Office of the State Coordinator for HIT Meeting ONC Expectations.

Meeting ONC Expectations

ID Milestone Fulfillment Criteria Status

Planning X

P.1 Strategic Plan – Establish and implement a strategic plan.

P.10.10 No Strategic Plan – Ready to develop Strategic Plan N/A

P.10.20 Strategic Plan in place but not consistent with Planning Guidance N/A

P.10.30 Approach to developing Strategic Plan through broad-based stakeholder collaboration in a transparent manner that fosters buy-in and trust submitted to ONC.

P.10.40 Strategic Plan endorsed by Stakeholders

P.10.50 Strategic Plan submitted to ONC

P.10.60 Strategic Plan approved by ONC

P.10.70 Previously approved Strategic Plan reviewed and any necessary updates submitted to ONC

P.10.80 Updated Strategic Plan approved by ONC

ONC Required Milestones

GovernanceP.20 Operational Plan – Establish and implement an operational plan.

P.20.10 No Operational Plan – Ready to develop Operational Plan

P.20.20 Operational Plan in place but not consistent with Planning Guidance

P.20.30 Approach to developing Operational Plan through broad-based stakeholder collaboration in a transparent manner that fosters buy-in and trust submitted to ONC.

P.20.40 Operational Plan endorsed by Stakeholders

P.20.50 Operational Plan submitted to ONC

P.20.60 Operational Plan approved by ONC

P.20.70 Previously approved Operational Plan reviewed and any necessary updates submitted to ONC

P.20.80 Updated Operational Plan approved by ONC

GovernanceG.10 Governance Structure - Establish a governance structure that achieves broad-based stakeholder collaboration with

transparency, buy-in and trust.

G.10.10 Collaborative governance model established

G.10.20 Collaborative governance model approved by ONC

G.10.30 Collaborative governance model endorsed by stakeholders

G.10.40 Policy structures (bylaws and charter or organizational equivalents) established

G.10.50 Policy structures (bylaws and charter or organizational equivalents) endorsed by stakeholders

G.10.60 Key stakeholder participants identified (including public stakeholders, private sector stakeholders, government, public health, hospitals, employers, providers, payers and consumers)

G.10.60.10 Stakeholder representatives committed to participate

G.10.60.20 Stakeholder conflict of interest issues managed

G.10.70 Medicaid agency has designated governance role

G.10.70.10 Role of Medicaid representative in HIE governance established

G.10.70.20 Medicaid representative identified

G.10.80 Regional HIE initiative(s) have designated governance role

G.10.80.10 Role of Medicaid representative(s) in HIE governance established

G.10.80.20 Regional HIE initiative representative(s) identified

G.10.90 HIT Coordinator

G.10.90.10 Government HIT Coordinator position established

G.10.90.20 Government HIT Coordinator position filled

G.10.90.30 Role of HIT Coordinator in HIE governance established

G.10.100 Governance entity is holding regularly scheduled public meetings with active participation of key stakeholders

Governance

G.10.90.20 Government HIT Coordinator position filled

G.10.90.30 Role of HIT Coordinator in HIE governance established

G.10.100 Governance entity is holding regularly scheduled public meetings with active participation of key stakeholders

Governance

G.30 Oversight and Accountability – Establish oversight and accountability mechanisms to protect the public interest.

G.30.10 Oversight and accountability mechanisms to protect the public interest (e.g., transparency policies) established

G.30.20 Organization meetings posted and open to the public

G.40 Alignment with National HIE Governance – Account for the flexibility needed to align with emerging nationwide HIE governance.

G.40.10 Framework to align with the emerging nationwide HIE governance established

G.40.11 Governance model aligned with NHIN governance (as applicable)

G.40.21 State/SDE representatives in NHIN activities identified

FinanceF.10 Fiduciary Oversight - Develop capacity to effectively manage funding necessary to implement the state’s

Strategic and Operational Plans.

F.10.10 High-level budget established

F.10.20 4-year detailed budget established and approved

F.10.30 Actual expenditures are tracking with budget and spend plan; variances of >10% from plan are analyzed and explained and targeted for remediation

F.10.40 Governance organization reviews the budget with the oversight board on a quarterly basis

F.20 Sustainability Plan - Develop a path to sustainability including a business plan with feasible public/private financing mechanisms for ongoing information exchange.

F.20.10 Business plan established that includes a sustainability plan capable of supporting HIE governance and operations beyond the ARRA funding

F.20.20 Sustainability plan approved by ONC

F.20.30 Sustainability plan endorsed by stakeholders

F.20.40 Annual report on sustainability (including a business plan) reviewed, updated and submitted to ONC annually

F.20.50 $1 non-federal match for each $10 of federal funds

F.20.60 $1 non-federal match for each $7 of federal funds

F.20.70 $1 non-federal match for each $3 of federal funds

Finance

F.30 Financial Controls and Reporting – Financial policies, procedures and controls to maintain compliance with GAAP and all relevant OMB circulars are in place.

F.30.10 Financial policies, procedures and controls are consistent with state and federal requirements

F.30.20 State or SDE complies with the Single Audit requirements of the OMB

F.30.30 State or SDE submits progress and spending reports as required to ONC

Technical Infrastructure

T.10Identify and Leverage Resources – Leverage existing regional and state level efforts and resources that

can advance HIE, such as master patient indices, health information organizations (HIOs), and the Medicaid Management Information System (MMIS).

T.10.10 Existing HIE-related assets identified

T.10.20 Existing HIE-related assets assessed

T.10.30 Role of existing HIE-related assets determined

T.10.40 Asset integration plan established

T.10.50 Assets operational for statewide HIE

T.20 Technical Infrastructure - Develop or facilitate the creation of a statewide technical infrastructure that supports statewide HIE.

T.20.10 Technical infrastructure vision and priorities established

T.20.20 Technical infrastructure plan developed

T.20.30 Technical infrastructure plan approved by ONC

T.20.40 Technical infrastructure plan endorsed by stakeholders

T.20.50 Technical infrastructure plan reviewed and updated annually

T.20.60 Statewide technical infrastructure for supporting HIE services developed and ready for implementation

T.20.70 Statewide technical infrastructure integrates with state-specific Medicaid management information systems

T.20.80 Statewide technical infrastructure integrates with regional HIEs

T.30 Shared Services – Develop or facilitate the creation and use of shared directories and technical services, as applicable for the state’s approach for statewide HIE.

T.30.10 Shared services offerings determined

T.30.20 Shared directories and technical services for care providers developed

T.30.30 Shared directories and technical services for service providers (including laboratory, pharmacy and radiology service providers) developed

T.30.40 A plan is determined for how the creation and use of shared directories and technical services, as applicable to the state’s approach for statewide HIE, will be developed.

T.30.50 Shared directories and technical services for health plans developed

T.30.60 Shared service providers identified

T.30.70 RFP(s) for technical implementation released (where applicable)

T.30.80 Vendors for shared services selected, contracts signed and development underway

T.30.90 Interoperability of shared services tested and confirmed

Technical Infrastructure

Technical InfrastructureT.40 Interoperability and Certification – Technical infrastructure leverages the appropriate HHS

adopted standards and certifications for health information exchange.

T.40.10 Existing use of HIE-related national HHS adopted standards identified

T.40.20 Approach toward aligning existing (or planned) infrastructure to be consistent with HHS adopted interoperability standards established

T.40.30 Approach toward aligning existing (or planned) infrastructure to be consistent with HHS adopted interoperability standards approved by stakeholders

T.40.40 Testing of aligned interoperability approach successfully completed

T.40.50 Approach toward certification of relevant HIE components and services established

T.40.60 Approach toward certification of relevant HIE components and services approved by stakeholders

T.40.70 Initial certification of relevant HIE components and services completed

T.40.80 Plan for maintaining alignment with developing HHS adopted interoperability standards and related certification of HIE components and services established and on track

T.50 Federal Healthcare Provider Exchange Architecture – Technical architecture aligns with NHIN core services and specifications.

T.50.10 Vision and priorities for exchanging information with federal providers through NHIN core services and specifications established

T.50.20 Approach toward aligning existing (or planned) information exchange with federal healthcare providers through NHIN core services and specifications approved by stakeholders

T.50.30 Testing of connections through NHIN core services successfully completed

T.50.40 Initial certification of relevant NHIN connectivity capabilities completed

T.50.50 Plan for maintaining alignment with NHIN core services and specifications established and on track

Business and Technical Operations

B.10 Technical Assistance to HIOs - Provide technical assistance as needed to HIOs and others developing HIE capacity within the state.

B.10.10 Approach to provide technical assistance as needed to HIOs and others developing HIE capacity within the state submitted to ONC

B.10.20 Training scheduled and appropriate modules developed based on user needs of technical ability

B.10.30 Training, educational modules, and related resources (guidance) rolled out

B.20 Program Alignment – Coordinate and align efforts with related programs to meet overall HIE objectives as well as Medicaid and public health requirements for HIE & meaningful use criteria.

B.20.10 Plan that indicates how recipients will align with the State Medicaid HIT Plan (SMHP) submitted to ONC

B.20.20 SMHP alignment plan approved by State Medicaid Director

B.20.30 Alignment achieved between Medicaid HIE plan and statewide HIE plan

B.20.40 Plan that indicates how recipients will align with and leverage as appropriate the Public Health agency’s existing initiatives and future plans that submitted to ONC

B.20.50 Public healh alignment plan approved by State Public Health Administrator

B.20.60 Alignment achieved between public health requirements and statewide HIE plan

B.20.70 Collaboration achieved with relevant Regional Extension Centers (Regional Centers) to support the state’s plan for HIE.

B.30 Monitoring Capacity - Monitor and plan for remediation of the actual performance of HIE throughout the state.

HIN TPPAC and OSC

B.30.10 Approach for monitoring and plan for remediation of the actual performance of HIE throughout the state developed and submitted to ONC

B.30.20 Project management protocols implemented and operational

B.30.20.10 Processes , roles and responsibilities developed for project management, performance monitoring, reporting and issue resolution, including escalation process

B.30.20.20 Functional requirements and resulting workflow changes for sustainable HIE adoption defined

B.30.20.30 Technical and operational work plans developed and published

B.30.20.40 Project management protocols reviewed and updated as necessary

B.30.30 State or State Designated Entity is monitoring and reporting on all required program evaluation metrics

B.40 Staffing – Establish and maintain adequate staff to effectively operate statewide HIE functions. HIN

B.40.10 Staffing plan established and submitted to ONC

B.40.20 Key roles filled, including Executive Director (or equivalent), Chief Privacy Officer (HIPAA-mandated role), and Chief Technology Officer (or equivalent)

B.40.30 All staff positions filled

Business and Technical Operations

B.50 Communications – Effectively communicate with key stakeholders and the health community RFP

B.50.10 Communications plan and strategy developed and submitted to ONC

B.50.20 Communications strategy implemented

B.50.30 Organizational website established and implementedOSCHIN

B.50.40 Communications strategy regularly reviewed leveraging feedback mechanisms

Business and Technical Operations

Legal/Policy

L.10 Harmonization – Identify and harmonize legal and policy requirements that enable appropriate HIE.

L.10.10 Outline of the legal framework for facilitating health information exchange developed and submitted to ONC

L.10.20 Plans for addressing the privacy and security issues related to health information exchange within the state and between states have been established

L.10.30 State is actively engaged in privacy and security policy harmonization and coordination activities to establish consistency on an interstate basis

L.10.40 Privacy policies are updated as needed to reflect new flow and uses of protected health information and any new obligations of patients

L.20 Statewide Policy Framework – Establish a statewide policy framework that allows incremental development of HIE policies over time.

L.20.10 Statewide Policy Framework established and submitted to ONC

L.20.20 Statewide Policy Framework endorsed by stakeholders

L.20.30 Needed modifications to state laws to enable and foster health information exchange within the state and interstate have been identified and, where possible, enacted

L.20.40 Policies, procedures and trust agreements have been established to enable and foster health information exchange within the state and interstate

L.20.50 Privacy policies, procedures and trust agreements incorporate provisions allowing for public health data use

L.30 Enforcement – Implement enforcement mechanisms that ensure appropriate safeguards are in place and adherence to legal and policy requirements.

OSCHIN

L.30.10 Plan for addressing issues of noncompliance with federal and state laws and policies applicable to HIE, including a robust risk mitigation process, established and submitted to ONC

L.30.20 Enforcement mechanisms have been implemented and are actively maintained

L.40 Implementation and Evaluation – Policies and legal agreements are implemented and evaluated as a part of annual program evaluation.

HINOSC

L.40.10 Policies for privacy training, use and disclosure, notice and consent, local enforcement, auditing and research have been established

L.40.20 Categories of users for which different levels of access are authorized have been defined

L.40.30 Annual report on the implementation and evaluation of policies and legal agreements related to HIE submitted to ONC HIN

Legal/Policy

Outcomes and Performance Measures

O.10 Outcomes and Performance Measures – Monitor and maintain a targeted degree of participation in HIE enabled state level technical services.

O.10.10 A plan to monitor and maintain a targeted degree of participation in HIE enabled state level technical services established.

O.10.20 XX% of healthcare providers in the state are able to send electronic health information using components of the statewide HIE Technical infrastructure

O.10.30 XX% of healthcare providers in the state are able to receive electronic health information using components of the statewide HIE Technical infrastructure

O.10.40 XX% of pharmacies serving people within the state are actively supporting electronic prescribing and refill requests

O.10.50 XX% of clinical laboratories serving people within the state that are actively supporting electronic ordering and results reporting

O.10.60 Trust agreements covering XX% of the state’s providers have been signed

O.10.70 Semi-annual progress reports submitted

O.10.80 Program performance measurement results submitted

O.10.90 Statutory requirements for HIE as defined in the HITECH Act achieved

O.20 Alignment with ARRA – Statewide HIE efforts are aligned with other federal programs. OSCConnectME

O.20.10 XX% of healthcare providers in the state have access to broadband services

O.30 Track Progress of Meaningful Use – Document how the HIE efforts within the state are enabling meaningful use.

O.30.10 Track progress of meaningful use by documenting how the HIE efforts within the state are enabling meaningful use

O.30.20 Annual report on statewide HIE alignment with other federal programs submitted to ONC

Outcomes and Performance Measures

Technical Assistance and Other

TA.10 Participate in training and technical assistance

TA.10.10 Two attendees participate in State HIE Forum

TA.10.20 Two attendees participate in State HIE Leadership Training

TA.10.30 Participate in NHIN Governance Training

TA.10.40 Review updates to the statewide HIE toolkit modules as new guidance is announced

TA.10.40 Review updates to the statewide HIE toolkit modules as new guidance is announced

TA.20 State-Specific Rescrictions

TA.20.20 Clarify how the state plans to obtain broad stakeholder participation and ensure their needs will be included in the strategic and operational plans.

TA.20.10 Timeline showing milestones for submitting state plan (Strategic and Operational) submitted to ONC

TA.20.20 Clarify how the state plans to obtain broad stakeholder participation and ensure their needs will be included in the strategic and operational plans.

TA.20.30 Provide an updated communication strategy for reaching out and obtaining feedback from stakeholder communities.

TA.20.60 Demonstrate Medicaid agency has agreed to participate in planning

TA.20.70 Commitment to develop financial policies, procedures and controls are consistent with state and federal requirements

Technical Assistance and Other

TA.20.80 Commitment toward aligning existing (or planned) infrastructure to be consistent with HHS adopted interoperability standards established

TA.20.90 Commitment to participate in all TA opportunities (including leadership training)

TA.20.100 Commit to having meetings with participants transparent to public (meeting schedules and minutes posted)

TA.20.110 Commitment to coordinate and align efforts with other federally funded related programs to meet overall HIE objectives as well as Medicaid and public health requirements for HIE & meaningful use criteria.

TA.20.120 Provide a plan for extension center coordination.

Technical Assistance and Other