State HIE Cooperative Agreement Program:

Michigan’s Response

Beth Nagel, HIT Coordinator

Michigan Department of Community HealthOctober 15, 2009

www.michigan.gov/mdch

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State HIE Cooperative Agreement

Program Key Information

Total Amount of Funding Available: $564,000,000Award Floor $4,000,000Award Ceiling $40,000,000Approximate Number of Awards: 56Program Period Length Four yearsLetter of Intent Due: 11-Sep-09Application Due: 16-Oct-09Award Announcements: 15-Dec-09Estimated Start Date: 15-Jan-10

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States will be expected to use their authority, programs, and resources to:

Develop and implement Strategic and Operational Plans

Develop state level directories and enable technical services for HIE within and across states.

Remove barriers and create enablers for HIE, particularly those related to interoperability across laboratories, hospitals, clinician offices, health plans and other health information trading partners.

Convene health care stakeholders to ensure trust in and support for a statewide approach to HIE.

Ensure that an effective model for HIE governance and accountability is in place.

Coordinate an integrated approach with Medicaid and state public health programs to enable information exchange and support monitoring of provider participation in HIE as required for Medicaid meaningful use incentives.

Develop or update privacy and security requirements for HIE within and across state borders.

State HIE Cooperative Agreement Program State Roles & Responsibilities

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State HIE Cooperative Agreement Program

Michigan’s Approach A Project Abstract

A Project Narrative

Strategic Plan (submitting Conduit to Care but not as a final strategic plan)

Operational Plan

Four separate 1-year budget narrative/justification

Letters of Commitment from key stakeholders

Letter from Governor

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State HIE Cooperative Agreement Program

Michigan’s Approach First Deliverable: Strategic & Operational Plans

Strategic plan It will be updated

Expanded information will be consistent with the “5 Essential Domains”

Michigan is working on an operational plan Work must be consistent with the “5 Essential Domains”

Needs stakeholder input (equivalent to the Conduit to Care process) to fill in and finalize

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State HIE Cooperative Agreement Program

Michigan’s Approach What needs to be done to have a complete

approach for Michigan? Technical Architecture

Business & Technical Operations Plan

Financial plan

Functioning governance structure

Privacy & Security policies for system development, use

Stakeholder engagement, feedback, input and buy-in on all components of strategic & operational plan

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Current State of HIE Capacity in MI: MiHIN Conduit to Care Michigan HIT Commission HISPC Broadband (FCC and ARRA) MiHIN Grant Program

9 MiHIN Regions MiHIN Resource Center

Community HIEs

State HIE Cooperative Agreement Program

Key Details

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Current State of HIE Capacity in MI Electronic Eligibility & Claims

BCBSM EDI Clearinghouse CHAMPS

E-Prescribing Initiatives SEMI CIPA Medicaid

State HIE Cooperative Agreement Program

Key Details

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Current State of HIE Capacity in MI Public Health Reporting

MCIR MDSS Laboratory Information Management System Michigan Electronic Death Registry Michigan Syndromic Surveillance System Web Electronic Birth Certificates

Quality, Care Coordination and Patient Engagement Medicaid Warehouse BCBSM PGIP Michigan Primary Care Consortium

State HIE Cooperative Agreement Program

Key Details

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Self Assessment Michigan has made significant progress Continued Planning must occur to meet ONC

criteria Michigan needs an updated Strategic Plan Michigan needs an Operational Plan

State HIE Cooperative Agreement Program

Key Details

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Proposed Project Strategy Build upon groundwork of state programs Leverage & add value to private investments Enable achievement of “meaningful use” Extensive stakeholder engagement

State HIE Cooperative Agreement Program

Key Details

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Strategic & Operational Planning Now through March 2010 Must finalize Strategic & Operational Plans before

receiving implementation funding Must work through specific milestones in five

domains: Governance Technical Architecture Business and Technical Operations Finance Legal/Policy

State HIE Cooperative Agreement Program

Key Details

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Implementation & Ongoing Efforts Technology “stood up” At least two pilots with at least two priority

services Security services implemented Testing Measurement

State HIE Cooperative Agreement Program

Key Details

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State HIE Cooperative Agreement Program

Key Details

1 2 3 4

Spending by Year

Year 1 No Match Until Oct. 2010 Year 2

10% MatchYear 3 14% Match

Year 4 33% Match

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State HIE Cooperative Agreement Program

Key Details

Supplies1%

Travel0%

Fringe 4%

Personnel9%

Indirect 2%Other

3%

Contractual23%

Technology58%

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Nearly 60 letters of support HIE Initiatives, Providers,

Organizations/Associations, Universities and Colleges of Medicine

Letter from Governor Letter from MDIT Letter from M-CEITA

State HIE Cooperative Agreement Program

Key Details

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Stakeholder Engagement

A wide array of stakeholders must be engaged to give input throughout all aspects of the project

Engage the MiHIN Regional entities to build on their significant progress

Form structured workgroups to get focused, detailed input

Hold public review and input sessions to ensure consideration of all perspectives

Utilize tools for transparency such as an online work space where all documents and information are readily available

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Finalized Strategic & Operational Plans Due ~ April 2010

Letter of Intent Due September 11

Workgroup Informational Session September 18

Applications Due October 16 Notice of Awards

December 15

Cooperative Agreement Signed January 15, 2010

September October November December2009 2010

Continuous, in-depth planning to meet April 2010 Due Date

Michigan’s Timeline

HIT Commission September 10

HIT Commission October 15

Workgroup Kickoff November 10

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Workgroup Formulation Principles Open & Inclusive

Meetings are open to the public

Transparent Meeting information will be readily available to anyone

Diverse Workgroups will include membership from diverse representation

Scalable & Feasible Workgroups may need to be scaled to an efficient number of voting

members. Web-ex and Teleconference will be used where appropriate. Clinical and Technical workgroups co-chairs are part of Governance/Finance

Fair Technology vendors that participate in any workgroups will not be eligible to

bid on any component of the technical solution(s)

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Work Groups Governance Workgroup

Finance sub-group

Measurement sub-group

Technical Work group Privacy & Security sub-group

Business Operation (formerly Clinical)

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Save the Date…

November 10, 2009

MiHIN Kick Off

Lansing

Details TBD

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For More information…

www.michigan.gov/mihinworkgroups

http://healthit.hhs.gov