Nov 2011 Lyman Dennis Organizer & Facilitator
Dec 24, 2015
What is Health Information Exchange?Exchange of clinical (and administrative)
information among unaffiliated providersPush data point-to-point called “clinical
messaging”Starter approach; will always work but more
complex as add more participating providersOptions
1.Direct provider-to-provider exchange2.Provider-to-central HIE; HIE to relevant
providers
Hospital
Hospital Hospital
Doctors Office
Doctors Office
Doctors Office
Dental OfficeDental Office Dental Office
Urgent Care
Urgent Care
Urgent Care
Speciality Surgery
Speciality Surgery
Insurance
Pharmacy Pharmacy
HIE
HIE PlayersCal eConnect – State-designated entityActive HIEs (e.g.s)
Standalone HIEs Santa Cruz HIE Western Health Information Network Redwood MedNet Orange County Partnership… (OCPRHIO)
Vertical HIEs Kaiser VA John Muir Sutter Health CHW Partnership HealthPlan of California
Startups
Meaningful Use for IncentivesStage 1
EHRBasic exchangeLimited number of clinical measures
Stage 2, Stage 3Use of EHR features for more patients (to 50% to 90%)Menu items become core itemsElectronic medication administration Chemotherapy automationRecord patient communication preferencesJudge clinician performance based on patient adoption
of PHRsLongitudinal care planningPublic health enhancements
Cal eConnect – Current PlanFocus on what is important to the
stakeholdersFocus on what is needed to sustain
the grant funding from ONC and the State:Provide an ability for ePrescribingReceipt of structured lab resultsSharing patient care summaries
Enabling data sharing through Direct and emphasizing importance of and reliance on local HIEs
Cal eConnect Strategic & Operational Framework
Gov
erna
nce
¹
Technical Assistance²
¹ Policy, Leadership, & Barrier Removal² Expert support to select or develop solutions to problems³ Conserving scarce resources and making big impacts
Coordination³
ONC & CHHS PrioritiesEstablish Trust EnvironmentRobust Support for Ancillary Services
Public HealthCommunity PharmaciesCommunity Diagnostic
LaboratoriesCoordinate, Monitor,& Report on HIE Landscape
Sustainable HIE in California
InteroperabilityStates’ Vendors’ EHR/HIE Interoperability
Project– Increase the value of the individual EHR systems
by assuring integration with HIE providers– Create a set of interoperable implementation
specifications not unlike what IHE has developed for the Interoperability showcase
– Leverage the power of a consortium of states to influence vendors to adopt the reference implementations (1/3 to ½ of the US population)
– Encourage vendors to provide these standard interfaces “out-of-the-box” for all installs
– Encourage other states and vendors to adopt the reference implementations
Multi State/Vendor Collaborative
• Allscripts• eClinicalWorks• eMDs• Greenway• McKesson• NextGen• Sage• Siemens
States• California• New York• Maryland• Massachusetts• New Jersey• Ohio• Oregon• Delaware• Colorado
EHR Vendors
HIE Vendors• Medicity• Axolotl• InterSystems • • Cerner
New States• Arizona• Florida• Virginia • Maine• Texas
New HIE Vendors
AccomplishmentsAugust: Data and Metadata Workgroup completed
work on the C32 specifications to create a fully defined and constrained implementation specification.
September: Push Workgroup completed work on a robust specification for implementation of NwHIN Direct using SMTP s/MIME or SOAP/HPD+ with Directory Services.
September: C32 specification fully aligned with Beacons and ONC S&I efforts.
October: Pull Workgroup completed a constrained implementation specification for NwHIN Connect using XCPD and an optional state-wide MPI.
In Process: Alignment of the States’ Interop work with ONC – ONC statement of support imminent. Pilots being sought.
Privacy & SecurityPrivacy & Security Advisory Board and CalOHII
have led the State in development of guidelines. PSAB Eliminated by Gov Brown Exec Order.
Regulations now in their second draft out for public comment and input:http://www.ohi.ca.gov/calohi/
Committees:Privacy Committee: Focused on consent and use of
datahttp://www.ohi.ca.gov/calohi/eHealthPolicy/PrivacySteeringTeam.aspx
Security Committee: Focused on securing the datahttp://www.ohi.ca.gov/calohi/eHealthPolicy/SecuritySteeringTeam.aspx
Privacy & SecurityCal eConnect Committees:
Policy Advisory Group: Focused on policies governing the use of Cal eConnect funded services. The goal is to build and leverage HIE policy based on evidence and supported by consensus.
http://www.caleconnect.org/?page_id=525Technology Advisory Group: Provides a
neutral forum for adoption and/or establishment of standards-based approaches to technical operations for those organizations that wish to participate in Cal eConnect services.
http://www.caleconnect.org/?page_id=527