Health Information Technology Oversight Council February 2 nd , 2017 - PowerPoint PPT Presentation

Health Information Technology Oversight Council February 2 nd , 2017

Agenda Welcome, Introductions & HITOC Business Oregon Health Policy Board Update Governance/ Network of Networks Models from Other States: Review and Learnings – Oregon Network of Network straw models OHIT Programs and Work in Progress Update • HIT Commons/ Governance • HIE Onboarding Program Oregon HIT Program Updates 2

Goals of HIT-Optimized Health Care 1. Sharing Patient 2. Using Aggregated 3. Patient Access to Information Across Data for System Their Own Health the Care Team Improvement Information • Providers have access to • Systems (health systems, • Individuals and their meaningful, timely, CCOs, health plans) families access their relevant and actionable effectively and efficiently clinical information and patient information to collect and use use it as a tool to improve coordinate and deliver aggregated clinical data their health and engage “whole person” care. for quality improvement, with their providers. population management and incentivizing health and prevention. • In turn, policymakers use aggregated data and metrics to provide transparency into the health and quality of care in the state, and to inform policy development. 3

Oregon Health Policy Board Update Susan Otter, Director of HIT Karen Joplin, OHPB member liaison to HITOC

Oregon Health Policy Board Update • January Retreat – focus on refresh of Action Plan for Health – HITOC 2016 2-page report – Matrix of Key Actions, Priorities, 2017-19 plans, OHPB opportunities – Opportunities for OHPB related to HIT work: • Endorse Strategic Plan • Endorse Governance Concept • Ensure alignment between HIT efforts and – Behavioral health, – Payment model, – Metrics alignment work • February meeting – wrap up Action Plan for Health 5

Governance/ Network of Networks Models from Other States: Review and Learnings Rim Cothren, HealthTech Solutions OHA Consultant

Colorado / CORHIO and QHN • Example of a Robust HIE model – Few HIEs, near complete state coverage • There are currently no statewide infrastructure services – HIEs exchange a great deal of data, driven by customer needs – Data is routed as part of HIE function rather than state service – Statewide MPI, PD proposed/funded; receive little provider support • Good cooperation between HIEs – Jointly decide on projects to cooperate on, grants to apply for • State created Office of eHealth Innovation (OeHI) as SDE – Staffed by Governor's office, includes HIT Coordinator, payers, state offices, HIEs – No budget, acts as advisor on priorities – Focus of future federal grants 7

Washington / OneHealthPort • Extreme example of Robust HIE model with only 1+ HIE • No state services outside of OneHealthPort – HIE is for-profit organization designated by state as the state HIE • Priorities for new services set by customer needs – OneHealthPort operated as line of business – Medicaid is largest customer • State role in governance is simply as (large) customer – State designated OneHealthPort as single designated HIE • Governance based on oversight board – Provides oversight on pricing (review and approval w/15% profit cap), privacy & security, information access policy – Not making operational decisions – HCA has 4 of 7 seats on board 8

California / 15+ HIEs • Example of a Robust HIE model – Many HIEs, significant white space • Initial plan for statewide services have been discontinued – No state involvement in HIE at state or regional level – HIEs, provider orgs see little value in statewide services; rely on HIE services or national initiatives – Voluntary governance through consensus data sharing policies • Good cooperation, sharing of best practices among HIEs • No State Designated Entity; state only eligible applicant for most federal funding – No state HIT Coordinator 9

Texas / THSA and 7 HIEs • Example of Robust Statewide Services model – Several HIEs, significant white space – Services facilitate inter-HIE exchange via query-based and directed exchange – Gateway services to federal agencies – Regional HIEs responsible for last mile data delivery, longitudinal community records, etc. • Governance through public-private partnership – Established THSA as non-profit through legislation • State is significant source of ongoing funding – Public funds allocated through legislation – Additional funds through participant fees, accreditation and certification programs 10

Michigan / MiHIN and 7 HIEs • Example of Robust Statewide Services model – Several HIEs, some white space – Includes ADTs, registries, medication reconciliation, advance directives, care plans, immunization forecasts, SSO, lab orders/results, patient attribution, provider directory, notifications – Gateway services to state/federal agencies, national initiatives – Regional HIEs responsible for last mile data delivery, longitudinal community records, etc. • Robust governance model – Includes robust model for new services, assessing maturity – Participants play advisory role in operations • State participates in governance – Commission advises on priorities – Very active in operational committees 11

Spectrum of Examples Robust HIEs Robust Services Washington Colorado California Texas Michigan Number of HIEs Complexity of Services Governance Structure 12

Comparison – Governance Robust HIEs Robust Services Washington Colorado California Texas Michigan • HIE operated as • HIEs govern their • HIEs govern their • Governed by • Priorities set by a business own operation own operation public private Board partnership with • High level of • Good • Operations stakeholder input cooperation cooperation advised by between HIEs among HIEs • Legal & technical committees of frameworks participants • Consensus on important data sharing • Little inter-HIE policies • Certifies and cooperation accredits participants State Involvement • Largest customer • Commission • Not involved in • Govern • Commission provides advice governance statewide provides advice • On oversight on priorities services through on priorities board, no public private operational • Active in partnership responsibility operational committees 13

Comparison – Infrastructure Services Robust HIEs Robust Services Washington Colorado California Texas Michigan • All provided by • No state services • Discontinued PD • Services limited • Many statewide designated HIE and other state to those that services • New commission services enable exchange • Singe state- as SDE planning • Includes among HIEs designated HIE MPI and PD • HIEs see little gateways to provides all value in • Gateway to state, federal • Little HIE or services statewide federal agencies agencies provider support services beyond • New services • Based on • Robust model for convening, added as national network service maturity advocacy sustainable technologies • Robust process business to sponsor, fund, decisions develop new services State Involvement • State designated • Proposing MPI, • Not involved in • Provides • User of many single statewide PD funding/using governance services HIE services through public private partnership 14

Comparison – Funding Robust HIEs Robust Services Washington Colorado California Texas Michigan • All new services • All current • All statewide • Supported • No direct state funded by for- activities self- activities funded through public support profit HIE funded by HIEs by member HIEs funds and • Activities funded participant fees • New services • New state • State only through member added only if designated entity authorized • Income from use fees found business will be future recipient of certification, • Active in federal decision recipient of federal funding accreditation grants, pilots federal funding, • Some individual operationalizing HIEs active in services through grant funding contracts to HIEs • Individual HIEs active in grant funding State Involvement • None directly – • Funding MPI, PD • None • Partially funded • Sponsor of many (state is through new services customer for legislation public health and funding Medicaid specific clinical registry) 15

Trends • Inter-HIE cooperation important in Robust HIE models • State involvement in governance and funding generally low in Robust HIE models • Robust Statewide Service models have greater state involvement • Funding responsibilities for statewide services vary 16

Support for Statewide Infrastructure • Colorado and California HIEs perceive little value in statewide infrastructure services – Providers in Colorado not supporting new development – California now abandoning all statewide services • Washington embraced designated statewide HIE – Not the same as statewide infrastructure; both infrastructure and exchange services • Texas and Michigan embracing services that support regional HIEs – Texas concentrating on inter-HIE exchange – Michigan adding other enabling services 17

Network of Networks Straw Models for Oregon Sean Carey Policy Analyst

• State partnership model with governance over “network of networks” 19