Health Information Exchange (HIE) Community of Practice (CoP) Medicaid EHR Incentive Program April 21, 2015

Transcription

1 This is an advance copy of the HIE presentation for your review only. The presentation is subject to change and should not be reproduced. The final version of the presentation will be posted to the Medicaid HITECH TA Webs site at a later date. Health Information Exchange (HIE) Community of Practice (CoP) Medicaid EHR Incentive Program April 21,

2 Agenda Introduction Kathy Frye, MeT Sandeep Kapoor, MeT CRISP HIE Infrastructure & Services Migration Key Considerations Scott Afzal, Program Director CRISP Paul Messino, Maryland Department of Health & Mental Hygiene Questions, Wrap Up and Next Steps Kathy Frye, MeT 2

3 HIE Infrastructure and Services Migration Key Considerations April 21 st, 2015

4 Vision Mission Guiding Principles Our Vision To advance health and wellness by deploying health information technology solutions adopted through cooperation and collaboration. Our Mission We will enable and support the healthcare community of Maryland and our region to appropriately and securely share data in order to facilitate care, reduce costs, and improve health outcomes. Our Guiding Principles 1. Begin with a manageable scope and remain incremental. 2. Create opportunities to cooperate even while participating healthcare organizations still compete in other ways. 3. Affirm that competition and marketmechanisms spur innovation and improvement. 4. Promote and enable consumers control over their own health information. 5. Use best practices and standards. 6. Serve our region s entire healthcare community. 4

5 Annual Focus Areas and Theme Setting

6 Technical Overview

7 Factors Driving Migration Consideration There are a range of factors that could drive a decision to migrate a component or an entire HIE infrastructure. Expense of existing arrangement is unsustainable or transactionally unjustifiable. Performance of the solution is not meeting customer expectation. Implementation services and product support are slow. Components are too rigid to respond to custom needs. Product roadmap is not directionally aligned with HIE objectives.

8 Strategic Considerations While a migration decision may be premised on a core issue or combination of issues, a decision to migrate also presents opportunity to achieve new strategic objectives/considerations. For example: Control over connectivity In-house vs. vendor supplied technical services Component vs. Single Vendor Model Codification of more specific service level agreements (and consequences for not meeting SLAs)

9 Key Migration Area Consideration The practical steps in migrating to a new technology or service provider can be daunting, but are accomplishable when defined and accounted for effectively. Technical Infrastructure / Hosting Migration Networking Migration Feed Migration / Existing Mapping (in bound and out bound) Consent Preferences Patient Identity Information / Master Patient Index Provider Directory Existing Clinical Data Migration End-User Services Migration End-User Training

10 Migration Objectives Migrating technical infrastructure also poses an opportunity to evaluate the status and future direction of service offerings. Defining the high-level service objectives related to the migration can be a helpful exercise to define the migration plan. Core Stats Service Lines Plan for Service post Migration Current Vendor Future Vendor 1 Clinical Results Delivery Sunset 2 Query Portal Expand 3 Direct Messaging Deploy 4 E-Prescribing Sunset 5 Public Health Reporting Expand 6 PDMP Expand

11 Service Inventory Documenting the current service offerings and the details related to how those services are deployed allows for a more in-depth assessment of how those services will be migrated and if the new service provider is capable of supporting them as currently implemented Service Lines Clinical Results Delivery Query Portal Direct Messaging Notifications 4 5 Public Health Reporting 6 Data Sources (Type) Hosp, Labs, Rads All Source End User Created Data Hospitals Data Recipients (Type) Practices, Ordering & Cc'd Providers Clinicians / Query Portal Users Direct Account Holders Providers / Carriers PDMP pharmacy Users Clinical Data Type Lab and Rad Results Encounters, Labs, Rads, Trns, Meds User Entered / Attached Data Format Inbound / Outbound Transformation Required? Inbound Transport Outbound Transport Integration Type (view-based, HL7, IHE) HL7 ORU Yes / Yes VPN VPN HL7 HL7 / NCPDP Yes / No VPN https (web app) N/A No / No Direct Direct ADT HL7 Yes / No VPN Medications as erxs NCPDP No / No VPN Direct / WS / sftp https (web app) View-based / Download Possible View-Based / Download Possible View-Based / other View-based / Download Possible Supporting Vendor / Technology Hosting Partner / Facility

12 Infrastructure Reliance Each current or future service has a set of infrastructure dependencies. Not all services rely on all infrastructure components. Documenting which services rely on which components is a helpful process to ensure the migration plan accurately accounts for / includes the relevant components. Service Lines Master Patient Indexing Inbound Interface Engines Outbound Interface Engines Vocabulary Translation Services Clinical Data Repository Secure Messaging / HISP ehealth Exchange Gateway erx Service 1 Clinical Results Delivery 2 Query Portal 3 Direct Messaging 4 Notifications 5 Public Health Reporting 6 PDMP 7 Service 7 8 Service 8 9

13 Financial Modeling Near-Term Migration Expense vs. Long-Term Costs Migrating infrastructure will incur upfront migration expense and potentially new license expense. Some vendor cost models have historical assumptions or fees that aren t rational in the context of the current HIE s services or projects. These expenses can be prohibitive if not taken together with longer term savings associated with the migration or shift toward a more rational cost model. Funding opportunities may exist that can support the upfront / capital expense of the migration activities.

14 Contracts and Timing It is important to understand and validate the current contract provisions of existing vendor relationships. Exiting often requires an active step to give notice within a certain timeframe prior to a term renewing automatically. Many agreements will not permit termination without cause. Termination for cause can be a significant legal undertaking and will generally require a strong basis.

15 Please enter your question or comment in the Questions pane in your webinar control panel. Questions and responses from this webinar will be provided for your reference after the call. Thank You! 15

16 What s Next Suggestions for the HIE CoP sessions can be sent to: MeT.CoP@MedicaidHiTechTA.org 16