Health Information Technology Council 
Meeting
November 7, 2016

•	Welcome  [5 minutes] – Alice Moore
•	Approval of August 2016 Meeting Notes 
•	eHealth Plan  [10 minutes] – Alice Moore
•	HIway Regulations Update  [50 minutes]  – Gary Sing & Kathleen Snyder
•	Update on Efforts to Increase Provider-to-Provider Coordination Over the HIway
        (Deep Dive Program)  [10 minutes]  - David Whitham  
•	Relationship Listing Service (RLS) Update  [10 minutes]  - Dave Bowditch
•	Conclusion  [5 minutes] – Alice Moore  
•	Next Steps
•	2017 Meeting Schedule

Appendix:  HIway Operations Update

eHealth Plan
Alice Moore

HIway Regulations Update
Gary Sing, Kathleen Snyder
Background
Public comment period 

Update on Efforts to Increase Provider-to-Provider Coordination Over the HIway (Deep Dive Program)
David Whitham
Focus on workflow modernization

Deep Dive Program Goal: Improve provider to provider communication and patient transitions of care through increased use of direct messaging

Approach: Support provider organizations with workflow modernization using Mass HIway resources who are experienced with technology and workflow improvement
•	Establish technical readiness with provider organization and trading partner(s)
•	Engage clinical and business leadership (this is not an IT project)
•	Undertake one very focused care transition workflow improvement - iterate
•	Report metrics/outcomes
•	Share lessons learned through Use Case Library 

Current status: Work initiated with 14 organizations
Deep Dive Milestones & Deliverables
Deep Dive Dashboard
Maples Rehabilitation and Nursing Center
Lowell General Hospital 
Lessons Learned – Deep Dive
Lessons Learned from Deep Dive projects:
•	Motivation and Commitment – Project only moves forward when two or more information trading partners are highly motivated and committed to exchanging information with one another.
•	Direct technology is still far from “plug and play” – Most project time is spent establishing, testing, and validating end-to-end technology connection
•	Many clinical and operational conventions still need to be established - Much inter-organizational work is left to do to establish the basics of electronic information exchange:
–	Who?  Establishing team and message triage
–	What?   Establishing message content for various clinical scenarios
–	Where?  Establishing addressing conventions
–	When?    Establishing workflows for patient care transitions
•	Change Management, both people and processes, is essential - Changes are needed at multiple points from front desk to clinical teams, medical records and IT
•	Executive Sponsor is needed - Successful project completion requires an executive sponsor/project champion within each provider organization who can lead/influence the administrative, clinical and technical sides of the project

Relationship Listing Service (RLS) Update
Dave Bowditch
RLS Pilot Background
Background on the Mass HIway RLS Pilot:
•	The RLS Pilot (formerly Query & Retrieve pilot) was launched in 2014
•	The service helps a clinician identify the other healthcare organizations that hold medical information for one of his or her patients – Once a patient is identified the service facilitates a record request with the medical record holder
•	Components of the service include:
–	An enterprise Master Patient Index (eMPI) for unambiguous identification of a patient
–	A Relationship Listing Service (RLS) for a consented list of the healthcare organizations visited by a given patient
–	A Medical Records Request (MRR) service to facilitate an information request to the medical record holder
•	Four healthcare organizations are participating in the RLS Pilot:
–	Atrius Health 			– Holyoke Medical Center
–	Beth Israel Deaconess Medical Center 	– Tufts Medical Center
•	Each organization is at a different stage of implementing the components of RLS, but none has reached the point of using the RLS to request medical records.
Concluding the RLS Pilot
Key Reasons for Concluding the RLS Pilot
•	EOHHS is planning to launch its next generation of HIway-Sponsored Services – this is to include a statewide Event Notification Service (ENS) as a high priority.
•	Simultaneously EOHHS is going through the public process to issue regulations for the opt-in and opt-out mechanism that will apply to future HIway-Sponsored Services.
•	When the new regulations take effect the current RLS would need to be frozen with no new participants because the centralized opt-out mechanism is not in place.
Impact on pilot participants is low
•	The pilot is only at the data submission stage – All 4 pilot organizations tested population of the RLS successfully – BIDMC has a production data feed in use.
•	None of 4 pilot organizations are at the data use stage – The second phase of opening access to production data in the RLS has not been executed.

Main Takeaway:
•	Patients and providers who have been educated about the RLS capabilities and purpose have been excited about participating; however, stakeholders are ultimately interested in the RLS in conjunction with a real-time data retrieval service of records from within their EHR system – there is no significant demand for a stand-alone, web-based RLS system.

Other Takeaways:
•	The current Active Opt-in Consent requirement presented a significant barrier to implementation; will need to change this in order to promote widespread adoption.
•	Patient matching processes require specialized skillsets – both technical skills for configuring and operating the eMPI system and a combination of analytical and customer relationship skills required to manage and resolve a queue of potential matches.
The Mass HIway team and the RLS Pilot teams are capturing detailed notes about their lessons learned for reference as future HIway-Sponsored Services are planned.

Conclusion 
Alice Moore

Thank you!

Appendix:  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
               HIway Participation Jul 21 – Oct 20
•	Alan B. Silken, MD
•	Apotheker, Harvey, DMD
•	Central Boston Elder Services
•	DentaQuest Institute 
•	Howard M. Zolot, DMD
•	Joseph G. Maloney, DMD
•	Michael D. McKenzie MD, PC
•	Newton Wellesley Interventional Spine, LLC
•	Newton Wellesley Urology
•	Northeast Clinical Services, Inc.
•	Oakdale Dental
•	Porchlight VNA/Home Care
•	Root Family Medicine
•	Rosemarie E. Camoscio, M.D.
•	Sturdy Memorial Associates
•	Western MA PT
•	Xuan Q. Zhang
•	Alan B. Silken, MD
•	Apotheker, Harvey, DMD
•	Cape Cod Dermatology
•	Cape Cod Pediatrics
•	Central Boston Elder Services
•	DentaQuest Institute 
•	Howard M. Zolot, DMD
•	Hunt Nursing & Retirement Home
•	Joseph G. Maloney, DMD
•	Lab USA, Inc. 
•	Michael D. McKenzie MD, PC
•	Natick Visiting Nursing Association, Inc.
•	Newton Wellesley Interventional Spine, LLC
•	Newton Wellesley Urology
•	Northeast Clinical Services, Inc.
•	Oakdale Dental
•	Pilgrim Rehabilitation & Nursing
•	Porchlight VNA/Home Care
•	Root Family Medicine
•	Rosemarie E. Camoscio, M.D.
•	Wediko Children's Services
•	Western MA PT
•	Xuan Q. Zhang
•	Plus 291 Connections to Non-Participant Users
HISP to HISP Connectivity