ONC HIT Policy Committee Interoperability and HIE Workgroup

1. ONC HIT Policy Committee Interoperability and HIE Workgroup Panel 3: State/Federal Perspectives August 22, 2014 Jennifer Fritz, MPH Deputy Director Office of Health Information Technology Minnesota Department of Health

2. MN Health Information Exchange Oversight Law • Minnesota Statute 62J.498 – 62J.4982 • Purpose: Provides a Governance Framework to ensure that a patients electronic information follows them across the full continuum of care; To prevent fragmentation, encourage collaboration between market partners, while ensuring the use of HIE national standards so that data integrity is maintained and that information is shared in a safe, secure manner. • Currently, Minnesota has 1 State-Certified HIO and 6 State-Certified HDIs

3. Minnesota HIE Oversight Requirements • HIOs required to obtain full EHNAC HIE accreditation • Both HIOs and HDIs – Not required (but all have agreed to participate so far): • Direct Trust member/participation/EHNAC accreditation for HISPs • MN Statewide Shared HIE Services • Look up a direct address • Record opt-out of record locator services • Standards for query across record locator services • Monitor through quarterly reports and annual re-certification requirements 3

4. Acknowledgement of Types of HIE Mechanisms in Minnesota* • Robust Requirements in HIE Oversight Law • Non Profit • State Shared Services Architect • Push/Pull/Query but may not be using National HIE Standard Protocols • Interstate consent needed • HealtheWay- developing Nationwide connectivity • Included in Oversight Law • Direct/Push/Pull • HIE protocols may be proprietary • May be a HISP and/or provide HISP to HISP connectivity • HIE between affiliated providers • Common EHR or information system • May or may not be using National HIE Standard Protocols • Connects Provider A to Provider B • Uses Push/Pull/Query but may not be using National HIE Standard Protocols • No Standard Trust Agreement • Difficult to Scale • EHR may act as HISP- push only • EHR may use another HIE Service Provider for HISP services- push and pull Currently defined in HIE Oversight Law * December 9, 2013

5. Example Definitions / Consensus Needed – Governance + • Common definition, components, and minimum standards for a strong governance structure from different perspectives/roles (e.g., provider, consumer, intermediary) • Commoncore sets of HIE services and standards that support health care reform • Standards for interoperability across services • Accreditations/certifications – minimum / recommended • Framework/mechanisms for interoperability across entities providing HIE services and for providers/payers seeking to participate in HIE • Consent management/ granular consent / tracking consent / auditing • Clinical data query • Data aggregation Models • Terminology Mapping • Message Conversion • Case/Care and Population Management • Data Access Models • Provider authentication • HIE user directories • Patient matching • Record access logging

6. Questions? • Jennifer Fritz • Jennifer.Fritz@state.mn.us http://www.health.state.mn.us/e-health