TEXAS COUNCIL OF COMMUNITY CENTERS:DATA WORK GROUPMARCH 14, 2013
Healthcare Intelligence Partners, LLC
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Agenda
Welcome and Introductions Overview of the Day/Approach National Landscape Texas Landscape Initiate Development of Group Charter Next Steps Meeting Schedule/Wrap-up
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Overview of the Day/Approach
Conceptual Model Review national efforts Agreement on an approach for resolving
major challenges: Identify key areas for greater exploration Identify areas of specific focus in Texas
Key goals for the workgroup Meeting operations:
Group Charter Meeting schedule
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Major Issues
Data Standards/Implementation Specifications
Patient Consent Measurement
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Conceptual Model
Functional Domains: Interoperability Privacy/Security
(Consent) Measurement
Infrastructure EHRs HIEs
Legal
Techno-
logically
Possible
Operationally Feasible
Clinically
Relevant
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Agenda
Welcome and Introductions Overview of the Day/Approach National Landscape Texas Landscape Initiate Development of Group Charter Next Steps Meeting Schedule/Wrap-up
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National Landscape
Functional Domains: Interoperability Privacy/Security (Consent Management) Measurement
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National Landscape
HIE Models: Push/Direct Model
A referring provider “pushes” data to another provider.
Requires a provider directory Standards developed nationally
Pull/Patient Record Locator HIEs are notified when a patient record has new
information. Providers must query HIE regarding a specific
patient to find out of there are other patient records available.
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National Landscape
Interoperability Terms: Standards Specifications
Message Components: Message content Message ‘envelope’
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National Landscape
Interoperability Health Level 7 (HL7): Behavioral Health CCD
Project Behavioral Health CCD implementation guide (BH
CCD), which will constrain the C32 profile required for Meaningful Use Stage 1.
Currently being ‘balloted’ and tested. Center for Integrated Health Solutions (CIHS)
SAMHSA/HRSA Center for Integrated Health Solutions – Health Information Exchange (HIE) of Behavioral Health and Physical Health Care Data
5 state HIE Initiative (IL, KY, ME, OK, RI)
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National Landscape
Interoperability Behavioral Health Data Exchange
Consortium Managed by RTI’s State Health Policy
Consortium. Projects are expected to be completed by 3/31/13.
Florida, Michigan, Kentucky, Alabama and New Mexico have joined together to develop a common set of data exchange procedures for inter-state Direct exchange.
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National Landscape
Interoperability Workgroup (IWG) A project of the New York eHealth Collaborative
(NYeC) Vendors, States, and Providers Includes Texas
Not clear how information is devolving to HIEs in Texas.
Intended to create “plug and play” standards for HIE and EHR vendors.
States are supposed to use policy levers to promote the use of products that use these specifications.
Use market forces to drive interoperability.
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Privacy and Security
Patient Consent Identity Management/Trusted Entities
Authentication Authorization Certificate Management SAML Assertion
Data Use and Reciprocal Support Agreement (DURSA) Framework for allowing participating organizations to
share data. Supported by ONC and HHS; referenced in THSA
documentation.
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Privacy and Security
S&I Framework (http://wiki.siframework.org) The S&I Framework is a collaborative community of participants
from the public and private sectors who are focused on providing the tools, services and guidance to facilitate the functional exchange of health information. Each S&I Initiative tackles a critical interoperability challenge through a rigorous process that typically includes Development of clinically-oriented user stories and robust use cases Harmonization of interoperability specifications and implementation
guidance Provision of real-world experience and implementer support through
new initiatives, workgroups and pilot projects Mechanisms for feedback and testing of implementations, often in
conjunction with ONC partners such as NIST Data Segmentation for Privacy (DS4P) (handout)
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Measurement
ONC-SAMHSA Behavioral Health Technical Expert Panel (TEP)
The purpose is to: Recommend BH measures for widespread
adoption and utilization for future stages of the Medicare and Medicaid EHR Incentive Programs
Recommend future measure development needs by evaluating available clinical research
Provide private sector input regarding measure implementation feasibility
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TEP Endorsed Measures
MEASURE CONCEPT SUBGROUP
Recommended
PrioritySETTI
NGNQF
#STEWA
RDBipolar Disorder (BD and Major Depression (MD): Appraisal for alcohol or chemical substance use Alcohol 1 EP 110 CQAIMH
BBD and MD: Assessment for Manic or hypomanic behaviors Depression 1 EP 109 CQAIMH
BD: Suicide Risk Assessment Suicide 1 EP 111 CQAIMH
Maternal Depression Screening Depression 2 EP 1401 NCQA
Follow-up after Hospitalization for Mental Illness Depression 1 EP 576 NCQARisky behavior assessment or counseling by age 13 – Alcohol, Tobacco, Substance Abuse, Sexual Activity
Substance Use Disorder (SUD) 1 EP 1406 NCQA
Risky behavior assessment or counseling by age 18– Alcohol, Tobacco, Substance Abuse, Sexual Activity (SUD) 1 EP 1507 NCQA
Alcohol Screening Alcohol 1 EH 1661 TJC
Alcohol Brief Intervention Alcohol 1 EH 1663 TJC
Bipolar antimanic agent Depression 2 EP 580 RHI
From: http://www.healthit.gov/policy-researchers-implementers/behavioral-health-expert-panel (3/12/2013)
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Agenda
Welcome and Introductions Overview of the Day/Approach National Landscape Texas Landscape Initiate Development of Group Charter Next Steps Meeting Schedule/Wrap-up
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Texas Landscape
THSA and the Federated HIE model Update on conversations with THSA
Collaboration Council Pilot implementation with one HIE
Getting started on getting information
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Conceptual Model
Functional Domains: Interoperability Privacy/Security
(Consent) Measurement
Infrastructure EHRs HIEs
Legal
Techno-
logically
Possible
Operationally Feasible
Clinically
Relevant
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Technological Capability
Functional Domains: Interoperability Privacy/Security (Consent) Measurement
Infrastructure EHRs HIEs
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Technological Capability
Will the interfaces across EHRs in use by TCCC members and local HIEs support your legal, clinical, and operational goals? Consider the different requirements across
HIEs. Can they be modified to support your
legal, clinical and operational goals?
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Operational Feasibility
Functional Domains: Interoperability Privacy/Security (Consent) Measurement
Infrastructure EHRs HIEs
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Operational Feasibility
EHRs Eg. Anasazi and Topaz: Supported CCD
standards? Others?
HIEs: How many? Similarities/differences? Supported CCD standards? Patient consent management approaches? Data segmentation?
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Legality
Functional Domains: Interoperability Privacy/Security (Consent) Measurement
Infrastructure EHRs HIEs
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Legality
IL Document (Handout) How do Texas privacy laws differ from
federal privacy laws?
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Clinically Relevant
Functional Domains: Interoperability Privacy/Security (Consent) Measurement
Infrastructure EHRs HIEs
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Clinically Relevant
Can you send clinically relevant content with appropriate care partners?
Do you receive clinically relevant content from care partners?
Do you have enough data to develop/use clinical quality measures?
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Agenda
Welcome and Introductions Overview of the Day/Approach National Landscape Texas Landscape Initiate Development of Group Charter Next Steps Meeting Schedule/Wrap-up
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Group Charter
Name Goals Objectives In-Scope/Out of Scope Deliverables Roles Meeting frequency/duration
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Content Sharing/Decision-Making Setting meeting agendas? When do you have enough information
to make a decision? How will decisions get made?
In-scope/out-of-scope? Strategies? Technical Issues?
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Agenda
Welcome and Introductions Overview of the Day/Approach National Landscape Texas Landscape Initiate Development of Group Charter Next Steps Meeting Schedule/Wrap-up
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Next Steps
Next Meeting Topic Explore speakers?
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Agenda
Welcome and Introductions Overview of the Day/Approach National Landscape Texas Landscape Initiate Development of Group Charter Next Steps Meeting Schedule/Wrap-up
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Meeting Schedule/Wrap-up
Meeting date Meeting duration
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Smarter Strategies for Better Healthcare
David BergmanFounder
(207) [email protected]
Healthcare Intelligence Partners