR DISCUSSION USE ONLY – March 7th, 2019
Discussion: Proposed Legal Frameworks for eCR services John Loonsk, MD FACMI, Consultant to APHL FOR DISCUSSION USE ONLY – March 7th, 2019
eCR and Health Data Networks John W. Loonsk MD FACMI, Consultant to APHL FOR DISCUSSION USE ONLY – March 7th, 2019
eCR and Health Data Networks • The current electronic case reporting (eCR) architecture: • Helps to eliminate jurisdictional and program variability for clinical care organizations and EHR vendors doing eCR • Has raised some questions about technical and trust / legal scaling and interoperability • Health Data Networks (HDNs) offer the opportunity to address both scaling and interoperability issues and make eCR services broadly and readily accessible • APHL and others have engaged leading HDNs to discuss opportunities for eCR • As in the context of TEFCA, the plan is to eventually have eCR services available on all connected HDNs as a shared service 18 FOR DISCUSSION USE ONLY – March 7th, 2019
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