Commonwealth of Massachusetts
Executive Office of Health and Human Services

Health Information Technology Council
Meeting

May 7, 2018

Agenda

Welcome
Undersecretary Lauren Peters

EOHHS ENS Initiative Update
David Whitham

HIway 2.0 Migration Update
Dave Bowditch

HIway Outreach Transition and HAUS Initiative Update
Julie Creamer and Keely Benson

Cape Cod Healthcare Use Case Success Story
Darlene Vendittelli, Greg Everson, and Jennifer Bendfeldt

Appendix A: HIway Operations Update

Welcome

Undersecretary Lauren Peters

New HIT Council members

EOHHS would like to welcome and thank HIT Council members who have
joined since the Council’s last meeting

Dr. Dicken Ko
Chief Medical Officer/ Vice-President of Medical Affairs, St. Elizabeth's Medical Center
HIT Council seat:  Representative from a community hospital

Linda McGoldrick
CEO and President, Financial Health Associates International
HIT Council seat: Representative with experience or expertise in health information technology

Dr. Pramila Yadav
Private Practice Obstetrics & Gynecology, Beth Israel Deaconess Medical Center
HIT Council seat: Representative from a small physician group practice

EOHHS Event Notification Service (ENS) Initiative Update

David Whitham

ENS Initiative – Request for Responses (RFR) Milestones:

The RFR was posted to COMMBUYS on February 15

Questions from potential Bidders were received on  March 15

Seven potential Bidders submitted 48 questions

Answers were posted in two parts, on April 2 and April 11

The RFR Bid Opening date was extended to April 27

EOHHS received 6 Responses that are currently under review

Questions encompassed:

Administrative aspects of setting up an ADT Repository and an ENS

Operational and technical inquiries regarding the SaaS platform and housing of the solution

Policies involving governance and partnering with EOHHS

Answers clarify aspects of the ENS Initiative including:
The phases of the Initiative
The centralized opt-in/opt-out mechanism
The roles and relationships among the participants

Answers to the questions also:

Promote flexibility in the proposals from potential Bidders

Highlight future partnership undertakings

The RFR is available on COMMBUYS:

–	Bid #: BD-18-1039-EHS01-EHS02-18707
–	Hyperlink: https://www.commbuys.com/bso/external/bidDetail.sdo?docId=BD -18-1039-EHS01-EHS02-18707&external=true&parentUrl=bid

First and Second Quarter of Calendar Year 2018:
Release RFR (completed)

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)

HIway 2.0 Migration Update

Dave Bowditch

HIway 2.0

The HIway team at EOHHS is working closely with Orion Health to implement and operate a new
Mass HIway Direct Messaging System, also known as “HIway 2.0”

HIway 2.0 uses Orion Health Communicate, an EHNAC/DirectTrust accredited, cloud-based, multi- tenant, Software as a Service solution that is an ONC 2015 Edition certified Direct Project, Edge Protocol, and XDR/XDM product

The upgrade to HIway 2.0 was necessary to leverage the national standards for Direct messaging that didn’t exist when the HIway was launched in 2012, and to make it easier for organizations to connect to the Mass HIway and to other health care organizations via the Mass HIway

Migration Progress Highlights

The testing team is verifying connectivity to the Clinical Gateway nodes for Public Health Reporting and processes for migrating each connection type (Webmail, Direct XDR, and Connect devices)

The communications team is preparing the forms and documents required for EHNAC compliant identity proofing of all migrating Participant organizations

The onboarding team is lining up pilot sites that are willing to step carefully through the migration process and provide feedback to help improve the process as well as the instructions, forms, and other materials prior to their general availability

10

Migration Activities Timeline

Initial Setup & Install – Complete

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

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

CG Node Testing and Pilot Participant Coordination – April and May 2018

Clinical Gateway node connection and interoperability testing with Communicate

Pilot Participant coordination

Specific sites are being 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.

Migration Activities Timeline (continued)

Pilot Operations – June and July 2018

Clinical Gateway nodes tested and moved to production

Pilot Participant connections tested and moved to production

Production Operations – starting August 2018

All new Participants will be onboarded to HIway 2.0

Existing Participants will start migrating from HIway 1.0 to HIway 2.0

Migrations will take place in waves

Migration date will be set when registration and identity proofing is complete

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

HIway 1.0 Sunset – 1st Quarter 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

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 (unless desired)

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 will be more common
XDR/XPL to Communicate Direct XDR

New certificate chain and personal certificate delivery
Participant installs certificates on their infrastructure
Test in non-production environment may be required

HIway Outreach Transition and HAUS Initiative Update:
Julie Creamer

Keely Benson, MeHI

New Contract Signed!

EOHHS has signed a new contract with the Massachusetts eHealth Institute (MeHI) to provide outreach and education, account management, and provider consulting services to Mass HIway Participants

The selection of MeHI as the new vendor is the result of an open, competitive procurement process that took place over many months

These services had been provided by the Massachusetts eHealth Collaborative (MAeHC) through March

The Mass HIway team at EOHHS is grateful to the MAeHC team for their dedication and hard work and recognizes the team for its significant contribution to the growth of the Mass HIway over the past 5 years

Vendor Transition Complete

A smooth transition occurred over the last six weeks and MeHI is fully onboard
and assuming all responsibilities as the Mass HIway’s vendor

Key Areas of Focus

The team will focus on the following key areas in the coming year:

o HIway Adoption and Utilization Services (HAUS): Provider Consulting Services aimed at supporting health information exchange among MassHealth ACOs, Community Partners, and Community Service Agencies

o HIway Regulations: Providing subject matter expertise to providers regarding HIway attestation and connection requirements, including the creation of written communication materials, webinars, and in-person presentations

o HIway 2.0 Migration Support: Account Managers will work with EOHHS and Orion Health to ensure a smooth and efficient migration to HIway 2.0. The team will act as a resource for Participants with questions related to the migration. The team also will actively assist the onboarding team with initial and follow up outreach to Participant contacts, as needed.

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 driver 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 Supports 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 also will develop on-demand resources and host events to support
efforts to advance care coordination using the Mass HIway

MeHI Background

MeHI, the Massachusetts eHealth Institute at the Massachusetts Technology Collaborative, is the designated state agency for promoting Health IT innovation, technology, and competitiveness to improve the safety, quality, and efficiency of health care across the Commonwealth of Massachusetts

MeHI's background and experience with the Mass HIway has paved the way for a
smooth transition:

MeHI provided similar services on behalf of the Mass HIway when it was first launched back in 2012 and has continued to support the HIway via the development of its HIE toolkit and its HIway participant trading partner map

MeHI has managed numerous grant programs (eQIP and Connected Communities) for Massachusetts healthcare providers to support the adoption of EHR systems, encourage information exchange between regional partners, and to fuel connections to the Mass HIway

MeHI’s designation as the implementing agency for the Commonwealth’s Digital Health
Initiative ensures the Mass HIway remains aligned with the rapidly changing HIT landscape

Cape Cod Healthcare Use Case Success Story

Darlene Vendittelli, Executive Director, Information Systems, CCHC Greg Everson, Senior Manager, Patient Care Systems, CCHC Jennifer Bendfeldt, Consultant, ECG Management Consulting

Expert physicians. Quality hospitals. Superior care.

Cape Cod Healthcare
Connected Communities

May 7, 2018

Spring 2016 MeHI awarded CCHC a Connected Communities grant.

Summer 2016 Finalized collaborating partners for implementation.

Summer 2016

Summer 2017
Completed activities for milestone two:
Instituted new processes to send/receive electronic CCDAs through the Mass HIway

Winter 2018
Completed activities for milestone four:
Monitored transaction performance
Adjusted workflows as needed
Developed expansion plans

ECG worked with CCHC to develop a transformation plan.

Evaluated opportunities for improving
workflows/outcomes
Developed process improvement plans

Summer 2016 CCHC engaged ECG to help manage the project.

Fall 2016 CCHC/ECG assessed over 30 organizations to finalize collaborating partners for the
implementation.

Winter/Spring 2017
Completed activities for milestone one:
Assessed current-state workflows, policies, security, and IT capabilities
Developed standardized CCDAs, future-state workflows, and testing plans
Sent test electronic CCDAs through the Mass HIway
.

Fall 2017
Completed activities for milestone three:
Implemented process improvement plans
Established metrics, and developed custom reports to monitor performance

Spring 2018

Invited all stakeholders to a final networking event at CCHC.

22
Coordinating activities between so many different stakeholders and organizations with
varying levels of sophistication was one of the most difficult challenges.

Key Stakeholder Groups	
	State agency that promotes improved care through technology; issued Connected Communities	
	Includes Cape Cod Hospital and Falmouth Hospital; Connected Communities award recipient	
	State agency that facilitates the secure transmission of healthcare data between providers	
	Provided strategic advice and managed the Connected Communities project on behalf of CCHC	

The project began with over 30 potential collaborating organizations.
After careful vetting, CCHC identified 10 collaborating organizations to participate in the use case; however, some organizations needed to enroll in the Mass HIway or upgrade their technology prior to participating.
Ultimately the collaborating organizations went live in two separate waves, based on their readiness at the time of the initial evaluation.

Use Case One:
Wave One	Use Case One:
Wave Two	
Future	
JML Care Center
VNA of Cape
Cod
BAYADA
Home Health
Kindred at Home	Bourne Manor
Gosnold
Mayflower
Place
Pavilion
Windsor	Royal Cape Cod Rehab & Nursing
Royal of Cotuit
Royal Megansett
Royal Falmouth
Seashore Point
Spaulding Rehab
Wingate at Brewster
Wingate at Harwich	

To ensure success, community organizations had to meet a set of criteria to participate as collaborating organizations, including:
An active Mass HIway address to exchange information.
The use of EHR/webmail to send/receive information.
Willingness to commit resources to testing, training,
and go-live support.
Demonstrated buy-in from providers and staff.

Soarian Clinicals Communications Services
Unit secretaries attach the following documents from DM in Soarian Communications Services:
Transition of Care/CCDA
Discharge Summary (.pdf)
Discharge Instructions (.pdf)
Discharge Medications List (.pdf)

Documents in .xml package

Soarian DM

Cerner Advanced Interop.
Services (AIS)

AIS archives CCDA/ToC in DM AIS adapter transmits to HIway
LAND

LAND appliance at Comm. Way Data Center (connects CCHC to HIway)

CCHC Firewall

SOAP / XDM

SOAP / XDR

DIRECT integration with EHR:
Bayada (MA@Bayada.direct.hchb.com)

Surescripts HISP

XDR / XDM

Direct SMTP (Webmail)

SOAP / XDM

Cert. “handshake”

MedAllies HISP

Mass HIway (Orion HISP)

DIRECT webmail addresses:
VNA of Cape Cod (vnaof.capecod@direct.vnaofcapecod.massh

DIRECT integration with Kindred Med Mail:
Kindred at Home (kahsandwich@gentiva.kindreddirect.com)

(HIway maintains connections
and “trusts” to exchange with direct addresses provided by other HISPs)

iway.net)
JML
(jml.cc@direct.jml.masshiway.net)

Organizations used paper-based processes to exchange clinical discharges, which prevented them from being able to track the receipt of exchanged information. Patients were often referred without accompanying discharge documents.

	

I n i t i a l  G o - L i v e		

74% Discharges Include CCDA

CCHC could pinpoint issues preventing CCDAs from being sent successfully and made adjustments to workflows and system logic to increase the likelihood that a CCDA is successfully transmitted at the time of discharge.

100% Discharges
Include CCDA

F u t u r e
O b j e c t i v e s

P r e i m p l e m e n t a t i o n

No Data

The initial go-live give provides real-time access to discharge information in CCDA format and established a baseline for tracking how many CCDAs were successfully sent when a patient was discharged from the hospital to a collaborating organization.

		

T h r e e  M o n t h s a f t e r  G o - L i v e		

81% Discharges Include CCDA

CCHC will continue process- improvement efforts toward the goal of 100% of discharges that are sent to collaborating organizations having a corresponding CCDA. Efforts will also be made to increase the number of collaborating organizations that can receive electronic CCDAs.

	Success Rate	
CCHC-Bayada	67%	
FH-Bayada	53%	
CCHC-JML	83%	
FH-JML	76%	
CCHC-Kindred	87%	
FH-Kindred	88%	

CCHC developed a custom report to track what percentage of patients discharged from CCHC to a collaborating organization had a CCDA successfully sent in advance.

In general, the collaborating organizations understood the value of exchanging information electronically through the Mass HIway but may not have appreciated the level of effort it takes to implement the automated workflows.
Many organizations continued to print  CCDAs
for providers to quickly reference as a
temporary step until the structured clinical
data could interface directly into their EHRs
and/or the providers felt more comfortable
using EHRs.
Limitations in EHR functionality proved to be
one of the biggest barriers for all organizations.
Networking with other similar types of
organizations was beneficial, especially for
those organizations that have not been heavily
reliant on technology in the past.

Since incoming CCDAs through the Mass HIway do not include the patient’s name, staff must open up the documents to identify the patient; it would be nice to eliminate this extra step.

It took time for the providers to adjust to a new way of reviewing summaries.

Key Takeaways/Recommendations

Ensure there is adequate support/resources allocated to developing future-state design as well as testing, training, and supporting the changes.
Consider an iterative process to decrease the disruption to operations and staff.
Take advantage of resources such as MeHi and the Mass HIway for
guidance and as sources for connections.
Organizations that have not previously been the focus of EHR incentive programs (e.g., MU, PQRS) may require additional effort to upgrade technology and implement IT-centric workflows.

Ongoing performance improvement should be factored into all future- state designs; workflows should be designed to allow performance to be tracked and reported.
Technology limitations are common, and organizations should be prepared to work closely with vendors to develop the necessary functionality to support the changes.

0100.010\451865(pptx)-E2 DD 5-7-18

Expert physicians. Quality hospitals. Superior care.

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, August 6, 2018
Monday, November 5, 2018

Commonwealth of Massachusetts
Executive Office of Health and Human Services

Thank you!

Appendix A:	HIway Operations Update

Customer Status Dashboard
(April 20, 2018)

Tier (As of April 2018)	
Universe (Est.)	
Actively Using  %Active
Using	
ly	Connected	
%Connected	
Enrolled	
Tier Total	
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	6	55%	5	45%		11	
1d. Commercial imaging centers & labs	5	5	100%	3	60%		8	
2a. Small hospitals	51	38	75%	12	24%		50	
2b. Large ambulatory practices (50+)	33	18	55%	12	36%		30	
2c. Large LTCs (500+ licensed beds)	8	1	13%		0%		1	
2d. Ambulatory Surgical Centers	63	0%	1	2%		1	
2e. Ambulance and Emergency Response	39	0%		0%		0	
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	41	13%	37	12%		78	
3b. Large behavioral health (10+ licensed providers)	14	3	21%	12	86%		15	
3d. Large FQHCs (10-49)	30	18	60%	6	20%		24	
3e. Medium ambulatory practices (10-49)	365	60	16%	22	6%		82	
4a. Small behavioral health(<10 licensed providers)	90	8	9%	18	20%	1	27	
4b. Home health, LTSS	149	29	19%	40	27%	4	73	
4c. Small FQHCs (3-9)	29	5	17%	1	3%		6	
4d. Small ambulatory practices (3-9)	1595	182	11%	119	7%	1	302	
5a. Very Small ambulatory practices (1-2)	4010	282	7%	287	7%	4	573	

Grand Total	
6861	
730	11%	
586	
9%	
14	
1330	

17 New Participation Agreements

BayPath Elder Services, Inc.

Boston Dermatology and Laser Center Boston Home Health Aides, LLC Boulevard Medical Group
Care Navigator

Frank X. Pedlow Jr, MD, PC George H. Theodore, MD, PC
Greater Springfield Senior Services, Inc.

Heritage Dialysis Center, LLC Joan R. Golub, MD
John Siliski, MD

Mark Vonnegut, MD, PC, dba MVPediatrics Orthopedic Associates
Ralph Metson, MD

Shaila Associates Diagnostic

21 New Connections
A Quality Home Care, Inc. Alternative Home Health Care, LLC Amherst Pediatrics
Asthma & Allergy Affiliates, Inc.
BayPath Elder Services, Inc.
Boston Dermatology and Laser Center Boston Home Health Aides, LLC
Frank X. Pedlow Jr, MD, PC George H. Theodore, MD, PC Joan R. Golub, MD
John M. Siliski, MD
Levinson Harris Medical Group
Mark Vonnegut, MD, PC, dba MVPediatrics Orchard Healthcare
Orthopedic Associates Ralph Metson, MD SMART
Urology Consultants of the N. Shore, Inc.
West Cambridge Pediatric & Adolescent Medicine, PC
Weston Pediatric Physicians, PC
Women's Health Associates / Obstetrics-Gynecology
+ 6 Non-Participant Organizations

13 Month HIway Transaction Activity

10,166,649 Transactions* exchanged in April (03/21/2017 to 04/20/2018**)
237,454,255 Total Transactions* exchanged inception to date

12,000,000

10,000,000

8,000,000

6,000,000

4,000,000

2,000,000

	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
Total transactions:	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	10,864,328	9,029,211	10,166,649	

0

* Note: Includes all transactions over Mass HIway, both production and test
34  ** Note: Reporting cycle is through the 20th of each month.

HIway Production Transaction Trends – Provider to Provider (Apr 2017 – Apr 2018)

3% of HIway activity in April* was for Provider to Provider transactions

		

		

		
		
	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
Provider to Provider	217,828	219,597	361,745	267,970	248,112	264,261	254,248	273,854	263,471	235,936	267,449	251,407	286,722	

400,000

350,000

300,000

250,000

200,000

150,000

100,000

50,000

0

HIway Production Transaction Trends – Quality Reporting (Apr 2017 – Apr 2018)

5% of HIway activity in April* was for Quality Reporting transactions

		

		

	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
Quality Reporting	397,178	388,311	445,709	401,163	454,485	427,053	509,461	317,913	286,607	257,233	415,873	403,347	569,939	

600,000

500,000

400,000

300,000

200,000

100,000

0

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

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

35,000

30,000

25,000

20,000

15,000

10,000

5,000

	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
Payer Case	32,687	30,611	30,592	29,445	28,104	30,663	30,004	30,181	29,554	25,010	30,736	25,375	27,243	

0

HIway Production Transaction Trends – Public Health Reporting (Apr 2017 – Apr 2018) 91% of HIway activity in April* 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

0
Apr.2017  May.2017  Jun.2017	Jul.2017    Aug.2017   Sep.2017   Oct.2017   Nov.2017  Dec.2017   Jan.2018   Feb.2018  Mar.2018  Apr.2018
DPH Transactions  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  9,871,667  8,180,562  9,052,798

10,000,000

Public Health Reporting – Analysis by Application (Apr 2017 – Apr 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
Apr.2017   May.2017   Jun.2017	Jul.2017	Aug.2017    Sep.2017	Oct.2017    Nov.2017   Dec.2017	Jan.2018	Feb.2018   Mar.2018   Apr.2018
Syndromic  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  8,704,466  7,387,984  7,985,952

3,000,000

Public Health Reporting – Analysis by Application (Apr 2017 – Apr 2018) Immunization (MIIS) Transactions

2,500,000

2,000,000

1,500,000

1,000,000

500,000

	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
MIIS	867,478	683,917	796,230	798,267	500,981	1,407,977	2,402,660	2,324,526	1,337,427	928,058	1,111,071	739,769	981,979	

0

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

Boston Public Health Commission Transactions

20,000

19,500

19,000

18,500

18,000

17,500

17,000

16,500

16,000

	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
Boston Health	19,685	18,621	19,783	18,624	19,117	19,505	19,003	19,116	17,731	17,923	19,118	17,094	19,209	

15,500

		

		

		
		
	Apr.2017	May.2017	Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017	Dec.2017	Jan.2018	Feb.2018	Mar.2018	Apr.2018	
OTP	22,727	15,244	10,992	15,763	68,811	14,332	59,607	3,060	7,266	31,704	18,498	26,270	55,094	

80,000

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

70,000

60,000

50,000

40,000

30,000

20,000

10,000

0

7,000

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

Other Public Health Transactions

6,000

5,000

4,000

3,000

2,000

1,000

0
Apr.2017   May.2017    Jun.2017	Jul.2017	Aug.2017	Sep.2017	Oct.2017	Nov.2017    Dec.2017	Jan.2018	Feb.2018    Mar.2018    Apr.2018
ELR	233	236	242	227	223	246	289	514	579	589	755	562	651
MCR	57	82	32	98	179	1,204	6,261	4,469	5,679	5,527	5,659	5,134	5,364
PMP	0	0	0	0	0	0	0	0	0	0	0	0	0
CBHI	0	0	0	82	0	65	0	8	349	834	694	991	799
eReferral	485	360	333	238	212	461	430	478	327	391	393	142	281

Metric Targets:

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

44