Health Information Technology Council 
Meeting
November 6, 2017

•	Welcome & HIT Council Annual Report
Secretary Sudders
•	HIway Connection Requirement:  Year 1 & Year 2 Updates
Michael Chin
•	EOHHS Event Notification Service (ENS) Initiative Update
David Whitham
•	Mass Digital Health Initiative Update
Laurance Stuntz 
•	MeHI Behavioral Health Learning Collaborative Update
Laurance Stuntz 
Appendix A:  HIway Operations Update

HIway Connection Requirement:  Year 1 & Year 2 Updates
Michael Chin
HIway connection requirement
Background:
•	In February 2017, the Mass HIway Regulations went into effect 
•	One key part of these regulations was to implement the statutory requirement that all providers in the Commonwealth connect to the Mass HIway.  This presentation refers to that requirement as the “HIway connection requirement.”
•	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:
•	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)

•	How:   Year 1 Attestation Forms should be submitted to the Mass HIway 
             (via email  at:  MassHIwayAttestation@state.ma.us )

•	The Year 1 Attestation Form (and instructions) are available on the Mass HIway web page.

HIway connection requirement:  Years 1 - 4
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 should 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.

Year 1 Attestation Form:  Update
Year 1 Attestation Form:  Update
HIway connection requirements for 2018
Below are the HIway connection requirements for 2018:
•	Acute Care Hospitals:   
o	January 1, 2018:  Their Year 2 requirement is 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
o	July 1, 2018:  due date for the Year 2 Attestation Form 

•	Large & Medium Medical Ambulatory Practices and Large Community Health Centers:
o	January 1, 2018:  Their Year 1 requirement is to send or receive HIway Direct Messages for at least one use case (and that use case can be within any category of use cases)
o	July 1, 2018:   due date for the Year 1 Attestation Form

o	As per section 20.06 of the regulations, Large & Medium Medical Ambulatory Practices, and Large Community Health Centers have 10 or more licensed providers participating in providing health care.  
In the regulations, a licensed provider is defined to be a medical doctor, doctor of osteopathy, nurse practitioner, or physician assistant.

Next steps 
Year 1 Attestation Form:  Who, When, How
•	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.

•	How:   Year 1 Attestation Forms should be submitted to the Mass HIway 
             (via email  at:  MassHIwayAttestation@state.ma.us )

•	The Year 1 Attestation Form (and instructions) are available on the Mass HIway web page.

Year 1 Attestation Form:  What
The Year 1 Attestation Form collects the following information:
1.  How the organization met the Year 1 HIway connection requirement:
•	The Year 1 requirement:   To send or receive HIway Direct Messages for at least one use case
                                               (The use case may be within any category of use cases)
•	Questions on the attestation form include:
o	The use case is within what category of use cases?  
Categories include:    (1) Provider-to-Provider Communications, (2) Payer Case Management, 
	(3) Quality Reporting, (4) Public Health Reporting, (5) Other
o	Describe the use case
o	Approximate # of HIway Direct Messages per month for the use case
•	Describe whether or not the organization has an EHR (and if so, how does it connect to the HIway):
•	Questions on the attestation form include:
o	Name and version of the EHR?
o	Is the EHR an ONC Certified Health IT Product?
o	How is the organization connecting to the HIway? 
Options include:   (1) EHR directly to HIway, (2) EHR via a HISP,  or (3) via Mass HIway webmail

EOHHS Event Notification Service (ENS) Initiative Update
David Whitham
Background Information:  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, highlights from EOHHS’ stakeholder engagement, market research, and Request for Information (RFI) were described
•	The current landscape:
o	A wide variety of stakeholders have consistently raised the need for improved access to event notification services
o	Multiple private ENS vendors currently offer services in the Commonwealth
o	The technical and operational requirements are varied among different stakeholders

How to address two distinct needs
•	Stakeholders have identified two distinct needs:  
•	A statewide ADT repository
•	Improved access to receiving event notifications
•	In order to address these two needs, EOHHS considered a spectrum of approaches, including the following:
o	“Marketplace” approach:
i.e., EOHHS collects and shares ADTs with private ENS vendors, and does not produce notifications

o	“State ENS” approach:
i.e., EOHHS collects ADTs and produces notifications sent directly to participants

o	“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
•	EOHHS plans to implement the hybrid approach that may be implemented in two phases (which are described on the following slide)
Two phase approach to EOHHS’ ENS Initiative

•	Phase One – Implement a statewide ADT repository
In order to address the need for a statewide ADT repository:
o	EOHHS will implement a centralized statewide ADT Repository and share ADTs from this repository with authorized private ENS vendors
o	Implementation of the statewide ADT Repository will include patient identification and matching functions, and management of a centralized opt-in/opt-out mechanism

•	Phase Two (optional) –  Implement a statewide ENS
In order to address the potential need for access to receiving event notifications:
o	EOHHS will look for specific market segments that have difficulty in receiving notifications despite the implementation of Phase One
o	If EOHHS determines it necessary, it may implement a statewide ENS to produce event notifications for particular market segments that lack adequate access
Two phase approach (continued)

•	Benefits to the recommended hybrid approach:
o	Leverages EOHHS’ unique position (from statute and regulations) to create a statewide ADT repository to benefit care coordination, while allowing private vendors to utilize their strengths in innovation and meeting needs of various market segments
o	Recognizes the existing robust ENS vendor presence in the state by providing authorized ENS vendors with access to the statewide ADT repository 
o	May result in more rapid access to event notifications, by leveraging ENS vendors that already have experience and a presence in the state
o	Provides EOHHS with the flexibility to produce event notifications if there are gaps in access for certain market segments

•	Important aspects to keep in mind for implementing this approach:
o	Developing the process and criteria for authorizing ENS vendors to receive ADTs from the statewide ADT repository 
o	Assessing gaps in access to ENS services in a timely fashion
o	Monitoring and assessing the impact of statewide ADT repository, and making improvements/adjustments as the HIT landscape evolves

EOHHS ENS Initiative

EOHHS Key policy decisions

•	Second Quarter of Calendar Year 2017:   completed
Release RFI, review responses, meet with selected vendors 
•	Third and Fourth Quarter of Calendar Year 2017:   in progress
Prepare and release RFR  
•	First Quarter of Calendar Year 2018:  
Review RFR responses, select vendor, negotiate contract
•	Second and Third Quarter of Calendar Year 2018:  
Begin preparations for launching the ADT Repository 
(includes establishing business processes, testing, and defect remediation)
•	Fourth Quarter of Calendar Year 2018:  
ENS soft launch

Mass Digital Health Initiative Update
Laurance Stuntz
Mass Digital Health Initiative Update
Mass Digital Health Initiative
Mass Digital Health Goal
Make Massachusetts the leading global Digital Health ecosystem, in turn driving economic growth and improving healthcare outcomes and efficiency.
Mass Digital Health Cluster
Mass Digital Health Council
Mass Digital Health Council Organizing Framework
The Council’s stated objective is to support initiatives that create fertile ground for digital health companies and entrepreneurs to start, grow or move companies in/to Massachusetts, as opposed to picking and supporting specific companies or healthcare proposals.

Mass Digital Health Marketplace
Marketplace Challenges
Marketplace Framework
Needs / Gaps at Various Stages
Marketplace Program Overview
1. Create Collaboration Opportunities
2. Directly Facilitate Entrepreneur – Customer Connections
3. Scaling Company Support Network
•	Identify list of high-potential, high-growth firms 
•	Complete scaling firm interviews (18 completed so far)
•	Provide activist relationship management and business development support 
•	Explore Scaling Company Roundtables
•	Explore Customer Working Group 
•	Support ecosystem efforts to build relationships/connections via workshops and dinners 
•	12x12x12 2.0? 
Marketplace Program Tactics
Marketplace Program Status
UNDERWAY:
•	PULSE@MassChallenge Program (Year 1 complete, Year 2 underway)
•	TechSpring programs (Year 2 funding underway)
•	PULSECHECK and Tap into TechSpring Meetups
•	Asset Inventory Created of validation sites, sandboxes, accelerators, etc. 
•	Sponsorship/support for challenges/hackathons in key areas (outside Metro Boston, aging/caregiving)
•	Aging and Caregiving EOEA Champion Confirmed
•	Marketplace Manager hired (Garrett Quinn)
•	Aging Reverse Pitch HUBWeek event on 10/10/17
•	18 Scaling Company Interviews Completed, tracking 28 Scaling Firms
IN-PROCESS:
•	Startup Assessment Tool
•	Customer / Product Directory
•	Access to new entrepreneur resources, including checklists privacy/security documents, better security & interoperability education/tools
IDEAS / IN DEVELOPMENT:
•	Grant program to offset costs of high-value pilots/demonstration projects
•	Executive Mentor Network for Scaling Firms (12x12x12 2.0?)
•	Validation Network (Entrepreneurs, Researchers & Customers connecting and transparently sharing outcomes)
•	‘Innovation Fellows’ program to enable more community healthcare settings to become digital health customers

MeHI Behavioral Health Learning Collaborative Update
Laurance Stuntz
MeHI Behavioral Health 
Learning Collaborative Update

Pilot: Brockton Neighborhood Health Center (BNHC)
September 2017
•	Continued to use tools in both the Harm Reduction Clinic and the Mental Health Department
•	Qualitative feedback: staff reported that use of the tools was going well and that patients had few questions and were willing to sign the Consent Form. 
•	Next steps: BNHC is contracting to create an electronic version of the Consent Form to make filling out the form easier, including auto-populating demographic information, and to better track whether or not a consent form is on file. 

Conclusion 
Secretary Sudders

Thank you!

Appendix A:  HIway Operations Update
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
Customer Status Dashboard (October 20, 2017)
HIway Participation July 21- Oct 20
HIway Participation Jul 21 – Oct 20
HISP to HISP Connectivity