Health Information Technology Council Meeting

November 5, 2018
Agenda
•	Welcome
Undersecretary Lauren Peters
•	Mass HIway Program Director Introduction
Bert Ng
•	EOHHS Notification Services (ENS) Initiative Update
Bert Ng & David Whitham
•	HIway 2.0 Migration Update
Dave Bowditch
•	HIway Connection Requirement
Chris Stuck-Girard & Bert Ng
•	HIE Success Story
David LaPlatney, Behavioral Health Network

Welcome
Undersecretary Lauren Peters

Vote: Approve Minutes
MOTION: That the Health Information Technology Council hereby approves the minutes of the Council Meeting held on August 6, 2018 as presented/amended

Mass HIway Program Director Introduction
Bert Ng

Program Director Introduction
•	Key Objectives
–	Advance the mission of EOHHS by developing HIT policies that improve cost, care, and health outcomes
–	Work with the HITC to develop thoughtful policies to advance adoption and utilization of HIT to improve care quality
–	Develop a roadmap for future success of the HIway in concert with market evolution and federal regulatory changes
Program Director Priority Goals

EOHHS Notification Services (ENS) Initiative Update
Bert Ng & David Whitham
EOHHS ENS Initiative: Background
EOHHS Process: 
•	EOHHS issued an RFR in February, 2018 to develop a state-operated ADT repository with optional ENS services in the future. 
•	EOHHS assessment of responses showed ENS Vendors have significant market penetration with Acute Care Hospitals.
•	EOHHS determined the creation of a state-operated ADT repository would be duplicative of existing capabilities.
•	Accordingly, EOHHS is looking to leverage the existing ENS marketplace to achieve universal provider access to ADTs.
EOHHS ENS Procurement Activities
Market-led ENS Initiative RFI

•	EOHHS (Mass HIway and MassHealth) will continue to develop programs to support health information technology and exchange.
•	The RFI seeks comments on how best to use a market-led approach to make ADTs available across the Commonwealth.
•	We welcome comments from all community members including RFR respondents who are encouraged to submit responses to the RFI.

HIway 2.0 Migration Update
Dave Bowditch
HIway 2.0 Migration Update
HIway 2.0 Migration Update
HIway 2.0 Migration Update
HIway 2.0 Migration Update
HIway 2.0 Migration Update

HIway Connection Requirement 
Chris Stuck-Girard, Bert Ng

Outreach for the 2018 Attestation Cycle
2018 Attestation Update
Analyzing 2018 Attestation Forms

HIE Success Story
David LaPlatney, Behavioral Health Network

About BHN
BHN is a regional provider of comprehensive behavioral health services for adults, children and families with life challenges due to mental illness, substance use or intellectual and developmental disabilities. 
Behavioral Health Network

•	Offers more than 100 different programs:

•	Mobile and hospital-based crisis services
•	Respite, Day treatment and PHP
•	Residential Developmental Services
•	Outpatient, Residential and Detox-level SUD treatment services
•	Outpatient and IOP BH treatment services
•	Medication Management
•	Integrated Primary Care / Behavioral Health

•	Serves more than 40,ooo individuals each year.

Connected Communities Implementation (CCI)

•	BHN’s Project was one of 8 funded by MeHI Statewide, and the only one led by a BH organization
•	We supported 2 general use cases:

•	Facilitate the movement of individuals needing an acute level of BH care from the community into appropriate acute treatment facility
•	Support care coordination in medical practices with integrated behavioral health components

•	Collaborators included 3 separate Health Systems, 5 Inpatient Facilities, 6 Community Health Centers and/or Primary Care Practices

Focus: Integrated Primary Care and BH

•	Holyoke Health Center

•	Independent FQHC with locations in Holyoke and Chicopee
•	Member site for the Community Care Cooperative (C3) ACO
•	Offers Medical (including Pediatrics, OB/GYN and Cardiology), Pharmacy, Lab, Radiology, Dental and Vision services as well as SUD and Suboxone treatment
•	To 24 thousand individuals a year
•	Where the vast majority are Medicaid/Medicare Patients
•	Annual operating budget of $43 Million

•	NextGen EHR
•	NextgenShare HISP and custom middleware
•	Active Mass HIway connection via LAND

BHN and HHC

•	Identified Clinical Trigger Events (CTEs)
•	New BE is first signed
•	Patient misses/completes scheduled BH intake
•	Patient is at risk of losing/loses BH services
•	Psychiatric Evaluation and/or medications are started/changed/ended
•	Patient experiences a BH crisis event

•	Patient RoI Authorization check: ∃ valid RoI Auth for
•	CTE date…
•	That is appropriately signed based on…
•	The age and Legal Status of the individual
•	The content of the payload and
•	The payload type : CCD vs PDF, for example

Active, Automatic Transport Methods

•	“Autofax” pdf to any number

•	Any file type via sFTP

•	Any file type via secure (TLS) email

•	Standard CCD via Mass HIway

•	Customized/redacted CCD via the Mass HIway

•	Unstructured-type CCDA via the Mass HIway
•	Multiple file types embedded within a CCD “wrapper”
•	Can be automatically matched to a patient and imported into some EHRs…
Massachusetts Value-based Care Initiative

•	MassHealth offers essential health care coverage to 1.9 million members, or over 27% of the Commonwealth’s residents.

•	17 ACOs within 3 ACO types and 27 Community Partners selected statewide.

•	The ACOs and CPs work together to coordinate care for members with complex behavioral health and/or long-term support needs.

•	Massachusetts is the first and only state to embed Social Determinants of Health into risk scores.

Principles and Goals of the Community Partner Program

•	Leverage the expertise of existing Community Based Organizations

•	Overcome service fragmentation

•	Improve member experience, continuity and quality of care

•	Break down existing silos

•	Invest in the continued development of IS and IT infrastructure

Implementation Challenges …

•	Government, Medical and BH staff and providers approach patient care from different perspectives, with different assumptions, expectations, language and treatment cultures. 
•	Contracting Process:  lots of “Whats”, very few “Hows”
•	⬆ Variability and ⬆Complexity
•	Complex Billing rules
•	We needed to be able to standardize our internal, clinical processes  ⬇ time and “brain space” our Clinicians spent tracking what to do next and
•	⬆ that spent on planning and coordinating…
•	While concurrently customizing inputs and outputs for 8 different ACOs
How we have been successful

•	We have been honest and realistic
•	We focused on adaptability as a Business Strategy
•	The Care Management platform we selected, JIVA by Zeomega, allows us to structure the workflows of our CMS staff
•	Our IS and IT investments allow us to automate “no value added” tasks  essentially just pushing data around
•	Create and publish out reporting “Data Marts” for CP staff and managers that automatically update
•	Automatically create and update patient records and care information in our various platforms

…to paraphrase W. Ross Ashby:

“The only way an organization can control its own destiny is to be more flexible than its environment.” 

Conclusion 
Undersecretary Lauren Peters

Thank you!

Appendix A:  HIway Operations Update
Customer Status Dashboard 
October 22, 2018
HIway Participation 
July 21 – October 20, 2018
HIway Connections 
July 21 – October 20, 2018
HIway Transaction Activity
HIway Transaction Analysis
HIway Transaction Analysis
HIway Transaction Analysis
HIway Transaction Analysis
Transaction Analysis – Detail
Transaction Analysis – Detail
Transaction Analysis – Detail
Transaction Analysis – Detail
Transaction Analysis – Detail