8 th Meeting Date : March 3, 2011 Time : 4:00 pm – 6:00 pm Location : NC Hospital Association 2400 Weston Parkway

1. 8th Meeting Date: March 3, 2011 Time: 4:00 pm – 6:00 pm Location: NC Hospital Association 2400 Weston Parkway, Cary, NC Dial in: 1-866-922-3257; Participant Code: 654 032 36#

2. Agenda

3. Statewide HIE Infrastructure...Tasks and Timelines Feb – April 2011 Tech Design, Business & Financing Foundation May – June 2011 Prepare for Test Phase July – Oct 2011 Test Phase Oct – Dec 2011 Prepare for Go Live • Tasks • Develop draft HIE requirements • Develop draft procedures for RFP process and evaluator recruitment • Hire RFP consultant • Develop detailed technical specs and draft RFP • Release HIE services RFP • Tasks • Evaluate HIE RFP responses • Collect interface data collection from QOs • Refine first step of value-add roll out • Determine consent management technical approach • Tasks • Select vendor and award HIE services contract • Build core services • Test interfaces for selected value-added services • Develop requirements for additional HIE service RFP (note: a separate may not be needed depending on strategy for initial HIE Service RFP) • Tasks • Complete and accept interfaces for selected value-added services • Work Group Recommendations • Unanimously recommended that the Statewide HIE RFP include the full range of value added services identified in the North Carolina State HIE Operational Plan (Feb 11 meeting) • Unanimously recommended that NC HIE maintain the flexibility to bundle services and sequence implementation in its selection of a vendor for Statewide HIE services (Feb 11 meeting) • Unanimously recommended that NC HIE develop policies and procedures to: develop the statewide HIE RFP; identify and select reviewers; and manage the review and selection process. (Feb 11 meeting)

4. Statewide HIE Infrastructure: Near term Tasks • 1. Build the RFP Requirements (today’s focus) • Hire RFP consultant • Develop an initial draft of statewide HIE requirements • Input from Clinical and Tech Operations Work Group Members • Input from other stakeholders 2. Develop Draft Polices and Procedures for the Procurement Process • Process for selecting evaluators • Selection procedures

5. Statewide HIE RFP Consultant to Assist in RFP Process

6. RFP Consultant: Objective, Expectations, and Timeline • Objective: Identify an organization to assist NC HIE develop a RFP for statewide HIE services • Key Requirements of RFP Consultant: • Develop RFP within required timeframe (initial target was April 4; will need to be pushed back) • Finalize Statewide HIE requirements with NC HIE staff, Work Group, and Manatt • Finalize policies and procedures for the HIE Service RFP • Develop evaluation criteria • Draft and finalize HIE Services RFP • Collect and respond to vendor questions • Manage HIE Service RFP evaluation process; facilitate oral presentations • Prepare final evaluation and selection report • Support NC HIE during vendor selection, negotiations, and bid protests (if needed) • Timeline: • Jan 21........ Release RFP • Feb 11....... Deadline for responses (8 responses received) • Mar 1-11... Conduct negotiations • Mar 14...... Advance recommendation on RFP award to Executive Committee • Mar 17...... Finalize contract • Mar 18...... Introduce consultant to Work Group

7. Statewide HIE RFP Developing Requirements

8. Statewide HIE Requirements: Process and Timelines • 1. Input from Clinical and Technical Operations Work Group • Goal: Leverage Work Group member’s expertise and perspective on anticipated integration with and consumption of statewide HIE services to generate detailed list of requirements • Timeline: • Feb 9... Draft NC HIE Statewide Requirements spreadsheet transmitted to Work Group • Feb 11... Requirements spreadsheet explained and discussed at Work Group meeting • Mar 3... Work Group member’s comments and questions reviewed at Work Group meeting • Mar 11... Deadline for comments and questions from Work Group members • Mar 18... Review of Work Group member comments • 2. Input from Stakeholders • Goal: Expand collection of requirements through a public request for information • Timeline: • Mar 7......... Release request for information • Mar 21........ Proposed deadline for feedback; responses publicly posted • Mar 22-25.. Compile and analyze responses • Mar 28........ Distribute updated Requirements Spreadsheet to RFP consultant • Apr 8........... Review updated Requirements at Work Group Meeting

9. Statewide HIE Requirements: Compilation and Tracking Thorough and Transparent Process • All input/comments will be parsed, catalogued, and addressed • Input/comment spreadsheet will be shared with Work Group

10. Clinical & Tech Operations Work Group Member Input • Input Received To Date • Two Work Group members provided comments • Functional Themes from the Responses • Utilize existing identifiers where possible for facility and provider • Clarify provider matching and cross-referencing features: Link and associate multiple provider identifiers and demographics • Consolidate similar requirements • Clarify patient matching and identification in multiple systems • Clarify that connectivity with existing HIEs will utilize listed integration components • Clarify IHE integration profiles vs HL7 specifications

11. Clinical & Tech Operations Work Group Member Questions • Question 1 : Where is CCD generation? • Answer: CCD generation is covered under the Value Added Services tab under 2.4 CCD/CCR exchange • Question 2: Where is Images / PACS? • Answer: Support for route or linking images is covered under 1.5 of the Value Added Services tab

12. Clinical & Tech Operations Work Group Members: Next Steps • What we need from you by March 11 • Complete review of the requirements • Ask questions • Point out elements that require clarification • Based on your organization’s viewpoint, needs and services, the services and features you want and expect to exist

13. Input from Stakeholders

14. Statewide HIE RFP Policies and Procedures

15. Statewide HIE RFP: Policy and Procedures • Goal: Ensure a thorough, sound, and effective process to collect, respond, review, recommend, select and procure a vendor to provide statewide HIE services. Vendor selection will: • be fully transparent • respond to input from and the needs of all constituents • take into account all available information • be approved by the Board • Types of Policies/Procedures: • Evaluator conflict of interest and non-disclosure documents • Evaluator qualifications, recruitment and selection • Handling of RFP responses • Process for reviewing, rating, prioritizing and selecting statewide HIE vendor • Timeline: • Feb 13-Mar 13... Staff collect information on review process best practices • Mar 16............... Draft Policy and Procedures transmitted to Work Group member • Mar 18............... Draft Policy and Procedures discussed at Work Group meeting • Mar 21-31.......... Policies and Procedures refined with input from RFP consultant • Apr 8.................. Finalized Policies and Procedures advanced to Board • Apr 21................ Board approval of Policies and Procedures

16. Updates on Other HIE Programs Beacon Community Program State HIE Challenge Program

17. Update on Additional HIE Activities Beacon Community Program NC HIE Challenge Program

18. Public Comment

19. Next Steps

20. Next Steps Upcoming Meetings Technical/Clinical Operations – March 18 Board Meeting – March 24 Key Tasks Release Request for Comments Develop 1st draft of policies and procedures Recommend and finalize selection of HIE RFP consultant Finalize 1st draft of HIE requirements Develop plan to support NC Beacon Program

21. Attachments

22. Statewide HIE Components Core HIE Services • Foundational services hosted by NC HIE that facilitate exchange health information across organizational boundaries, such that multiple entities can: • Identify and locate each other in a manner they both trust; • Reconcile the identity of the individual patient to whom the information pertains; • Exchange information in a secure manner Security Services Provider Directory Message / Record Routing / Return Receipt Identity Management and Authentication Transaction Logging Consent Management Terminology Service Transformation Service Patient Matching / RLS NHIN Gateway Value-Added HIE Services • Services that support the clinical priorities and use cases to help providers, patients, and care givers improve the safety, quality, and cost effectiveness of heath care. • Value-added services will be accessible via core services • Value-added Services can be offered at the state, regional, or enterprise level. • Value-Added services will be incrementally deployed based on feasibility, cost, and magnitude of benefits CCD Exchange Lab Results Delivery Lab Normalization Lab routing for reporting Quality Reporting Immuniz Access Rad Results Delivery Med Hx Rad Image Delivery Procedure Results Delivery Disease Surveillance CCD Translation Access to Aggregated Data Clinical Decision Support Phase 1 Value Added Services proposed in Operational Plan Phase 2 Value-Added Services proposed in Operational Plan Final decision regarding phased implementation will be informed by forthcoming statewide HIE RFP

23. Technical Relationships: Core HIE Services, QOs, & QO Participants Key Points: • Core services provide a foundation for identifying QOs, ensuring security, and providing a gateway to other QOs and additional HIE services • QOs link to core services by conformance to interoperability specifications • QOs provide a gateway to core services for their participants NC HIE Security Services Provider Directory Message / Record Routing / Return Receipt Identity Management and Authentication Transaction Logging Consent Management Terminology Service Transformation Service Patient Matching / RLS NHIN Gateway Example QOs... Physicians (IPA, PHO, PO) Regional HIO Large Hospital System Example QO Participants... Physician Practice Hospital Physician Practice Physician Practice

24. Technical Relationships: Value-added Services, QOs, & QO Participants Key Points: • Value-added Services are available to network participants and can be hosted by different entities. For example: • NC HIE could host a CCD Exchange service • The Dept of Health could host an Immunization Access service • A QO could host a CCD Translation service • Based on considerations of efficiency and practicality, the NC HIE Tech/Clinical Ops Work Group continues to evaluate the ideal location for Value-added Services Physician Practice Physician Practice Large Hospital System NC Immunization Registry 3. CCD Translation 2. Immuniz Access NC HIE Security Services Provider Directory Message / Record Routing / Return Receipt Identity Management and Authentication Transaction Logging 1. CCD Exchange Consent Management Terminology Service Transformation Service Patient Matching / RLS NHIN Gateway Physicians (IPA, PHO, PO) Regional HIO Large Hospital System Physician Practice Hospital Physician Practice Physician Practice