Commonwealth of Massachusetts
Executive Office of Health and Human Services

Health Information Technology Council
Meeting

February 5, 2018

Agenda

Welcome
Undersecretary Lauren Peters

HIT Annual Report
Undersecretary Lauren Peters

HIway 2.0 Update
Dave Bowditch, Ryan Thomas, Jeffrey Grant

HIway Connection Requirement: Year 1 & Year 2 Updates
Michael Chin

EOHHS Event Notification Service (ENS) Initiative Update
David Whitham

Highway Adoption & Utilization Service (HAUS) Highlight
Julie Creamer, Padma Sastry, Shawn Howland, Michele Crehan

Appendix: HIway Operations Update

HIT Council Annual Report

Undersecretary Lauren Peters

New Mass HIway Direct Messaging System:	“HIway 2.0”

Dave Bowditch

Ryan Thomas – Orion Health Jeffrey Grant – Orion Health

Implementing the New Mass HIway
Direct Messaging System:	“HIway 2.0”

Contract Signed!

EOHHS is pleased to announce that it has selected Orion Health to implement and operate a new Mass HIway Direct Messaging System, also known as “HIway 2.0”

EOHHS and Orion Health executed a new contract effective January 1, 2018.

Benefits of HIway 2.0

HIway 2.0 will use Orion Health’s Communicate product, a SaaS solution.

Accredited by EHNAC for participation in DirectTrust – automatic, immediate connection to all DirectTrust HISPs

Supports current Direct standards, making it easier to connect to other systems

Improved Provider Directory (HPD)

Certified ONC Edge Protocol

Multiple Recipient Support

Maintained with regular enhancement releases and product support

5

Implementing “HIway 2.0” (continued)

Current Communicate Clients

Alaska HIE
Catholic Health Initiatives

Greenville Health System
Inland Empire HIE
Keystone Health Information Exchange
Louisiana HIE
New Mexico HIE
North Carolina HIE
North Dakota HIE

Oklahoma Department of Health
Mary Washington HIE
Western Connecticut HIE
The Koble Group HIE
St. Vincent HIE

A

MASSACHUSETTS tflALTH 'NFOfiMAii Of.4 H CiHWAY

HISP Organization	WHI-W-AY-
"'"'UM'H•I•,-n• H..AI lH o  ()......nt)ff tonnHWAY	......
..D..,ircctTrust	
ORION-;::_ Commu nicate
t-tB:AL.Tt-t	
Athenaheatth.Inc..	X	X	Trusted	
Care Acco r'd	X	X	Ttu ted	
Cel"net	X	X	Ttusted	
Cemer Moblle MD		X	Trusted	
Covlslnt		X	Trusted	
Co eva .. Applied Reseatch Works		X	Trusted	
DataMotion		X	Trusted	
eCIInlcaiDirect LLC (Plus)	X	X	Ttusted	
EMR Direct	X	X	Trusted	
Glenwood Systems		X	Trusted	
Health Companion.. Inc.		X	Trusted	
HealthUnity Corporation		X	Trusted	
HIXNY		X	Ttusted	
Indian Hea th Servf c.e		X	Trusted	
Informatics Corporation of' Amel"'ca		X	Trusted	
lnprlva.. Inc.	X	X	Trusted	
INTEGRIS Health, Inc.		X	Trusted	
lntetmounta1n Mea thcare		X	Trusted	
100Incorporated		X	Trusted	
IShare Medical		X	Trusted	
MaMMD	X	X	Trusted	
MedAIIIes	X	X	Trusted	
Medlclty Inc.	X	X	Ttusted	
Medfcsasoft		X	Trusted	
MHIN		X	Trusted	
Mirth LLC (NeMGen Share)	X	X	Trusted	
MRO Corporation		X	Tru ted	
New York eHealth Collabor"a tfve (NYeC)		X	Trusted	
Nltor	X	X	Trusted	
Orlon Health Ltd	X	X	Trusted	
Pulse Systems,.Inc .		X	Trusted	
Quest Diagnostics		X	Tru ted	
RelayHea th	X	X	Trusted	
Rochester RHIO		X	Trusted	
secure Exchange Solut:fons	X	X	Trusted	
surescrlpts, LLC	X	X	Trusted	
The Heal1:h Co llaborative		X	Trusted	
Truven Health Anaf vt:lcs		X	Trusted	
UpdoM	X	X	Trusted	
Wellport (Lumlra)	X		Will add Pr"lor to participant cutover, aareements will transfer	
MyHealthProvlder	X		Will add prior to participant cutover,. aa:reements will transfer	
eLINC	X		Will add prior to participant cutover agreements will transfer	
AP rlma	X		Will add Drlor to D&rtlcJDant cutover, aa:re.ements will transfer	
eCIInlcaiDirect (non-Plus)	X		Will add prior to participant cutover, aareements will transfer	

What Migration to HIway 2.0 means for current Participants…

New verification and paperwork requirements for LOA 3

Level of Assurance 3 (LOA 3) is the government standard for electronic authentication of identity required for health information exchange

Domain names and Direct addresses do not change

Webmail to Communicate Webmail
Low participant impact
Migration of mailbox data

LAND to Communicate Connect
Device and Usage review (replace old hardware if necessary)
Remote login and image update

XDR/XPL to Communicate Direct XDR
New certificate chain and personal certificate delivery

Participant installs certificates on their infrastructure

8

Set-up Activities Prior to Go-Live

Initial Setup & Install – January and February 2018

Connection of EOHHS to Communicate, Orion Health’s EHNAC Accredited platform

DirectTrust HISP-to-HISP setup for HIway 2.0 domains and services

Pilot Participant Coordination – March 2018

Pilot Participant sites

Specific sites to be identified by the Mass HIway team

Pilot Participants will complete registration paperwork

The Mass HIway team will configure Pilot Participant connections

Mass HIway and Pilot Participants will review test and cut-over plans

Early adopter planning: OCHIN, MEDITECH Multi-Recipient Users, etc.

Begin initial Webmail migrations

Final timing depends on readiness and priorities

Implementation Timeline

The following are some of the key milestones.

April 2018

HIway 2.0 goes live

Pilot Participant connections tested and moved to production

All new Participants will be onboarded to HIway 2.0 as they join

Existing Participants will start migrating from HIway 1.0 to HIway 2.0

HIway 1.0 will continue to operate in maintenance-only mode with no new
enhancements or upgrades

January 2019

All existing Participants expected to be migrated from HIway 1.0 to HIway 2.0

HIway 1.0 will be decommissioned after all Participant migrations have completed

10

HIway Connection Requirement:	Year 1 & Year 2 Updates

Michael Chin

HIway Connection Requirement:	Background

The HIway connection requirement is the requirement for providers to connect to the Mass HIway, as set forth in M.G.L. Chapter 118I (section 7) and as detailed in the Mass HIway Regulations (101 CMR 20.00).

The Mass HIway Regulations went into effect in February 2017.

The regulations implemented a phased-in approach for the HIway connection requirement:

The phased-in approach progressively encourages use of the Mass HIway for Provider-to-Provider communications and bi-directional exchange of health information.

The approach was phased-in by several different aspects, including:

Three types of Provider Organizations (i.e., Acute Care Hospitals, Large & Medium Medical Ambulatory Practices, Community Health Centers) have connection dates that are specified in the Mass HIway Regulations.

EOHHS anticipates that Provider Organizations which are not specified in the regulations will be required to connect at a future date, with future guidance providing at least one year notice for affected organizations to connect.

The initial date by which an organization needs to connect to the HIway (i.e., the “Year 1 HIway
connection requirement”) is different for different types of provider organizations.

The specifics of what organizations must do to meet the HIway connection requirement are different in Year 1 vs. Year 2 vs. Year 3 (see next slide for more details).

The HIway connection requirement follows a four-year phased-in approach that progressively encourages use of the Mass HIway for Provider-to-Provider communications and bi-directional exchange of health information.

How Provider Organizations connect:

Year 1:  Send or receive HIway Direct Messages for at least one use case.
The use case may be within any category of use cases.

Year 2:	Send or receive HIway Direct Messages for at least one use case that is within the
Provider-to-Provider Communications category of use cases.

Year 3:		Send HIway Direct Messages for at least one use case, and also receive HIway Direct Messages for at least one use case. Both of these uses cases must be within the Provider-to-Provider Communications category of use cases.

Year 4: The provider organization may be subject to penalties, if that organization has not met the requirements established in this section. Penalties do not take effect until Year 4 of the connection requirement (i.e., in January 2020, at the earliest).

Acute Care Hospitals: In addition to using HIway Direct Messaging, Acute Care Hospitals are also required to send Admission Discharge Transfer notifications (ADTs) to the Mass HIway within 12 months of the ENS' launch as a part of the HIway connection requirement.

In calendar year 2017: Acute Care Hospitals were the first group of provider organizations that had a HIway connection requirement

Who & When: Provider organizations that have HIway connection dates that are specified in the Mass HIway Regulations are required to submit a Year 1 Attestation Form by July 1st after their initial HIway connection requirement.

Provider Organization	
Date of the “Year 1” HIway connection requirement	
Due date of the Year 1 Attestation Form		
					
	Acute Care Hospitals	February 10, 2017	July 1, 2017		
					
	Large and Medium
Medical Ambulatory Practices	
January 1, 2018	
July 1, 2018		
	
Large Community Health Centers	
January 1, 2018	
July 1, 2018		
	
Small Community Health Centers	
January 1, 2019	
July 1, 2019		

Update: EOHHS received Year 1 Attestation Forms from 100% of Acute Care Hospitals in the
Commonwealth

In calendar year 2018: There are two key milestones ….

Large & Medium Medical Ambulatory Practices and Large Community Health Centers have a HIway connection requirement

Who & When: Provider organizations that have HIway connection dates that are specified in the Mass HIway Regulations are required to submit a Year 1 Attestation Form by July 1st after their initial HIway connection requirement.

Provider Organization	
Date of the “Year 1”
HIway connection requirement	
Due date of the
Year 1 Attestation Form	
	
Acute Care Hospitals	
February 10, 2017	
July 1, 2017	
				
	Large and Medium
Medical Ambulatory Practices	
January 1, 2018	
July 1, 2018	
	
Large Community Health Centers	
January 1, 2018	
July 1, 2018	

Small Community Health Centers	
January 1, 2019	
July 1, 2019	
How:	Year 1 Attestation Forms should be submitted to the Mass HIway by either:
The preferred method: the on-line version of the form (which is expected to be available in March 2018)
The alternate method: the PDF version of the form (which should be completed, printed, signed, scanned, and emailed to: MassHIwayAttestation@state.ma.us)
Where: The Year 1 Attestation Form (updated Dec 2017, including instructions) is available on the HIway web page.
.	15

In calendar year 2018, the second milestone is:

Acute Care Hospitals enter Year 2 of the HIway connection requirement

Provider Organization	
Date of the “Year 2” HIway connection requirement	
Due date of the Year 2 Attestation Form	

Acute Care Hospitals	
January 1, 2018	
July 1, 2018	

The main difference between Year 1 and Year 2: To meet the Year 2 HIway connection requirement, Provider Organizations need to send or receive HIway Direct Messages for at least one use case that is within the Provider-to-Provider Communications category of use cases (instead of sending or receiving for a use case within any category of use cases).

Acute Care Hospitals that want to discuss implementation of Provider-to-Provider Communication use
cases can contact their HIway Account Manager.

How:	Year 2 Attestation Forms should be submitted to the Mass HIway by either:

The preferred method: the on-line version of the form (which is expected to be available in March 2018)

The alternate method: the PDF version of the form (which should be completed, printed, signed, scanned, and emailed to: MassHIwayAttestation@state.ma.us)

Where: The Year 2 Attestation Form (including instructions) is available on the Mass HIway web page.
16

Mass HIway hosted a webinar on the Mass HIway connection requirement & attestation process on January 18, 2018.

The webinar presentation is available on the “Events” page within the Mass HIway website:
www.masshiway.net

Leading up to the July 2018 attestation form due date, EOHHS expects to receive questions about the HIway connection requirement and attestation process

EOHHS encourages stakeholders to contact the HIway with questions and comments related to the HIway connection requirement

EOHHS anticipates reviewing questions and updating the Mass HIway Regulations FAQs prior to the July 2018 attestation due date

Email address for general questions about the connection requirement & attestation
process: MassHIway@state.ma.us

Email address to submit a completed attestation form: MassHIwayAttestation@state.ma.us

The preferred, on-line versions of the Year 1 and Year 2 Attestation forms are expected to be available on the HIway website (at www.masshiway.net) in March 2018, prior to the July 1, 2018 submission deadline.

EOHHS Event Notification Service (ENS) Initiative Update

David Whitham

Background Information:
The EOHHS ENS Initiative

Mission Statement

EOHHS will facilitate event notification services statewide, with the goal of improving care coordination regarding transitions of care and health care events such as emergency room and hospital admission, discharges and transfers

Background

At the previous HIT Council meetings, EOHHS presented plans to implement the hybrid approach (i.e., EOHHS collects and shares ADTs with private ENS vendors, and has the option of producing notifications to be sent to participants)

The EOHHS ENS Initiative may be implemented in two phases

Phase One: Implement a statewide ADT repository

Phase Two (optional): Implement a statewide ENS

The ENS Initiative requires that the bidder must be able to do three things:

The selected vendor must implement the “core services”

Provide a centralized, statewide “ADT Repository”

Share ADTs with authorized ENS vendors

Provide and manage a centralized opt-out mechanism

Maintain patient identification and matching capabilities

Note: Producing ENS notifications is not included in the list of “core services”

The selected vendor should be able to produce notifications

The selected vendor would provide Subject Matter Expertise to help deliver on
#1, and to inform EOHHS’ decision on #2

Second Quarter of Calendar Year 2017:
Release RFI, Review Responses, Meet with Selected Vendors (completed)

Third and Fourth Quarter of Calendar Year 2017:
Prepare and Approve RFR (completed)

First and Second Quarter of Calendar Year 2018:
Confirm CMS Approval of RFR

Release RFR

Review Responses

Select Vendor

Negotiate Contract

Third and Fourth Quarter of Calendar Year 2018:
Begin Preparations for Launching the ADT Repository

(includes establishing business processes, testing, and defect remediation)

First Quarter of Calendar Year 2019:
ENS Soft Launch (repository ready to receive and distribute ADTs)

Highway Adoption & Utilization Services (HAUS) Highlight
Julie Creamer

Padma Sastry – Circle Health Shawn Howland – Circle Health Michele Crehan – Circle Health

HIway Adoption & Utilization Services

Highlights

The HIway Adoption & Utilization Services (HAUS) initiative (formerly known as the Deep Dive initiative) will be re-aligning its services in the spring of 2018 to support MassHealth’ s transition to alternative payment models.

The goal of the Initiative is to increase use of Direct Messaging for care coordination purposes and to more closely align these services with the real drivers of change in the Health IT space – payment reform.

Mass HIway is working closely with MassHealth to understand the health information exchange needs of its ACO participants, Behavioral Health and Long Term Services and Support Community Partners (CPs), and Community Service Agencies (CSAs).

Services provided will include technical assessments, end-to-end management of health information exchange projects among multiple trading partners, workflow support, and overall change management.

Mass HIway will also develop a host of on-demand resources and events to support efforts to advance care coordination over the Mass HIway.

Circle Health – Mass HIway

Interoperability Use Cases

Presenters:

Padma Sastry –	Senior Project Leader, Circle Health Shawn Howland – Senior Application Analyst, Circle Health Michele Crehan – Senior Application Analyst, Circle Health

25

Agenda

Circle Health/Lowell General Hospital – Who we are

Overview of Circle Health – Mass HIway Interoperability Use Cases

Circle Health – Atrius Health integration:
Enhanced communication between facilities, Better access to clinical
information, Coordination of care between facilities
ADT integration

Circle Health – Tufts Medical Center:
Enhanced communication between facilities, Reduction of faxes, Better
coordination of care
Tufts -> Circle Health Cerner practices ADT notifications
Circle Health OB/GYN and Woman Health practices <-> Tufts Maternal Fetal Medicine
Circle Health Mother and Child Unit <->Tufts Maternal Fetal
Medicine

26

Who We Are

Lowell General Hospital is a not-for-profit community hospital serving the Greater Lowell area and surrounding communities, with two primary campuses located in Lowell, Mass.

Lowell General Hospital merged with Saints Medical Center in 2012 to form Circle Health

2 hospital campuses, multiple satellite locations

Affiliated with several PCP and Specialty practices using multiple EMR platforms

27

Our Promise - Complete connected care

28   © Cerner Corporation. All rights reserved.

Growth timeline:	2012 – 2018

Circle Health Westford opens expanding urgent care, PCP, specialty and OB/GYN services

2014

Circle Health Billerica opens expanding urgent care, PCP, and patient service center services

2016

2012

Lowell General Hospital acquires Saints Medical Center to form Circle Health

2015

Outpatient and physical therapy departments expand to space in Chelmsford

2018

Circle Health Dracut scheduled to open with urgent care, PCP and specialty care services

© Cerner Corporation. All rights reserved.

29

2012 – 2017

Wellforce

Circle Health/Lowell General Hospital

Circle Health

Tufts Academic Medical Center (Adult & Children’s hospitals)

Hallmark Health System

2 Community Hospitals (Main Campus & Saints Campus)

Together: 4 community hospitals, academic

Lowell General
Hospital

2 Community Hospitals
(Main Campus & Saints
Campus)

8th Largest Hospital in MA

18 Ambulatory Clinics

Primary goal: Complete
connected care

How it works: collaboration of
physicians, hospitals, other health providers,
& community-based

medical center, children’s hospital, multiple health centers
~3,000 physicians

Primary goal: collaboration for hospitals &
physicians so
clinicians can deliver expert care where

organizations

it’s needed most

Interoperability Use Cases

Circle Health – Atrius Health integration (Status: Live)

Approximately 1000-1100 ADTs are sent per week from
LGH to Atrius Health over the Mass HIway

Atrius Health creates admit/discharge encounters from the ADT feed in their EMR to notify the providers when their patients have been seen at LGH.

Reports are distributed to case management and nursing for post acute care workflows such as reaching out to the patients to make follow up appointments.

31

Interoperability Use Cases

ADT notifications/CCDs from Tufts Medical Center to Lowell General PHO practices ( Status : LIVE)

LIVE at 17 practices using Cerner EMR

Currently receive notifications as well as fax

Overall goal is to eliminate faxes (potentially during spring 2018)

Office staff matches the patient and forwards the Direct message to the provider

This saves the provider the time it takes to match the patient

This also helps the office staff make sure the patient comes in to see their PCP within the required amount of time per their insurance

Planning to roll-out to other Circle Health affiliated practices with capability to receive ADTs.

32

Interoperability Use Cases

Circle Health Mother Infant Unit – Tufts Maternal Fetal Medicine integration	(Status: Testing)

Reports and other clinical documents sent to Tufts Specialists

Current process involves sending over 50 pages of faxes per
patient for consults and transfers

NST reports, OB notes, consult documents

Future state workflow of utilizing Direct messaging from the EMR would help streamline workflow

End goal of project is to replace the current fax workflow with new electronic exchange workflow using Direct messaging

33

Interoperability Use cases

LGH Medical Group – Woman Health and OB/GYN Associates of Merrimack Valley – Tufts Maternal Fetal Medicine integration	(Status: Testing)

Referrals for Level 2 Ultrasounds

Current process involves multiple pages of faxes per patient

Referral letter, Labs, Imaging results, OB notes

Future state process of utilizing Direct messaging would help streamline the workflow

34

Challenges

Direct messaging workflow – multiple Direct addresses

Practice workflow – Message Pool vs. Provider inbox

Variation between EMRs
Standards (no “Direct” standards for non CCDA exchange)
Type of documents that can be exchanged
Workflow

Transmission problems (certificate issues, various technical challenges related to exchange of information among as many as four different vendors)

Data reconciliation (medication reconciliation, lack of consistency around data presented, SNOMED vs. ICD-10, clinical workflow)

Organizational challenges – competing priorities, lack of resources to devote to interoperability projects

35

Lessons Learned

Achievable goals driven by use cases
Transitions of care
ADT notifications
Secure communication
Consult requests between physicians

IT knowledge base

Governance

Emphasis on value

Patients think we already have this capability

36

Questions ??

37

Conclusion

Undersecretary Lauren Peters

2018 Schedule

HIT Council - Meeting Schedule:
Typically the 1st Monday of every third month
Meetings are from 3:30 to 5:00 PM unless otherwise noted
All meetings are at One Ashburton Place, 21st Floor, Boston

Planned upcoming 2018 meetings:
Monday, May 7, 2018
Monday, August 6, 2018
Monday, November 5, 2018

Commonwealth of Massachusetts
Executive Office of Health and Human Services

Thank you!

Appendix:	HIway Operations Update

13 Month HIway Transaction Activity

9,757,005 Transactions* exchanged in January (12/21/2017 to 01/20/2018**)
207,394,067 Total Transactions* exchanged inception to date

12,000,000

10,000,000

8,000,000

6,000,000

4,000,000

2,000,000

	Jan.2017	Feb.2017	Mar.2017	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	
Total transactions:	7,029,969	7,100,105	7,463,101	7,460,597	7,718,904	7,909,195	7,894,635	7,793,259	8,685,940	10,305,258	10,555,739	9,673,458	9,757,005	

0

* Note: Includes all transactions over Mass HIway, both production and test

HIway Production Transaction Trends – Provider to Provider (Jan 2017 – Jan 2018) 3% of HIway activity in January* was for Provider to Provider transactions

		

		

		
	Jan.2017	Feb.2017	Mar.2017	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	
Provider to Provider	216,487	186,118	186,244	217,828	219,597	361,745	267,970	248,112	264,261	254,248	273,854	263,471	235,936	

400,000

350,000

300,000

250,000

200,000

150,000

100,000

50,000

0

HIway Production Transaction Trends – Quality Reporting (Jan 2017 – Jan 2018) 5% of HIway activity in January* was for Quality Reporting transactions

600,000

500,000

400,000

300,000

200,000

100,000

0
Jan.2017   Feb.2017  Mar.2017  Apr.2017  May.2017  Jun.2017    Jul.2017   Aug.2017  Sep.2017   Oct.2017  Nov.2017  Dec.2017   Jan.2018
Quality Reporting   325,166	339,380	270,903	397,178	388,311	445,709	401,163	454,485	427,053	509,461	317,913	286,607	257,233

HIway Production Transaction Trends – Payer Case Management (Jan 2017 – Jan 2018)

< 1% of HIway activity in January* was for Payer Case Management transactions

35,000

30,000

25,000

20,000

15,000

10,000

5,000

	Jan.2017	Feb.2017	Mar.2017	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	
Payer Case	29,700	28,538	27,786	32,687	30,611	30,592	29,445	28,104	30,663	30,004	30,181	29,554	25,010	

0

HIway Production Transaction Trends – Public Health Reporting (Jan 2017 – Jan 2018)

91% of HIway activity in January* was for Public Health Reporting transactions.
These Public Health transactions are analyzed by application on the following slides.

12,000,000

10,000,000

8,000,000

6,000,000

4,000,000

2,000,000

	Jan.2017	Feb.2017	Mar.2017	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	
DPH Transactions	6,401,741	6,452,225	6,867,272	6,656,846	6,122,834	6,790,207	7,072,265	6,845,895	7,739,614	9,315,930	9,719,506	8,911,308	8,886,811	

0

Public Health Reporting – Analysis by Application (Jan 2017 – Jan 2018) Syndromic Surveillance Transactions
9,000,000

8,000,000

7,000,000

6,000,000

5,000,000

4,000,000

3,000,000

2,000,000

1,000,000

0
Jan.2017	Feb.2017   Mar.2017   Apr.2017   May.2017   Jun.2017	Jul.2017	Aug.2017    Sep.2017	Oct.2017    Nov.2017   Dec.2017	Jan.2018
Syndromic  5,480,332  5,454,437  5,094,559  5,742,681  5,400,986  5,899,280  6,232,258  6,253,392  6,292,697  6,824,744  7,364,445  7,539,295  7,899,103

Public Health Reporting – Analysis by Application (Jan 2017 – Jan 2018)

Immunization (MIIS) Transactions

		

		

	Jan.2017	Feb.2017	Mar.2017	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	
MIIS	888,367	837,521	1,733,218	867,478	683,917	796,230	798,267	500,981	1,407,977	2,402,660	2,324,526	1,337,427	928,058	

3,000,000

2,500,000

2,000,000

1,500,000

1,000,000

500,000

0

Public Health Reporting – Analysis by Application (Jan 2017 – Jan 2018)

Boston Public Health Commission Transactions

20,000

19,500

19,000

18,500

18,000

17,500

17,000

16,500

16,000

15,500

Jan.2017   Feb.2017  Mar.2017  Apr.2017  May.2017  Jun.2017	Jul.2017   Aug.2017   Sep.2017   Oct.2017   Nov.2017  Dec.2017   Jan.2018

Boston Health	19,078	19,535	17,213	19,685	18,621	19,783	18,624	19,117	19,505	19,003	19,116	17,731	17,923

		

		

		
		
	Jan.2017	Feb.2017	Mar.2017	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	
OTP	10,266	136,844	18,324	22,727	15,244	10,992	15,763	68,811	14,332	59,607	3,060	7,266	31,704	

160,000

Public Health Reporting – Analysis by Application (Jan 2017 – Jan 2018) Opioid Treatment Program (OTP) Transactions **

140,000

120,000

100,000

80,000

60,000

40,000

20,000

0

50	* Note: Reporting cycle is through the 20th of each month.
** Note: OTP data available starting August 2017.

Public Health Reporting – Analysis by Application (Jan 2017 – Jan 2018)

Other Public Health Transactions

7,000

6,000

5,000

4,000

3,000

2,000

1,000

0
Jan.2017    Feb.2017   Mar.2017   Apr.2017   May.2017   Jun.2017	Jul.2017	Aug.2017   Sep.2017   Oct.2017   Nov.2017   Dec.2017    Jan.2018
ELR	176	402	268	233	236	242	227	223	246	289	514	579	589
MCR	226	73	111	57	82	32	98	179	1,204	6,261	4,469	5,679	5,527
PMP	0	0	0	0	0	0	0	0	0	0	0	0	0
CBHI	0	0	0	0	0	0	82	0	65	0	8	349	834
eReferral	250	426	430	485	360	333	238	212	461	430	478	327	391

Customer Status Dashboard (Jan 20, 2018)

Tier (As of January 20, 2018)	
Universe	
Actively Using	
%ActivelyUsing	
Connected	
%Connected	
Enrolled	
Tier Total	
	(Est.)							
1a. Large hospitals/Health Systems	37	29	78%	1	3%	4	34	
1b. Health plans	9	3	33%	2	22%		5	
1c. Multi-entity HIE	11	5	45%	5	45%		10	
1d. Commercial imaging centers & labs	5	5	100%	2	40%		7	
2a. Small hospitals	51	39	76%	11	22%		50	
2b. Large ambulatory practices (50+)	33	18	55%	12	36%		30	
2c. Large LTCs (500+ licensed beds)	8		0%	1	13%		1	
2d. Ambulatory Surgical Centers	63		0%	1	2%		1	
2e. Ambulance and Emergency Response	39	1	3%	3	8%		4	
2f.Business associate affiliates	5	1	20%	1	20%		2	
2g. Local government/Public Health	8	1	13%	7	88%		8	
3a. Small LTC (<500 licensed beds)	310	42	14%	37	12%		79	
3b. Large behavioral health (10+ licensed providers)	14	3	21%	13	93%		16	
3d. Large FQHCs (10-49)	30	18	60%	8	27%		26	
3e. Medium ambulatory practices (10-49)	365	58	16%	20	5%		78	
4a. Small behavioral health(<10 licensed providers)	90	8	9%	19	21%	1	28	
4b. Home health, LTSS	149	28	19%	41	28%	4	73	
4c. Small FQHCs (3-9)	29	5	17%	1	3%		6	
4d. Small ambulatory practices (3-9)	1595	179	11%	107	7%	1	287	
5a. Very Small ambulatory practices (1-2)	4010	272	7%	285	7%	4	561	

Grand Total	
6861	
715	
10%	
577	
8%	
14	
1306	

19 New Participation Agreements

Alternative Home Health Care, LLC Boston Home Health Aides LLC Essex Neurological Associates. PC
Greater Lynn Senior Services, Inc. (GLSS) Haffey Center for Attention & Memory Heritage Dialysis Center, LLC
Hill Eye Associates P.C.
Mudrock, John MD
North Shore Elder Services (Senior Care) North Shore Shoulder, LLC
One Medical Group PC
Pediatric Specialists
Redwood Pediatric and Adolescent Medicine SeniorCare Inc
Shaila Associates Diagnostic SMART
South Cove Manor Nursing & Rehabilitation Center
The Brien Center (Northern Berkshire Counseling Center) WestMass ElderCare

Alan Ertel, MD
Anna Jaques Hospital Baystate VNA

91 New Connections (page 1 of 2)

Franklin Segall, MD
Fresh Pond Women's Health Gary P. Gurka, MD

Beth Israel Deaconess Hospital - Plymouth Beth R. Hardiman, MD
Betsy Sherry, MD Boston Medical Center Boston Medical Center
Boston Urogynecology Associates
Breast and Endocrine Surgical Specialties Burton Rabinowitz, MD
Cambridge Neurosurgical SpineCare, LLC Center for Women
Chelsea Center Crimson foot and ankle David Disimone, MD
Davis Square family Practice
East Boston Neighborhood Health Center East Boston Neighborhood Health Center ENT Surgery Associates, LLC
Essex Neurological Associates. PC Fitchburg Family Practice

Geriatric Outreach Services- Quimbley Center Guy Rochman, MD
Haffey Center for Attention & Memory Heritage Nursing Center
Heywood Hospital
Integrated Health and Fitmess James F. Conner, Jr., MD
John Chobanian, MD Julio C. Ayala, MD Kinnari R. Kher, Md
Lawrence General Hospital Leominster Family Practice Leominster Pediatrics Lexington Ob/gyn Association Longfellow Primary Care Martha Martents, MD
Mount Auburn Anticoagulation Services Mount Auburn Cardiology Associates, Inc. Mount Auburn Cardiothoracic Surgery Mount Auburn Diabetes Education

91 New Connections (page 2 of 2)

Mount Auburn Cardiology Associates, Inc. Mount Auburn Cardiothoracic Surgery Mount Auburn Diabetes Education Mount Auburn Endocrinology Waltham
Mount Auburn Gastrointestinal Consultants Mount Auburn Healthcare at Arlington Mount Auburn Healthcare at Cambridge Mount Auburn Healthcare at Lexington Mount Auburn Healthcare at Union Square Mount Auburn Healthcare at Waltham Mount Auburn Hospital Nutrition
Mount Auburn Hospital-Maternal Fetal Medicine Mount Auburn Infectious Disease Department Mount Auburn Medical Associates
Mount Auburn Occupational Health Services MAH Mount Auburn Occupational Therapy
Mount Auburn Physical Therapy Mount Auburn Practice for Women
Mount Auburn Prenatal diagnosis Center
Mount Auburn Pulmonary Consultants Mount Auburn Pulmonary Rehabilitation Mount Auburn Rheumatology
Mount Auburn Sleep Disorders Center Mount Auburn Speech Therapy Mount Auburn Surgical Associates

Mount Auburn Travel Medicine Center
Mount Auburn Walk-In Center
Mount Auburn Weight Management and Bariatric Surgery New England Physiatry, LLC
North Shore Ear, Nose & Throat Assoc., PC Palm skilled Nursing Center
PAMA Cardiology Pediatric Specialists Primary Care Center Qualifacts
Richard J. Kerbal, MD
Russell Nauta, MD
Shaila Associates Diagnostic Somerville Family Practice South Shore Hospital
Taylor and Sullivan Plastic Surgery
Torey Morgan, M University Skin Oncologist Watertown Primary Care Waverley Primary Care WestMass ElderCare Willow Manor
Women's Healthcare at Arlington Women's Healthcare at Waltham
55	+4 Non-Participant connections

25 HISPs Connected to Mass HIway

Allscripts (MedAllies HISP)

Aprima

ASP.MD

Athenahealth

CareAccord

CareConnect (NetSmart HISP)

Cerner

DataMotion

eClinicalWorks

eClinicalWorks Plus

eLINC

EMR Direct

npriva

MaxMD

MatrixCare

McKesson (RelayHealth)

Medicity

MyHealthProvider (Mercy Hospital)

NextGen Share

NHHIO

PCE Systems

SES

Surescripts

UpDox

Wellport (Lumira HISP)

January 2018 availability is shown as of 1/29/2018.

Metric Targets:

“Total Monthly Availability” – no lower than 99.9% (downtime no more than ~44 minutes/month)