THE SEQUOIA PROJECT Trusted Convener of Industry & Government to Address Health IT Interoperability 1 © 2015 The Sequoia Project. All Rights Reserved.

© 2015 The Sequoia Project. All Rights Reserved.

THE SEQUOIA PROJECTTrusted Convener of Industry & Government

to Address Health IT Interoperability

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Healtheway rebrands to reflect expanding mission for health IT interoperability, including:

• Increasing number of collaborative initiatives• Enhancing interoperability education• Promoting industry-wide best practices


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Why “The Sequoia Project”?

• Sequoia trees are among the most enduring, massive living things. • An interconnected root system allows individual trees to support each

other, making the entire system stronger.

A thriving health IT community requires interconnectedorganizations working together for the benefit of all.

Connected We Stand.


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The Sequoia Project is the trusted, independent convener of industry and government

Works to address the challenges of secure, interoperable nationwide health information exchange (HIE).

The Sequoia Project’s Role

NATIONWIDESECURE INTEROPERABLE


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Continued Support for Carequality and eHealth Exchange

• The Sequoia Project will continue to serve as the steward of its independent initiatives.

• The initiatives will continue to be governed independently by its respective members.

• The Sequoia Project will be actively pursuing additional interoperability initiatives that will aid in making secure data exchange a reality in the U.S. More information will be forthcoming within the year.


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Acting in the Public Interest

As a nonprofit 501 (c) 3 organization operating in the public interest, our public-private governance process insures transparent oversight of this work. The Sequoia Project serves as a neutral, third party convener. The practical application of our work: • Enables consensus agreement on the policies and

standards required to reduce barriers to data exchange• Advances development and continued support for health

information exchange governance frameworks• Provides services that enable health information exchange

networks to interoperate


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The Sequoia Project Initiatives

The Sequoia Project’s independent initiatives each have their own:

• Mission• Governance• Membership• Structure

The Sequoia Project is an ideal home for projects that require a collaborative environment where multiple parties with differing perspectives can work together.

• © 2015 The Sequoia Project. All Rights Reserved.

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Current Sequoia Project Initiatives

The eHealth Exchange is the largest and fastest growing health information exchange network in the US

Carequality is a public-private collaborative building consensus on a national-level interoperability framework to inter-connect networks


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The Sequoia Project and Care Connectivity Consortium (CCC) Strategic Alliance

• CCC is a collaborative of 5 prominent healthcare organizations: – Geisinger (PA)– Intermountain Health (UT)– Kaiser Permanente (CA, OR, WA,

VA, MD, HI, GA, CO)– Mayo Clinic (MN, FL, AZ, GA, WI)– OCHIN (17 states)

• CCC enhances capabilities of current HIE technologies and allows for sharing between organizations and health IT systems

• The CCC aids eHealth Exchange growth by: – Serving as a test bed for

new technologies– Contributing innovations to the

eHealth Exchange community

• The CCC participates in Carequality and serves on its:– Steering Committee– Trust Framework Work Group– Query Work Group– Operations Work Group


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The Largest Health Information Exchange Network in the U.S.


An initiative of

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Introduction to the eHealth ExchangeRapidly growing network for securely sharing health information over the Internet

Shared Governance and Trust Agreement Common Standards, Specifications & Policies

Tech Vendors

Federal Govt

States

PharmaciesPayers

HIEs

Care Facilities


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10 Years of Progress

2006ONC sponsors prototype

architectures, followed by trial implementations.

2008Focus shifted to

supportingproduction pilots

2009First production

exchange between Social Security Administration

and MedVirginia, followed by Veterans Health Administration

and Kaiser Permanente

2012Exchange

transitions from government to private sector. Private sector connectivity

increases

2015Nationwide

implementation across 50 states


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Largest Health Information Exchange Network in the U.S.

Today, the eHealth Exchange connects:

10,000 medical groups

900+ dialysis centers

8,200 pharmacies

Supporting more than 100 million patients

All 50 states

Four federal agencies(DoD, VA, HHS including

CMS, and SSA)

30% of U.S. hospitals


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eHealth Exchange Growth (2015 Projected)

• Operations supported by ONC

• Network doubles

• Growth fueled by MU2 TOC measures

• Testing Program launched

ONC Initiative: NwHIN Exchange

2009 2013 2014 20152011

• Network matures

• Product Testing Program launched

• Increased network adoption

• New use case

• New types of participants / networks

• Enhanced capabilities

• Streamlined testing / onboarding

44Total

ParticipantsTotal

Participants

23TotalParticipants

4

81Total

Participants

150+Projected

Participants


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eHealth Exchange Overview

eHealth Exchange Has Trust Foundation– Legal Agreement – Governing Committee– Operating Policies and Procedures

eHealth Exchange Uses Technical Services– Web services registry (phone book of network

Participants)– Security (x.509 Managed Certificate Authority)– Automated testing using Aegis platform


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Sample Use CasesTreatment / Care CoordinationAllows access to critical information (e.g., test results, medication history, allergy info, immunizations) and makes available to providers when patient is transferred

Responder Only Profile Supporting the Treatment Use case (New)Allows other networks (e.g., release of info companies and SAAS model vendors) to respond to queries from eHealth Exchange Participants on behalf of their client

Military/Veteran HealthDoD and VA exchange active service members and veterans’ records to provide government and private caregivers with up-to-date medical histories

Disability DeterminationSocial Security Administration requests claimant records electronically to make disability determinations. Cuts down claims processes from months to days

Quality Reporting for the End Stage Renal Disease Program – CMSAllows Dialysis centers to send quality data to CMS to assure that individuals with End Stage Renal Disease receive the highest quality of care


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eHealth Exchange: BenefitsBenefit How eHealth Exchange Achieves Benefit

Reducing Costs

Using common standards, legal agreements and governance enables participants to reduce legal fees and avoid building custom interfaces with trading partners.

Improving Clinical and Business Decisions

Access to a nationwide data sharing network provides secure access to the comprehensive health data that healthcare providers, pharmacies and payers require to improve clinical decision making, patient safety, process improvement and fair payment.

Exchanging Data with Government Agencies

Federal participation in the eHealth Exchange supports data sharing among all participants and with agencies such as Centers for Medicare & Medicaid Services, the Department of Defense, the Social Security Administration and the Department of Veterans Affairs.

Planning for the Future

Because the eHealth Exchange is governed by a representative set of participants, its multi-purpose interoperability platform has the ability to evolve and incorporate new use cases, standards, etc.


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Carequality for a Common HIE Framework

Accelerating seamless, interoperable health information exchange among networks


An initiative of

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The Challenge

What if you had a cell phone plan that only allowed you to call other

customers of your carrier?

That’s the situation for most healthcare

providers today, when they join a

data sharing network.


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The Solution

Carequality creates a standardized, national-level interoperability framework to link all data sharing networks

Carequality is creating a web of interconnected networks


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A Multi-Faceted Approach

Carequality’s strength lies in its diverse stakeholder base. We approach the interoperability challenge from all sides.

Collaborative

Multi-Stakeholder

Open

Real- World

Carequality is Managed by

The Sequoia Project is a nonprofit acting in the public interest. It convenes industry and

government to address common interoperability challenges.


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The Carequality Community

• Physicians

• Consumers

• Government Agencies

• Data Sharing Networks

• Payers

• Behavioral Health

• Acute Care

• Long Term and Post-Acute Care

• Hospice and Home Care

• Research

• Public Health

• Vendors

• Standards Development Orgs.

• Pharmacies

• EMS Services


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Carequality Members


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A Brief History

February 2014

Carequality Launch

May 2014

Operating Principles & Governance Model

June 2014

Steering Committee Formed

Aug/Sept 2014

Advisory Council & Work Groups Chartered

January 2015

Principles of Trust Adopted

April 2015

Initial RolloutKickoff


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Essential Elements

Common rules of the road: In order for the varied participants to trust each other with health information, everyone needs to have a legal obligation to abide by the same rules.

Well-defined technical specs: Shared rules are not enough; clear standards must be laid out in an implementation guide that all implementers can follow.

A participant directory: To connect using the common standards, systems must know the addresses and roles of each participant.


26 © 2015 The Sequoia Project. All Rights Reserved.

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Carequality Initial Rollout Began April 2015!

Initial Use Case Implementation Guide: Implement the technical, business, and policy requirements outlined in the Query Use Case Implementation Guide, and provide feedback to inform the version of the Guide adopted for general public use

Legal Framework for Exchange: Provide feedback on Carequality’s legal framework, and implement the standardized terms once they are adopted

It’s not too late to participate in the initial rollout! For information, contact [email protected]


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Carequality Initial Rollout Participants


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Carequality Initial Rollout Coverage

The initial rollout has have broad impact, covering:

• 200,000 Physicians

• Over 2,000 Hospitals

• Over 40,000 Clinics

• More than 15 million patient records shared per month


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There’s a lot more to health IT interoperability than document queries.

The initial Query for Documents Use Case is just the beginning.

The Carequality framework is flexible and is meant to be applied to many different use cases.


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Stakeholder Focus Groups

• Exploring other areas for potential use cases• Requesting input from stakeholder groups on

use cases that matter most to them• Likely stakeholder areas for exploration are:

– Payers– Mental and Behavioral Health– Long Term/Post-Acute Care– Population Health

If you’d like to join the conversation, please contact us at [email protected] and indicate your area of interest.


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Thank You!


THE SEQUOIA PROJECT Trusted Convener of Industry & Government to Address Health IT Interoperability 1 © 2015 The Sequoia Project. All Rights Reserved.

Documents

sequoia trees

ehealth exchange

thriving health

interoperability education

collaborative environment

continued support

interconnected organizations

secure data