HIE

State HIE Program WebinarJanuary 5th, 2010

1

Agenda for State HIE Program Webinar

2

• State HIE Program Updates and Q&A

20 min

• NHIN Update, IFR Update and Q&A

40 min

• State HIE Program Technical Assistance: Resources for Grantees

Facilitated through the State HIE Leadership Forum

45 min

o a. Overview

o b. State-HIE Toolkit Overview and Demonstration

o c. State HIE Planning – Using the Toolkit

• Next Steps

15 min

o a. Feedback

o b. Release of Additional Modules

o c. Listserv – Ongoing Forum Communication

Grants ProgramsHigh-Level Summary/Status

3

Agenda

• A. Overview of Funding Opportunities

15 min

o 1. Regional Extension Centers

o 2. Beacon

o 3. SHARP

o 4. Workforce

• B. HIE Overview and Resources Providing

Guidance

5 min

4

Currently Available Funding Opportunities

5

• Provide grants for the establishment of Health Information Technology Regional Extension Centers that will offer technical assistance, guidance and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of Electronic Health Records (EHRs).

• Application Deadline: Cycle 1: Full Applications – Due on November 3, 2009 Cycle 2: Preliminary Applications – Due on December 22, 2009; Full Applications - January 29, 2010

Health Information Technology Extension

Program (Cycle 2)

• Provide funding to communities to build and strengthen their health information technology (health IT) infrastructure and exchange capabilities to demonstrate the vision of meaningful health IT.

• Application Deadline: February 1, 2010 (Letter of Intent due January 8, 2010)

Beacon Community Cooperative

Agreement Program

• Fund research focused on achieving breakthrough advances to address well-documented problems that have impeded adoption: 1) Security of Health Information Technology; 2) Patient-Centered Cognitive Support; 3) Healthcare Application and Network Platform Architectures; and, 4) Secondary Use of EHR Data.

• Application Deadline: January 25, 2010 (Letter of Intent due January 8, 2010)

Strategic Health IT Advanced Research

Projects (SHARP) Program


6

• This funding opportunity, one component of the Health IT Workforce Program, will provide $10 million in grants to institutions of higher education (or consortia thereof) to support health information technology (health IT) curriculum development.


CurriculumDevelopment Centers

• This program, one component of the Health IT Workforce Program, seeks to rapidly create health IT education and training programs at Community Colleges or expand existing programs. Community Colleges funded under this initiative will establish intensive, non-degree training programs that can be completed in six months or less.


Community College Consortia to Educate

Health Information Technology

Professionals

• The purpose of this program, one component of the Health IT Workforce Program, is to rapidly increase the availability of individuals qualified to serve in specific health information technology professional roles requiring university-level training.


Program Assistance for University-Based

Training


• This funding opportunity, one component of the Health IT Workforce Program, will provide $6 million in grants to an institution of higher education (or consortia thereof) to support the development and initial administration of a set of health IT competency examinations.


Competency Examination for

Individuals Completing Non-Degree Training

• These grant programs will support states and/or State Designated Entities (SDEs) in establishing health information exchange (HIE) capacity among health care providers and hospitals in their jurisdictions. Such efforts at the state level will establish and implement appropriate governance, policies, and network services within the broader national framework to rapidly build capacity for connectivity between and among health care providers. State programs to promote HIE will help to realize the full potential of EHRs to improve the coordination, efficiency, and quality of care.

• Awards expected in early 2010

*State Health Information Cooperative

Agreement Program*Pending Award

7

REC – Application, Award Process, and

Timeline

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DEC JAN FEB MAR

2009 2010

21Due Diligence

NGA Issuance

NOV

3

FOA Updated

18

Prelim Apps Due

22 6

Full Apps Due

29

Objective ReviewCompletion

31

Cycle One

Cycle Two

11

15

NGA Issuance

Full Apps Due

Due Diligence

Preliminary App ReviewCompletion

Objective ReviewCompletion

REC Overview

9

• The purpose of the Regional Centers is to furnish assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement and meaningfully use certified EHR technology to improve the quality and value of health care.

• Priority shall be given to providers that are primary-care providers (physicians and/or other health care professionals with prescriptive privileges, such as physician assistants and nurse practitioners) in any of the following settings: Individual and small group practices (ten or fewer professionals with

prescriptive privileges) primarily focused on primary care;

Public and Critical Access Hospitals;

Community Health Centers and Rural Health Clinics; and

Other settings that predominantly serve uninsured, underinsured, and medically underserved populations.

Beacon, Sharp, and Workforce Timeline

10**Applications which do not meet Completeness and Responsiveness criteria will not pass on to Objective Review.

Execution of

Cooperative

Agreements

Key Steps and Anticipated Dates

FOA

Released

Letter

of

Intent

Full

Application**

11/25/2009 1/22/2010 3/20101/6/2010

12/15/2009 1/14/2010 3/20101/4/2010

12/17/2009 1/25/2010 3/20101/8/2010

12/17/2009 1/2010 3/20101/2010

BEACON

WORKFORCECommunity College

WORKFORCECurriculum Development

WORKFORCEUniversity Training

WORKFORCECompetency Examination

SHARP

12/02/2009 1/1/2010 3/20101/8/2010

12/17/2009 1/25/2010 3/20101/8/2010

Beacon Overview

• Will provide funding to communities to build and strengthen their health

IT infrastructure and exchange capabilities to demonstrate the vision of

the future where hospitals, clinicians and patients are meaningful users

of health IT, and together the community achieves measurable

improvements in health care quality, safety, efficiency, and population

health.

• Awards will be made in the form of cooperative agreements to 15

qualified non-profit organizations or government entities representing

geographic health care communities.

• Beacon Communities will generate and disseminate valuable lessons

learned that will be applicable to the rest of the nation’s communities as

they strive to build and leverage their health IT infrastructure for

healthcare improvement.

• Will include $220 million in grants to build and strengthen health IT

infrastructure and health information exchange capabilities, including

strong privacy and security measures for data exchange, within 15

communities. An additional $15 million will be provided for technical

assistance to the communities and to evaluate the success of the

program.11

Beacon Overview (cont’d)

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1. Extend existing (advanced) health IT and exchange infrastructure

2. Leverage this infrastructure to achieve specific and measurable healthcare improvements

Demonstrate vision of the future where hospitals,

clinicians and patients are meaningful users of health IT, and

together the community achieves measurable

improvements in health care quality, safety,

efficiency, and population health

15 Communities

SHARP Overview

•The purpose of the Strategic Health IT Advanced Research

Projects (SHARP) Program is to fund research focused on

achieving breakthrough advances to address well-documented

problems that have impeded adoption of health IT and to

accelerate progress towards achieving nationwide meaningful

use of health IT in support of a high-performing, continuously-

learning health care system.

• ONC expects to award four cooperative agreements:

Security of Health Information Technology

Patient-Centered Cognitive Support

Healthcare Application and Network Platform Architectures

Secondary Use of EHR Data

13

Workforce Overview (cont’d)

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Curriculum Development

Centers

Community College

Consortia

Competency Development

Testing

University-Based Training

Workforce Program

• The Curriculum Development Centers program will provide $10 million in grants to

institutions of higher education (or consortia thereof) to support health information

technology curriculum development.

• ONC plans to make up to 5 grant awards that will support curriculum development

to enhance programs of workforce training primarily at community college level.

• The materials developed under this program will be used by the member colleges

of the five regional consortia as well as be available to institutions of higher

education across the country.


15


Centers

Community College

Consortia


Testing


Workforce Program

• The Community College Consortia to Educate Health Information Technology Professionals in Health Care program seeks to rapidly create HIT academic programs at Community Colleges or expand existing ones.

• Students will be able to complete training in one of six roles within six months or less.• Academic programs may be offered through traditional on-campus instruction or distance

learning modalities, or combinations thereof. • It is expected that by the end of the two-year project period, collectively all of the

Community Colleges participating in the program will have established training programs with the capacity to train at least 10,500 students annually to be part of the HIT workforce.

Anticipated training capacity of the consortium as a whole must average 150 students per member College.

Training at all consortium member Colleges will be expected to begin by September 30, 2010

Colleges should have a plan collaborate with regional extension centers and state health information

exchange programs


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Centers

Community College

Consortia


Testing


Workforce Program

• The purpose of the Information Technology Professionals in Health Care: Program of Assistance for University-Based Training grants is to rapidly increase the availability of individuals qualified to serve in specific health information technology professional roles requiring university-level training. Four-year colleges or universities are eligible to apply for funding under this program, which will emphasize programs that can be completed by the trainee in one year or less.

• The six roles targeted by this funding opportunity are: Clinician/Public Health Leader

Health Information Management and Exchange Specialist

Health Information Privacy and Security Specialist

Research and Development Scientist

Programmers and Software Engineer

Health IT Sub-specialist


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Centers

Community College

Consortia


Testing


Workforce Program

• The Competency Examination for Individuals Completing Non-Degree

Training program, one component of the workforce program, will provide $6 million

in grants to an institution of higher education (or consortia thereof) to support the

development and initial administration of a set of health IT competency

examinations.

• The examinations will assess basic competency for individuals trained through

short-duration, non-degree health IT programs, and for members of the workforce

with relevant experience or other types of training who are seeking to demonstrate

their competency in certain health IT workforce roles integral to achieving

meaningful use of electronic health information.

State HIE Program

• Cooperative agreements will be awarded through the State

Health Information Exchange Cooperative Agreement

Program to states and qualified State Designated Entities

(SDEs).

Objective: To develop and advance mechanisms for information sharing

across the health care system.

A cooperative agreement is a partnership between the grant recipient and the

Federal government.

States and SDEs will be required to match grant awards beginning in 2011.

• Under these State cooperative agreements $564 million will

be awarded to support efforts to achieve widespread and

sustainable health information exchange (HIE) within and

among states through the meaningful use of certified

Electronic Health Records (EHRs).

The goal of meaningful use of EHRs is for health care providers to use this

technology to improve the quality and efficiency of care.

18

State HIE Program (cont’d)

• The grant programs will support states and/or SDEs in

establishing in developing and implementing strategic and

operational plans which address and facilitate HIE capacity

among health care providers and hospitals in their

jurisdiction.

• Grant performance will be evaluated on a quarterly basis to

determine if there is improved capability for providers to

actively exchange healthcare data focusing specifically on

electronic order and receipt of labs and test results as well

as e-prescribing.

• The respective state governments, federal government

(complimentary grants programs) and private sector will all

play important roles in advancing HIE among health care

providers through the grant programs.

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Aligning with Current & Future

State HIE Guidance

• Statewide Strategic and Operational Plans should be

developed and implemented based upon evolving

guidance. States will receive guidance from:

ONC

ONC – State HIE Team

Technical Assistance Providers (State HIE Toolkit, etc.)

CMS (Meaningful Use NPRM, etc.)

ONC FACA Committees (HIT Policy – NHIN Workgroup)

Other

20

Interim Final Rule and Notice of

Proposed Rulemaking of Meaningful Use

An Interim Final Rule (IFR) on an initial set of standards, implementation

specifications, and certification criteria was issued on December 30, 2009, with a

request for comments.

The Centers for Medicare & Medicaid Services (CMS) also issued a Notice of

Proposed Rulemaking (NPRM) on the definition of “meaningful use.”

• In order for professionals and hospitals to be eligible to receive payments under

the Medicare and Medicaid EHR incentive programs, provided through the

Recovery Act, they must be able to demonstrate meaningful use of a certified

EHR system.

The IFR will become effective 30 days after publication and will be open for public

comment for 60 days after publication. The final rule will be issued sometime in

2010.

More information on the IFR can be found at:

http://www.federalregister.gov/inspection.aspx#special

Public comments can be made at:

http://www.regulations.gov/search/Regs/home.html#home 21

http://www.federalregister.gov/inspection.aspx

http://www.regulations.gov/search/Regs/home.html

Technical Architecture & the NHIN

In Support of the State HIE Program

22

Agenda

• A. Overview & Approach of the Nationwide Health Information Network (NHIN)

10 min

o 1. Industry Engagement &The Evolution of the NHIN

o 2. Governance for the NHIN

o 3. Trust, the DURSA, & the NHIN

o 4. Standards, Specifications, and Meaningful Use

• B. Technical Architecture , NHIN, & State Health Information Exchange (HIE)

20 min

o 1. Key Principles & Information Exchanges to be Considered by States

o 2. Stakeholders Participating in HIE

o 3. Services to be Provided by &/or Used by States

o 4. Sharing Information with Current & Future NHIN Participants

o 5. Alignment with Current & Future Technical Architecture & NHIN Guidance

23

Overview & Approach of the

Nationwide Health Information

Network (NHIN)

24

NHIN: An Overview

• The Nationwide Health Information Network (NHIN)

is a collection of standards, protocols, legal

agreements, specifications, and services that

enables the secure exchange of health information

over the internet.

The NHIN provides a common platform for health information

exchange across diverse entities to achieve the goals of the

HITECH Act.

This enables health information to follow the consumer, be

available for clinical decision making, and support use of

healthcare information beyond direct patient care to improve

public health.

25

NHIN: An Overview

• In its initial pilot implementations, the NHIN

provides a vehicle for large and/or technologically

sophisticated organizations to securely exchange

electronic health information on a common

platform for HIE across diverse entities to achieve

the goals of the HITECH Act.

Moving forward, the NHIN will accommodate uses ranging

from simple local applications such as a healthcare provider

communicating a prescription to a pharmacy, to complex

interchanges involving nationwide participants and the

attendant network facilities and tools, and/or to consumers

seeking access to their health records from their local

caregivers.

26

NHIN: Industry Engagement & Evolution

• ONC will be engaged in diverse public discussions about

the various possibilities NHIN

One important source of input is through Federal Advisory Committees,

public meetings, and comments during formal rulemaking processes.

A NHIN Work Group (under the HIT Policy Committee) is being formed to

offer recommendations on creating a policy and technical framework that

allows the internet to be used for the secure and standards-based exchange

of health information, in a way that is open to all and fosters innovation.

The new NHIN Work Group will hold discussions on how to use the internet

to transform healthcare, including network security and access to health

information.

At the inaugural meeting on November 20, the work group was charged with

reviewing and refining the charge and initial activities, including:o Establishing an incremental approach that will generate immediate value (e.g., enable providers

to achieve meaningful use) while creating the components that will be needed for more

advanced information exchange (e.g., broadcast query).

o Describing the governance mechanism required for above.

o Providing recommendations to the HIT Policy and HIT Standards Committees.

Activities of the HIT Policy Committee can be found at:

http://healthit.hhs.gov/policycommittee 27

http://healthit.hhs.gov/policycommittee

28

NHIN: Current Governance

• As part of the 2009 NHIN limited production pilots, the

following interim governance structures were put in place

to support information exchange across the NHIN during

the formal rulemaking process:

The NHIN Technical Committee focuses on architectural and technical

issues such as prioritization of new functionality and approval of new or

modified technical requirements and specifications.

The NHIN Coordinating Committee has the authority to establish and

maintain the set of policies and legal agreements and accountability

measures for NHIN participants.

The current governance mechanisms may be enhanced or modified based on

recommendations from the HIT Policy Committee – NHIN Workgroup.

29

NHIN: Creating a “Fabric of Trust”

• Those who might want to use the NHIN for simple

exchanges of information may not require the rigorous

agreements that have been established for the exchange of

data during the limited production pilots. Therefore, even

simple exchanges require:

The sender of information must be confident of the address of the recipient,

The receiver of the data is the intended recipient

The substance of the information has not been altered during transmission.

Other users may have more extensive requirements to establish trust.

• The NHIN will require a “fabric of trust” that can serve

multiple users and can provide multiple layers to establish

confidence.

A “lightweight” layer

Additional layers

• A wide range of key stakeholders will need to be involved in

drafting new, and revising existing, elements of the NHIN

trust fabric (e.g. trust agreements, operating policies and

procedures, and Coordinating Committee processes.) 30

NHIN: DURSA – “A Fabric of Trust”

• Data Use and Reciprocal Support Agreement (“DURSA”) – is a

comprehensive, multi-party trust agreement.

The DURSA provides the legal framework governing participation in

nationwide information exchange by requiring the signatories to abide by a

common set of terms and conditions that establish the Participants’

obligations and the trust fabric to support the privacy, confidentiality and

security of the health data that is exchanged.

• Key terms and conditions of the DURSA are noted below:

Multi-Party Agreement

Participants in Production

Privacy and Security Obligations

Requests for Data Based on Permitted Purposes

Duty to Respond

Future Use of Data Received Through the NHIN

Duties of Requesting and Responding Participants. Each Participant has

certain duties when acting as a requesting or responding Participant.

o Breach Notification

o Mandatory Non-Binding Dispute Resolution

o Allocation of Liability Risk

o Applicable Law

31

NHIN: The Use of Standards

• The NHIN references, leverages and utilizes approved

standards.

The Health IT Standards Committee, a federal advisory committee is

responsible for making recommendations to the National Coordinator for

Health IT on standards, implementation specifications, and certification

criteria for the electronic exchange and use of health information.

The Health IT Standards Committee may be informed by standards

harmonization entities, standards development organizations (SDOs), etc.

To date The Health Information Technology Standards Panel (HITSP) has played a

significant role in harmonizing standards. Their work can be referenced here:

http://www.hitsp.org/

32


NHIN: The Development & Utilization of

Specifications

• The NHIN specifications which must be implemented in an

NHIN Gateway vary with the functionality an NHIN

Participant wishes to support. NHIN Specification are

developed in alignment with approved standards.

• Entities are encouraged to implement the complete set, so

that they may offer the full suite of NHIN services to

members of its healthcare value chain.

• The NHIN Specifications include:

Messaging, Security, and Privacy Foundation

Discovery Information Services

Information Services Profile

To date The Health Information Technology Standards Panel (HITSP) has played a

significant role in harmonizing standards. Their work can be referenced here:


33


NHIN: Aligning with Meaningful Use

2009 2011 2013 2015

HIT-Enabled Health Reform

Me

an

ing

ful U

se

Cri

teria

HITECH

Policies2011 Meaningful

Use Criteria

(Capture/share

data)2013 Meaningful

Use Criteria

(Advanced care

processes with

decision support)

2015 Meaningful

Use Criteria

(Improved

Outcomes)

34

Meaningful Use and Preliminary

Rulemaking Timeline

35

July

2009

August

2009

September

2009

Late

2009/Early

2010

Rulemaking

Preliminary

Definition of MU

(HIT Policy

Committee)

Preliminary

Standards

Identified to

Support MU

(HIT Standards

Committee)

Work Begun to

Develop HHS

Certification

Criteria for MU

(HIT Standards

Committee)

ONC IFRs &

CMS NPRMs

Released

2010 and

Onward

Regulations

Written into Law

and Executed

Status of Rulemaking

• An Interim Final Rule (IFR) on an initial set of standards, implementation

specifications, and certification criteria was issued on December 30, 2009, with a

request for comments.

• Represents the first step in an incremental approach to adopting standards,

implementation specifications, and certification criteria to enhance the

interoperability, functionality, utility, and security of health IT and to support its

meaningful use.

• The certification criteria adopted in this initial set establish the capabilities and

related standards that certified electronic health record (EHR) technology will

need to include in order to, at a minimum, support the achievement of the

proposed meaningful use Stage 1 (beginning in 2011) by eligible professionals

and eligible hospitals under the Medicare and Medicaid EHR incentive programs.

• In a related announcement, the Centers for Medicare & Medicaid Services (CMS)

also issued a Notice of Proposed Rulemaking (NPRM) on the definition of

“meaningful use.”

• In order for professionals and hospitals to be eligible to receive payments under

the Medicare and Medicaid EHR incentive programs, provided through the

Recovery Act, they must be able to demonstrate meaningful use of a certified

EHR system.

• The proposed standards and certification criteria in the IFR are fundamentally

linked to and specifically designed to support the 2011 meaningful use criteria.

36

Technical Architecture, NHIN, and

the State HIE Program

37

Technical Architecture: Key Principles

• Statewide Strategic an Operational Plans are expected to provide a

technical architecture that describes the interactions of

stakeholders and technologies to achieve the state’s strategic

health objectives.

• Architecture the components of a complex system and the

relationships and interactions among those components, whether

they be parts of a house, objects in a software application, or

elements of state health information exchanges. There are many

“moving parts” encompassed within state HIE initiatives:

• Exchanges of information among many different participants in

the healthcare value chain; Necessary technology infrastructure to facilitate these exchanges; and

Alignment to the national health IT agenda to ensure that these exchanges of health information are

secure and interoperable.

ONC realizes that States/SDEs may be at different levels of maturity and therefore is

providing additional guidance in the State HIE Toolkit and other TA Initiatives.

38

Technical Architecture: Key Principles

& Health Information Exchange (HIE)

• The development of and evaluation of state technical architectures will be

driven by well-defined principles that clearly advance the national health IT

agenda, namely:

• States/SDEs should ultimately advance the key tenets of the health reform

agenda: Improving quality of care and patient outcomes

Improving the cost-effectiveness of care

Enhancing the capabilities of public health

• States/SDEs should advance key priority areas for the meaningful use of

electronic health records. These key priority areas were originally defined

by the HIT Policy Committee in July 2009 and it is anticipated that they will

undergo review and update and will be written into law.

The priority areas which have been defined as short term (2011) include:o Electronic eligibility and claims transactions

o Electronic prescribing and refill requests

o Electronic clinical laboratory ordering and results delivery

o Electronic public health reporting (i.e., immunizations, notifiable laboratory results)

o Quality reporting

o Prescription fill status and/or medication fill history

o Clinical summary exchange for care coordination and patient engagement

39

Technical Architecture: Stakeholders

Participating in HIE

• States/SDEs should incorporate all key stakeholders within the

state’s healthcare value chain, including non-governmental

entities such as providers, health plans, labs and pharmacies, as

well as agencies with health-related missions at all levels of

government. The architecture should also conform to national standards for health IT, and should

facilitate participation in the NHIN.

• The scope of health information exchange activities

includes exchanges between health enterprises, both within

a state (intra-state) and across states (inter-state). “Health Enterprise” refers to an organization that maintains a common index of patients

and their associated documents/data, encompasses participants that have established

trust and business relationships, and have agreed to adhere to common standards. The

scope of a health enterprise could be as small as a single practice, but it would also

include large chains or delivery networks, existing jurisdictional HIEs/RHIOs, and state

or county agencies.

40

Technical Architecture: Services to be

Provided by and/or used by States

• State technical architectures should describe what shared

or common infrastructure they intend to supply to facilitate

the information exchanges described above. At a minimum,

state technical architectures must describe mechanisms to:

Provide or Participate in Location Services

Ensure Entities (Patients, Providers, etc.) are Discoverable

Provide services for trust, security and privacy

Integrate Medicaid Services

Integrate State-Level Registries

41

Sharing Information with Current and

Future NHIN Participants

• New users will soon be joining the existing NHIN

activities

Includes states, SDEs or other recipients of Federal

contracts to build and begin exchanging health information.

In addition, there are numerous Federal initiatives that will

depend upon information exchange via the NHIN, including

the CDC biosurveillance pilots, the Virtual Lifetime Electronic

Record implemented by the DoD and the VA, and the Social

Security Administration’s disability determination process.

42

Aligning with Current & Future

Guidance• Grantees are highly encouraged to plan for and participate

in the NHIN.

• Grantees Statewide Strategic and Operational Plans are

highly encouraged to address options for future NHIN

participation.

This may include planning for and implementation of

appropriate standards, specifications, technical architecture,

trust agreements, etc.

• Project Officers will evaluate Statewide Strategic and

Operational Plans based upon evolving NHIN guidance.

• States will receive guidance regarding the NHIN from:

ONC

ONC – State HIE Team

Technical Assistance Providers (State HIE Toolkit, etc.)

CMS (Regarding Meaningful Use)

ONC FACA Committees (HIT Policy – NHIN Workgroup) 43

Questions & Answers(If Time Permits)

44

Technical Assistance &

Toolkit Overview

45

State HIE Program

Technical Assistance Overview TA Goal: Support states in their efforts to build HIE

capacity to support Meaningful Use

TA Objectives:

Targeted to stages of development and responsive to

state identified needs

Aligned to support HITECH - State HIE Program

o Program goals

o Milestones across states

Leveraging collaborative expertise and resources

o ONC Program guidance, Project Officers, Regional

Consultants

o SLHIE Project T.A. Team (staff, consultants, other

collaborators)

o States and state-specific resources e.g. consultants

Organizing T.A. - Goals, Strategic Priorities

Distinctions about T.A. Services

Assumptions

• Most states will use hire

consultants either to help

develop Plans and/or to

execute on Plans.

• States need additional

source of guidance

Cross-cutting issues, barriers

Comparative information

about emerging best practices

Objective source of guidance

linked to State HIE Program

expectations

State HIE T.A. Services

• Targeting areas that states

otherwise can’t address via

vendors, consultants

• Providing program level

guidance and direction

• Helping states address

common issues

• Facilitating flexible state

approaches, stages while

also ensuring that states are

“on the right road.”

State HIE Program TA Services and Resources

Will Address These Type Questions…

• How do I get started (I don’t know what I need or who to choose to

help)?

• How do I pick a consultant/vendor?

• What do I do to get ONC approval for my state plans?

• What are the best practices across the states for implementing

effective HIE across the domains, especially governance?

• What are the best practices across states for overcoming a

particular issue/barrier?

• What is ONC’s position on a variety of issues?

• What are the NHIN specs; what can we do with our architecture to

become compliant (and not rely on the vendor’s word)?

• Is the proposal received from this consultant/vendor in compliance

with ONC guidelines?

State HIE Technical Assistance Services

and Resources

ToolkitVirtual Programs

Webinars

Communications Listserv

Coaching Virtual/On-site

Consulting

Leadership Training

Meetings Roundtable Discussions

Technical Assistance Consultations

Include

• Helping states identify

strategies and address

issues within and

across the five domains

• Supporting states to

meet milestones and

deliverables as required

by cooperative

agreements with ONC

Do Not Include

• Directly meeting

milestones for the

states

• Developing states’

deliverables

Technical Assistance Consulting Activities

Do Include….

• Provide recommended best practices as identified by SLHIE and other

ONC projects e.g. HISPC, State Alliance, NHIN. etc

• Assist to develop strategies to address issues, reach milestones or

deliverables by:

Provide advice on direction or resolution of an issue

Analyze specific issues, suggest potential solutions

Synthesize different approaches and outline the alternatives

Identify case studies or other states’ efforts to resolve similar issues and

bring these to attention where a state needs help

Technical Assistance Consulting Activities

Do Not Include….

• Developing systems

• Deploying technologies

• Giving legal advice

• Developing strategic and operational plans

• Completing audits

• Writing data sharing agreements

• Producing for states any State HIE Cooperative

Agreement Program deliverables or products

Anticipated Technical Assistance

Topics Evolving Across Stages

State HIE Toolkit

• Purpose

Resource to support state grantees to plan and lead activities to

accomplish targeted milestones and expectations outlined in state

plans and cooperative agreements

• Design

Aligns with State HIE Program guidance (domains, general areas)

Modules offer education, decision-making support, practical tools

States have ready access, ability to customize use

Iterative, expanding content to provide access to emerging best

practices, lessons learned in the field

• Dissemination

Released in versions with ongoing updates

Available through Forum Web site and directly at

http://www.statehieresources.org

http://www.statehieresources.org/

Toolkit Beta Release

• Toolkit Contento Initial modules focus on planning fundamentals

• Next Version releaseo Additional set of modules planned January 31, 2010

• Feedback on Beta versiono Enhancements, expanded resources will address feedback about

states’ needs, priorities

Using the Toolkit

• Tackling key fundamentals

Establishing governance

Organizing to address key planning priorities

Next Steps

• State HIE Forum Participants Sign up for Listserv through Toolkit or Forum Web site

• SLHIE Project – Will send Listserv request for feedback on the Toolkit

States respond with suggestions, resource requests, etc

Moderated communication will begin to circulate state inquiries, requests, resource sharing

• Beginning in 2010 T.A. assessments and planning

Webinar series

HIE

Health & Medicine

achieving

fund research

interim final

onc faca committees

industry engagement

hit policy

regional extension

state technical