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Review of Alabama HIE Operational Plan. 06/24/2010 at 08:30 AM Central Time Link: https://alabamamedicaid1.ilinc.com/join/fjcvbzm/pykxmfc     Primary Dial-In: 1-800-915-8704     Passcode: *1273929*. Agenda. Update on RFP Process – Gary Parker

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review of alabama hie operational plan

Review of Alabama HIE Operational Plan

06/24/2010 at 08:30 AM Central Time

Link: https://alabamamedicaid1.ilinc.com/join/fjcvbzm/pykxmfc    Primary Dial-In: 1-800-915-8704    Passcode: *1273929*

agenda
Agenda
  • Update on RFP Process – Gary Parker
  • Review of Operation Plan Key Points – Patricia MacTaggart
  • Review Master Issue List - KBDA
  • Review of Project Plan within the Op Plan – Richard Jensen
  • Next Step – Review of Document by Work Groups and then Submission to Full Commission
environmental scan consent
Environmental Scan: Consent

Potential Issue: potential need for focus

effort related to e-consent implications

scan percentage of physicians who qualify for medicaid adoptive incentive
Scan: Percentage of Physicians Who Qualify for Medicaid Adoptive Incentive
  • Potential Issues:
  • Small number of respondents
  • Small % of family practitioners eligible for incentives
scan percentage of practice specialties that qualify for medicaid adoptive incentive
Scan: Percentage of Practice Specialties that Qualify for Medicaid Adoptive Incentive

Potential Issue: How can FQHC numbers be so low?

rec readiness assessment of providers additional information
REC Readiness Assessment of Providers:Additional Information
  • The assessment is scheduled to be released by the end of July 2010.
  • The assessment will determine provider interest in obtaining REC services as well as gather information about existing HIE services including EMR and EHR usage. 
  • The information will serve as an enrollment process for providers. 
  • The assessment will be distributed to all providers and will be used to help identify priority primary care providers.
timeline for critical implementation milestone action steps fy10
Timeline for CriticalImplementation Milestone Action StepsFY10

6/15/10

07/10

8/1/10

9/1/10

9/30/10

HIT

Coordinator

In Place

HIT

Staffing

in

Place

Exchange Participation Operating

Rules

(DURSA/QSO)

Draft Leg. to

Establish

Board

including appointment

process

Operating

Policies &

Procedures

Enforcement

Authority

Fed. Law

Comparison

interim statewide hie advisory commission
Interim Statewide HIE Advisory Commission
  • Until authority for a permanent governance structure is in place, the Advisory Commission will continue to operate, along with its workgroups as it has through the Strategic and Operational Planning and implementation phases with the Medicaid Agency providing ongoing staff support to the Advisory Commission.
  • The Advisory Commission will create an initial set of exchange rules that are expected to mirror the rules for connecting with the statewide exchange. Many of the rules are being decided by the CMS certification requirements and/or existing regulations (e.g., HIPAA).
  • Additional rules, including the upfront licensing including who has to be licensed, of entities exchanging health information, will be promulgated through the administrative rule making process.
  • It was decided that it was not necessary to incur additional expenses to have a regulatory board at this juncture for an industry that is very limited and as the industry potentially grows many of the rules and regulations will be governed at the national level and easily adaptable
legislation for ahie operating commission will address
Legislation for AHIE Operating Commission will Address
  • Commission Membership
    • Membership of commission and how members are selected
    • Clarify that selection of members is an open process and consumer are included.
    • Duties/responsibilities of a commission member
  • Reporting Requirements for the HIT Office will be delineated. The HIT Office will be required to provide a formal report at each commission meeting that a minimum will include the following regarding each of the units within the office:
    • Project status
    • Budget/financing
    • Progress on operational plan
  • Explanation of how Operational Commission and HIT Office will oversee HIO in the state.
  • Enforcement Agency – Specify the state agency that will be the Enforcement Agency for the HIE.
longer term ahie operating commission
Longer Term AHIE Operating Commission
  • In the long term, transition to the Operating Commission, which will be a public-private membership as a 501(c)(3) non-profit organization or other formal type of government governing board, will occur when deemed necessary by factors such as, but not limited to, when HIE is funded by less than a pre-determined amount of public funds, and/or when the product and process is stabilized, or when necessary to mitigate risks to the federal and/or state government. If the model becomes a 501(c)(3), authority will be designed that assures compliance with all federal and state laws and assuring Medicaid retains a leadership role.
  • The State HIT Coordinator and staff, as state employees, will administratively report to the Governor but will functionally report directly to the Operating Commission.
timeline for technical infrastructure action steps
Timeline for Technical InfrastructureAction Steps

6/10

07/10

8/10

9/10

3/11

HIE System Features & Design Finalized

HIE ITB/RFP Released

HIE Bids Due

Beta Sites Identified and Contracted

HIE Evaluations Complete

HIE Contract Review Committee

HIE Contract Begins

HIE Operational Level One (RLS, MPI, Provider Index, Messaging)

slide18
Gateway

Birmingham

AHIE Stakeholders Communicating via the NHINArchitecture

Gateway

Auburn

Medicaid

Gateway

  • AL-HIE Stakeholders
  • Primary Provider
  • Pharmacy
  • EMT
  • Hospital/Clinic
  • Health Organization/Center
  • Payor
  • Wellness Community
  • Personal Health Records

Gateway

Stakeholder

Mobile

slide19
Authorization

Consumer

Preferences

Document

Query &

Retrieval

Data

Transform

Service

Discovery

Message

Platform

Adaptor

Web

Service

Subject

Identity

Audit

Log

Master

Subject

Index

Data

Store

NHIN

Service

Registry

NHIN

Gateway

Alabama

As

NHIOs

Enterprise Service Bus

Other NHIOs

Authorization

Engine

slide20
CMS FED

TN Medicaid

Gateway

Gateway

Gateway

Birmingham

GA Medicaid

Gateway

Gateway

Auburn

Medicaid

Gateway

Gateway

MS Medicaid

Gateway

Mobile

AL–HIE Stakeholders Exchanging Health Information viaNHIN Gateways to the NHIN

slide21
AL-HIE Leveraging the NHINImproved Health Care Value Through eHealth Collaboration

CMS FED

TN Medicaid

LHIO

Driven by

Local Needs

GA Medicaid

Birmingham

Standard Interface &

Technology

Auburn

MS

Medicaid

AL Medicaid

NHIN

Community

NHIN Enterprise Reference Architecture

Kevin Puscas

Mobile

slide22
Policy Framework for NHIN “Chain of Trust”

Gateway Shared

Services

Access Consent Policies

Authorization Framework

Document Query

Retrieve Documents

Health Event Messaging

Messaging Platform

Patient Discovery

Web services Registry

Etc.

Community

HIE(s)

State-level HIE

Domain-specific or

Non-geographic HIE

PublicHealth

IDN

FQHC

Affinity-grouped

Providers

Medicaid or State Health Plan

National Health Plans

IDN

State-Level

DURSA

IOA

DURSA

22

business and technical operations
Business and Technical Operations
  • Success Factors/Metrics:
    • Achieve a 20% response rate on the annual after first year environmental scan of physicians and 40% rate on hospital scan.
    • Alabama’s HIE passes pilot testing with minimal problems and is ready for utilization by all providers by March 2011.
    • 25% of providers register with the AHIE before Sept. 2011.
    • 20% of all providers achieve meaningful use by Sept. 2011, notwithstanding any major vendor issues.
    • 40% of all providers achieve meaningful use by Sept. 2012, notwithstanding any major vendor issues.
legal and policy process legal research team lrt
Legal and Policy ProcessLegal Research Team (LRT)
  • LRT to aid in the process of sourcing and analyzing legal information related to privacy and security, interoperability, Medicare and Medicaid, and the development of relevant policies and procedures.
  • LRT will identify and determine whether the laws or standards conflict with one another, conflict with federal law or regulations or hinder the mission of Alabama’s HIE.
  • LRT tasked with gaining an understanding of other state policies regarding HIE, including conducting a survey of Alabama’s border states (FL, GA, MS and TN) to determine where common ground exists and to identify where Alabama policy changes may need to be pursued.
  • Existing Legal and Policy Workgroup continues to function as an advisory body.

Potential Issue: Staffing all the work

legal and policy current state assessment
Legal and Policy: Current State Assessment
  • Potential Issues:
  • Detail work is tremendous
  • Timeline is demanding
  • Staffing to support
policy and procedure development
Policy and Procedure Development

Key Point:Identified issues but actual work is significant

finance year 1 budget
Finance: Year 1 Budget

Key Points: Retaining original budget for now – will update later -- Added Medicaid (federal/state)

finance year 2 budget
Finance: Year 2 Budget

Key Points: Retaining original budget for now – will update later -- Added Medicaid (federal/state)

finance year 4 budget
Finance: Year 4 Budget

Key Points: Retaining original budget for now – will update later --- Added Medicaid (federal/state)

communication marketing plan core messaging
Audiences

Hospitals

Physicians

Laboratory/X-ray

Pharmacy/

Ancillary Services

Other Providers

Rural Health Clinics

Patients/Consumers

Payers

Purchasers

State Agencies

Health Professional Schools

General Public

Government

Timeline

Year 1 (through 9/30/10) – Preparation for HIE Implementation

Year 2 (FY11) – Implementation

Year 3 (FY12) – Adoption and Use

Year 4 (FY13) – Transition to Long-Term Sustainability

Communication/Marketing Plan Core Messaging
  • Success Factors/Metrics
  • HIE Commission partners committed to project success
  • Clearly articulated benefits, ROI
  • Consistent, clear and honest communications about issues that directly impact consumers (Transparency, privacy and security of data)
  • Stakeholder/Target Audience understanding /acceptance of role in HIE adoption
  • Meaningful, real opportunities for all target audiences to contribute ideas
core messages
Core Messages

One Health Record means that a basic set of health information on a patient will be available, safe and secure, when and where it is needed to provide quality care for that patient.

The needs of patients/consumers are at the center of Alabama’s HIE. OHR will lead to improved information sharing and communication between providers and patients and help create a “medical neighborhood” for each patient.

The availability of health information via AHIE will empower consumers to understand & access personalized health information in order to better manage

Alabama’s HIE is being developed as an independent, transparent, secure, evidence-based system by Alabamians. Federally-funded, state-run Regional Extension Center is available to assist in HIE adoption / meaningful use by providers.

The secure exchange of health care data is an essential part of a reformed health care system, providing information to reduce duplication, increase efficiency, improve patient health outcomes, prevent fraud/abuse, and lower health care costs.

core messages40
Core Messages

Availability of health data through Alabama’s HIE will improve public health services by making it possible to monitor – and potentially prevent – public health emergencies by timely reporting of information about illness outbreaks; and by providing information about prevalence of chronic illness so disease interventions can be more effective.

HIE will make it possible for vital health information to be securely shared with health care providers during times of public emergency. (e.g. hurricanes)

Adoption and use of HIE in Alabama will provide information and resources to expand health care services to rural and underserved populations.

Alabama has been on leading edge – we have the foundation for success due to Medicaid’s Together for Quality project; lessons learned from that initiative will enable state to build on successes, to “get it right.”

The HIE system in Alabama is designed to be a long-term, self-sustaining entity that will not increase the cost of health care, but instead support better care at a lower cost.

Unprecedented opportunity for funding to do something substantive to get better health care at a lower cost; to move past the “silos” to create a system that provides doctors and patients with better information.

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