Provider Directory Advisory Group August 2015 Agenda Welcome, - PowerPoint PPT Presentation

Provider Directory Advisory Group August 2015

Agenda • Welcome, introductions, and agenda review • Review procurement timeline • Review ranking of uses across groups • Rank justification exercise (HIE and Delivery only) • Review materials and homework instructions • Questions 2

HIT Portfolio Milestone Timeline Special Procurement Notice posted on ORPIN CC PD PD QA vendor vendor selected implementation implementation CC onboard complete* complete* vendor selected 2015 2017 Q3 Q 4 Q 1 Q 2 Q 3 Q 1 Q2 Q 4 10 /1/2015 1/1/2016 4/1/2016 7/1/2016 10 /1 /2016 1/1/2017 4/1/2017 Prime contractor CQMR CQMR starts implementation vendor selected Complete use cases complete* and requirements The provider directory (PD) is part of a package of Health IT (HIT) services procured under a contract amendment that extends prime services. Other HIT services include Common Credentialing (CC) and the Clinical Quality Metrics Registry (CQMR) *Tentative until a Prime Contractor has been brought onboard, implementation dates will be formalized as individual solutions are contracted for. 3

Ranking across groups calculation Ranking Weight 0 0 X 0.55 1 1 Weight scores 2 0.9 from groups 3 0.8 were added across uses to 4 0.7 develop totals 5 0.6 6 0.5 Note : while we attempted to score and rank across groups, there were inconsistencies in how the groups ranked items. This should only be used as a guide . 4

Ranking across all groups Class 1 (rating 2 Class 2 (rating 1 Class 3 (rating < Core or higher) or higher) 1) • 1: Integrate CC • 14: Contact info/ • 6: HIE address • 19: Performance data Care search analytics Coordination • 2: Integrate HPD • 21: System of • 13: Outcomes directories • 15: Local query record and intervention contact info (add/edit/delete) • 3: Integrate State • 24: Analytics Data • 16: federated • 11: Source of extract contact info payer info • 4- Integrate HIE • 18: Practice flat files • 8: PD Validation • 20: Network location analytics adequacy • 22/23: Report • 12: Privileging inaccurate data • 17: In network info search • 7: HIE for MU • 5: GIS • 10: Medicaid EHR audit • 9: Accepting new patients • 25: Integrate authoritative sources 5

Rank Justification exercises – HIE and Delivery HIE Delivery • 2 - Referrals/care • Network Adequacy coordination (Use 14) (Use 20) • 4 –Local query contact info (Use 15) • 4- federated contact info (Use 16) • 5 - Meet HIE requirements for meaningful use (Use 7) 6

HIE: Top ranked uses Rank Use Use # Class 1 HIE address search 6 2 2 Contact Info/Care Coordination 14 1 (find providers) 3 - Outcomes and intervention, X 3 Performance measure analytics 4 Local query contact info 15 1 Federated contact info 16 1 5 Meet HIE requirements for 7 3 meaningful use 7

Analytics: top ranked uses Rank Use Use # Class 1 Analytics extract 24 3 3 Performance analytics 19 3 Outcomes and 13 intervention Practice location analytics 18 4 Source for payer info 11 2 5 Source for privileging info 12 3 State sources of data and integrating HIE flat file sources were also top ranked but are now considered core uses 8

Plans: Top ranked uses Rank Use Use # Class 1 Validate Source 8 1 2 Local query contact info 15 1 3 System of record 21 2 (add/edit/delete) 4 Network adequacy 20 2 5 Contact info/care coordination 14 1 6 Federated contact info 16 1 9

Delivery: Top ranked uses Rank Use Use # Class 1 Validate Source 8 1 Contact info/care coordination 14 Local query contact info 15 Federated contact info 16 1 In network search 17 2 System of record (add/edit/delete) 21 2 HIE Address search 6 2 3 Source for payer info 11 2 4 Network adequacy 20 2 State sources of data and integrating HIE flat file sources were also top ranked but are now considered core uses 10

PDAG assignments • Uses (“what use cases”) wording review • Classification of data elements for: – Inclusion in the provider directory – Degree of accuracy • Ranking of state data sources • Plans and Delivery – review Provider Directory standards and requirements matrix 11

Uses wording review The purpose of this exercise is to check our understanding of the uses. Each use that was numerically ranked needs to be reviewed and are listed on separate tabs in your Excel workbook. The following needs to be reviewed for each use: 1. Does the use case wording make sense? 2. Is the depiction of the likely users associated with the use accurate? 3. Do the preconditions (assumptions, precursor uses, and affiliated uses) make sense? 4. Do the expected results make sense? 5. The total score is based on a scale from 0-4 and represents the calculated ranking across all PDAG groups. Your thoughts? 12

Uses wording exercise sample 13

Data Elements Classification • The purpose of this exercise is to understand which data elements are essential to be in the provider directory as well as the degree of accuracy for those elements. • Data elements on this sheet were taken primarily from the IHE-HPD Provider Directory standard and fields from the Oregon Common Credentialing application • Elements that come from Common Credentialing and HPD provider directories are marked with an “x” in the table • Elements that are primary source verified (PSV) are also identified • Data elements that are not in either source are also listed • Answers to the following is needed (based on your perspective and uses of the provider directory): – Which elements need to be included in the provider directory (rank as must have, nice to have, not needed)? – What is the level of accuracy needed for the data element (rank as high, medium, and low)? 14

Data elements exercise sample 15

State Source Ranking • The purpose of this exercise is to understand the use of state data and prioritization of the data sources. • State sources listed are ones that have been identified by stakeholders. • The following is needed for each of the 10 sources: – What data do you expect/need to get from this source – What is it going to be used for? – Rank each source – from 1-10 16

State data source exercise sample 17

Provider directory regulations (plans and delivery) • The purpose of this exercise is to obtain PDAG’s identification of various provider directory regulations and standards that we (OHA) will research and analyze. • We are trying to understand the various standards that the provider directory will need to meet in order for the provider directory to be a trusted source of information. • This list was developed from common credentialing regulatory and accrediting bodies, with a few additions for provider directory. • The following is needed: – Review regulatory and accrediting bodies that are listed. Do any need to be added? Do any need to be removed? Are any questionable? – Review Provider directory processes/data. Do these make sense? Are there any that need to be added? – Any other comments 18

Provider directory regulations exercise sample 19

Next steps Please have workbooks to Karen by September 9 th • • If you need any help, please reach out to us • We will be following up with groups and scheduling check-ins if needed • Next month, CA-HIE demo! October meeting – shift to October 21 st ? • 20