Updating the Vermont Health Information Plan (VHITP) Advisors Group - June 19, 2008

1. VERMONT INFORMATION TECHNOLOGY LEADERS Updating the Vermont Health Information Plan (VHITP)Advisors Group - June 19, 2008 Paul Forlenza pforlenza@vitl.net

2. Agenda • Review original process to develop VHITP • Review VHITP • Discuss legislative requirements for update • Decide what to update • Process for updating • Next steps

3. Process • Legislature directed development of VHITP • Advisors met for 10 months to review text developed by HLN based on advisors’ guidance • Consensus document • Controversy around applicability of national interoperability standards • Approved by VITL Board • Approved by Legislature with language calling attention to privacy and security (ACLU) and interoperability standards

4. VHITP – July 2007 – 140 pages • Introduction • Health Care Environment • Vision • Key Stakeholder Groups • Strategy and Objectives • Standards • Technology

5. VHITP • Privacy and Security • Education • Funding and Financing • Governance and Accountability • Moving Forward Appendices A - K

6. JRH 44 • That VITL be directed to continue to update the health information technology plan to include state and national privacy and security policies and procedures as they become available to reflect industry best practices. • That VITL be directed to update by January 1, 2009 the interoperability standards in the health information technology plan to reflect nationally accepted industry best practices relating to the exchange of data.”

7. Act 203 – Health Care Reform of 2008 • VITL shall update the plan annually to reflect emerging technologies, the state’s changing needs, and such other areas as VITL deems appropriate

8. What to update? Part I: Minimum is to address legislative requirements • Privacy and Security • Interoperability Standards • Emerging technologies • States changing needs • Other areas VITL deems necessary

9. Part II: Other areas deemed necessary • Describe progress and plans for implementing each of the four core objectives • Clarify and/or elaborate on selective original legislative requirements • Avoid incompatible systems and duplicative efforts (#6) • Practice transformation: clinical & business • Recommendations for legislative action

10. Structure of Update • New document • Use structure of original Plan? • At least one page per section OR • New format with items agreed to from prior 2 slides?

11. Process • HLN and VITL staff draft updates • Advisors review on a monthly basis • July, August, September, October • Presented to VITL Board for approval • November • Final edits and production of document • December • Present to legislature for their approval • January

12. Next Steps • Send advisors notes of this meeting • Staff and HLN work to develop an outline and schedule • Send new material to advisors prior to next meeting – July 9 • GoToMeeting or in person in Montpelier?

13. Items for Parking Lot

14. Next set of slides are linked from previous slides

15. Vision • Our vision is for a healthier Vermont, where shared health information is a critical tool for improving the overall performance of the health care system. The health care community will work together to achieve new efficiencies through the use of information technology in order to deliver better overall value and care to our citizens.

16. Core Objectives 1-2 • Encourage and enable deployment and use of electronic health record systems within the state to increase the amount of health information that exists in electronic form • Establish and operate the infrastructure necessary to promote secure electronic health information exchange to achieve plan’s vision • Empower consumers to take an active role in electronic health information intimidates in Vermont • Enable public health agencies to leverage HIT/HIE investments to monitor and ensure the public’s health more transparently and quickly

17. Standards • HIE • Core technical standards for HIE (required) • Messaging Standards for HIE (required as applicable) • Core Semantic Standards (should be used) • Recommendations • HIT Infrastructure and Applications (desirable) • Process Interoperability – (represent best practices) • Stakeholders are encouraged to conform • CON applicants will address standards

18. Privacy and Security • Framework • Privacy and Security Workgroup Principles • Markle Foundation Core principles • Adopt Policies and Procedures • Seek to be leader in VT • Create strategy to help providers meet legal obligations • Implement consumer education

19. Project Selection Strategy • Evaluate likely outcomes • Evaluate Infrastructure needs • Conduct business analysis

20. Part I: Core Objective • “Encourage and enable deployment and use of electronic health record systems within the state to increase the amount of health information that exists in electronic form” • Describe EHR pilot and lessons learned • Challenges to expanding pilot with new funds • Re-evaluate targets for EHR deployment

21. Part I: Core Objective • “Establish and operate the infrastructure necessary to promote secure electronic health information exchange to achieve plan’s vision” • Describe build out of the HIE • Describe services offered to stakeholders • Describe opportunities and challenges • Re-evaluate targets

22. Part I: Core Objective • “Empower consumers to take an active role in electronic health information intimidates in Vermont” • Describe educational and outreach projects • Describe challenges and re-evaluate targets • “Enable public health agencies to leverage HIT/HIE investments to monitor and ensure the public’s health more transparently and quickly” • Describe future plans and challenges • Re-evaluate targets

23. JRH 44 • “That VITL be directed to continue to update the health information technology plan to include state and national privacy and security policies and procedures as they become available to reflect industry best practices.” • Document existing and developing state and national privacy and security policies and procedures to reflect best practices • Document their applicability to operating VT’s HEIN • Document specific privacy and security policies and procedures VITL will use to operate the HIEN

24. JRH 44 • “That VITL be directed to update by January 1, 2009 the interoperability standards in the health information technology plan to reflect nationally accepted industry best practices relating to the exchange of data.” • Document interoperability standards best practices • Document their applicability to operating VT’s HIEN • Document which standards are mandatory or optional as they relate to: • Interfacing with the statewide HIEN • Within a local HIE • Within an EHR system

25. Act 203 – Health Care Reform of 2008 • “VITL shall update the plan annually to reflect emerging technologies, the state’s changing needs, and such other areas as VITL deems appropriate.” • Document emerging technologies (applications?) like eRx, IBM “check out” and emergency responder authentication • Document state’s changing needs for HIT/HIE • Document cross cutting issues (legal, funding, governance)

26. Act 70 – Health Care Reform of 2007 • “Recommend funding mechanisms for the ongoing development and maintenance costs of a statewide health information system, including funding options and an implementation strategy for a loan and grant program; • Update contributions and production funding • Describe Health IT-Fund • Describe EHR Pilot Project • Describe statewide deployment of EHRs

27. Act 70 – Health Care Reform of 2007 • “Incorporate the existing health care information technology initiatives in order to avoid incompatible systems and duplicative efforts;”

28. Act 70 – Health Care Reform of 2007 • “The plan shall serve as the framework within which certificate of need applications for information technology are reviewed”