Health Information Technology Council 
Meeting
April 4, 2016

•	Welcome  [5 minutes] – Alice Moore
•	Introductions
•	Approval of December 7, 2015 Meeting Notes
•	Opt-In/Opt-Out and Regulations Update  [45 minutes] – Sharon Boyle and Kathleen Snyder
•	State Medicaid Director Letter 16-003  [10 minutes] – David Whitham
•	Outreach Deep Dive Approach for Active Use  [10 minutes] – David Whitham
•	FAST Initiative Update  [10 minutes] – Dave Bowditch
•	Operations Update  [5 minutes] – Dave Bowditch
•	Conclusion  [5 minutes] – Alice Moore  
•	Next Steps
•	2016 Schedule

Appendix:
M.G.L. Chapter 118I references

Opt-In/Opt-Out and Regulations Update
Sharon Boyle and Kathleen Snyder
Executive Summary

HIway Regulations Discussion
Focus on Mechanism for Opt-In/Opt-Out

•	Background
•	Opt-In/Opt-Out
•	Proposed Regulations Language

HIway Regulations Discussion
Focus on Mechanism for Opt-In/Opt-Out

•	Background
•	Opt-In/Opt-Out
•	Proposed Regulations Language

DRAFT: Proposed Mechanism for Opt-Out

HIway Regulations Discussion
Focus on Mechanism for Opt-In/Opt-Out

•	Background
•	Opt-In/Opt-Out
•	Proposed Regulations Language

State Medicaid Director Letter 16-003
David Whitham

On February 29th, CMS/ONC issued a letter announcing:
•	Expansion of funding scope for HIEs:  Previously, matching funds were limited to supporting HIE for Meaningful Use EPs and EHs only. Given MU Stage 2/3 focus on coordination and transitions of care, guidance was updated. Now, Medicaid HITECH funds can be used to support Medicaid providers that EPs coordinate with.

•	This means that: Support is available to help non MU eligible Medicaid providers effectively use the HIE to help an EP achieve Meaningful Use Stage 2/3. Examples include behavioral health, long term care, substance abuse, and correctional health providers. 
–	“Support” includes activities under onboarding to the HIE and enhancing interoperability architecture.  It does not include ongoing operations and maintenance. 
–	Funds cannot be used to support EHR purchasing or implementation, or supplementing functionality of EHR systems. 
–	Non eligible providers are still non eligible providers. This does not expand the eligibility definition.  

HIE On-Boarding:
•	The letter defines On-boarding as: “The technical and administrative process by which a provider joins an HIE or interoperable system and secure communications are established and all appropriate Business Associate Agreements, contracts and consents are put in place.”
•	Medicaid provider examples include: behavioral health providers, substance abuse treatment providers, long-term care providers (including nursing facilities), home health providers, pharmacies, laboratories, correctional health providers, emergency medical service providers, public health providers, and community-based Medicaid providers. 
•	The SMD Letter also adds 3 new types of providers: 
–	Pharmacies
–	Clinical laboratories
–	Pubic health providers. 
All activities must directly support an EP’s achievement of MU Stage 2/3
The funding supports the cost of HIway onboarding activities only and does not provide for subsidies to support provider activities.

HIE Architecture and Interoperability Enhancement:
•	The SMD Letter supports the design, development, and implementation of infrastructure for HIE components and interoperable systems that support Eligible Providers in coordinating care with other Medicaid providers via HIEs or other interoperable systems, if doing so helps them demonstrate Meaningful Use
•	Examples include: 
–	Provider Directories:
–	Secure Electronic Messaging
–	Query Exchange
–	Care Plan Exchange
–	Encounter Alerting
–	Public Health Systems
–	Health Information Services Provider (HISP) Services
•	This is not an exhaustive list of the types of state costs for design, development, and implementation of HIE components and interoperable systems for which 90 percent HITECH match might be claimed. 

While this is an exciting opportunity that can enhance interoperability, it’s important to remember that: 
•	All activities are subject to prior CMS approval in the Implementation Advance Planning Document (IAPD).
•	State has to match funds at 90/10 rate.  
•	Funding must connect Medicaid providers to EPs, and help the EP achieve MU Stage 2/3. This means the State must map specific MU measures to HIE use, and describe activities to support trading partners. 
•	Benchmarks and implementation metrics are not defined. State must outline and submit to CMS for review, comment, and approval. 
•	Process of data reporting must be defined and implemented. State must have a process to track and report MU implications of all activities. Some new systems, like encounter alerting or care plan exchange) may not have defined data standards, but must support MU. State needs to determine how. 

EOHHS is in the process of further assessing the opportunities in the SMD Letter and will develop a plan for proposal and keep the community informed. 

Outreach Deep Dive Approach for Active Use
David Whitham
Focus on Active Use
•	The Mass HIway Account Management team has shifted focus from just connecting participants to helping participants actively exchange health information in SFY’16
•	Why the shift? 
–	Technical connectivity is not enough. Though connectivity converts to active public health reporting it does not convert to active care coordination.
–	Active exchange of health information requires complex multi-organizational change management. Healthcare organizations need coordination support, feedback from information trading partners, and shared learning.
–	Mass HIway is one of the entities that is positioned to assist providers. MeHI Connected Communities and HPC CHART staff are also focusing on this.
•	What is needed from a participating  healthcare organizations?
–	Commitment of organizational leadership
–	Direct involvement of business and clinical leadership (this is not an IT project)
–	Development of a discreet, time limited project that is in line with the shared clinical improvement goals.
eHealth Progression
A Catalyst for Collaboration
Sample questions raised and resolved through recent active exchange work with Massachusetts providers:
•	Who are our information trading partners? Who is connected? What is their address? Who can I talk to when setting up new communications processes?
•	How are our outbound messages being sent? When do we trigger them? To whom are they going? What content is being sent? 
•	How do we process inbound messages? Who should receive them? How should follow up work be managed and tracked?
•	We’re thrilled to be getting problems, allergies, medications, and immunizations but where are the discharge instructions and the specialist notes? We really need those!

The HIway Account Management team is available to begin the coordination of these types of discussions at all levels of a healthcare provider and continue to expand the ranks of Mass HIway Active Users.

FAST Initiative Update:
Provider Directory Update Simplification Overview
Dave Bowditch

Operations Update
Dave Bowditch

•	Commonwealth Pediatrics
•	Anthony E. Breglio, D.M.D
•	Bass River Pediatrics
•	BJD Pediatrics
•	Cape Ann Medical Center, LLC
•	Cape Ann Pediatricians PC
•	Child Health Associates
•	Dedham Medical
•	Dermatology Associates of Concord
•	Dr. Yolanda Lenzy, MD, MPH
•	Exceptional Health
•	Falmouth Women's Health
•	Granite Medical
•	Harvard Vanguard Medical Associates
•	Highland Pediatrics
•	Macony Pediatrics

•	Lowell Community Health Center
•	Macony Pediatrics
•	Merrimack Valley Pediatrics
•	Pediatric & Adolescent Medicine
•	Pediatric Associates of Fall River, Inc
•	Pediatric Associates of Greater Salem
•	Pediatric Health Care Associates
•	Pediatric Healthcare Associates
•	Pediatric Healthcare At Newton Wellesley
•	Plymouth Dermatology Associates, PC
•	QUEST DIANOSTICS Marlboro
•	QUEST DIANOSTICS NICHOLS
•	Rainbow Pediatrics / Northend Medical Associates
•	Rhode Island Department of Health
•	South Shore Medical Center
•	Steven R. Kanner MD, LLC (Orchard Healthcare)
•	Surgi-Care, Inc.
•	Woburn Pediatrics
•	Worcester Dermatology Associates, P.C.

•	Amherst Pediatrics 
•	Abington Pediatrics
•	BJD Pediatrics
•	Blue Hills Medical Associates (HermesIQ)
•	Bolton Street Pediatrics P.C.
•	Cambridge Health Alliance
•	Chelmsford Pediatrics
•	Child Health Associates
•	Commonwealth Pediatrics
•	Dedham Medical
•	Dermatology Associates of Concord
•	Dr. Yolanda Lenzy, MD, MPH
•	Dracut Family Healthcare
•	Drumhill Pediatrics
•	Fairview Pediatrics
•	Falmouth Women's Health
•	Granite Medical
•	Harvard Vanguard Medical Associates
•	Highland Pediatrics

•	Charles River Pediatrics
•	Garden City Pediatric Associates
•	Marion Pediatrics
•	Pediatrics West
•	Weston Primary Care

•	Bass River Pediatrics
•	Garden City Pediatric Associates
•	Milton Orthopedic & Sports Physical Therapy PC
•	Pediatrics West
•	Seven Hills Behavioral Health Inc
•	SMOC Behavioral Health Services
•	Weston Primary Care

•	ADS
•	Allscripts
•	Amazing Charts
•	Aprima
•	Athenahealth
•	BayCIS/ehana/AMS
•	Care at Hand
•	Carelogic
•	Cerner
•	CPSI
•	Credible
•	Dentrix
•	Eaglesoft Clinician
•	eClinicalWorks
•	EMA Modernizing Medicine
•	eMDs
•	encite

Conclusion 
Alice Moore

Thank you!

Appendix