Health Information Technology Council June Update
June 1, 2015

Agenda 

•	Welcome [5min]
-	April meeting minutes approval 
•	Consent Workgroup Update [15min] - Micky Tripathi 
•	MassHealth Update [20min] – Daniel Tsai
•	Massachusetts eHealth Institute Update [15min] – Laurance Stuntz
•	Operations Update [15 min] - Darrel Harmer 
•	HIT Council meeting frequency discussion [5min]
-	Council vote 

Discussion Item 2: Consent Workgroup Update 

Consent Workgroup

Consent Workgroup update
•	In past month a 37 member Consent workgroup was re-established with new members joining the previously established consent subgroup
•	Meeting was held  May 22nd at the Massachusetts Medical Society
–	First meeting focused on comprehending the universe of consents that Participants deal with when connecting with others electronically
–	Completed inventory of Federal, State, and other consents with details on consent type, applicability, and frequency
•	Workgroup agreed to 3 prong approach and will meet over the summer to work through the details:
–	Share current best practices solutions to thorny consent issues invoked when an organization connects with other  organizations for electronic exchange
–	Identify potential changes to laws and/or regulations to help solve current issues
–	Design broad public education campaign

Discussion Item 3: MassHealth Update 

Title Page: Update to the HIT Council

Priorities for MassHealth

Improve customer service and member experience

Fix eligibility systems and operational processes

Improve population health and care coordination through payment and care delivery reform 

Improve integration of physical, behavioral health and LTSS care across the Commonwealth

Scale innovative approaches for populations receiving long term services and supports

Improve management of our existing programs and spend

MassHealth Payment and Care Delivery reform strategy has 5 elements, which are complementary and mutually reinforcing

1.	Payment reform / model
2.	Approach to provider improvement
3.	Data support, infrastructure and policy initiatives
4.	Behavioral health and LTSS integration (emphasized throughout)
5.	Addressing social determinants of health (emphasized throughout)

Mass HIway has wide adoption for reporting related use cases, but very low adoption related to providing support for care transitions

Current state
26% of MA practices report they participate in an HIE

Of these, 51% are participating in the Mass HIway with others participating in private exchanges 

Predominant use of the HIway is reporting to the Department of Public Health/CDC (~77%)

Recognized challenges

Providers report that joining the HIway is a limited value proposition given absence of clinically and operationally meaningful provider tools for care transitions, e.g., ADT
Only 28% of practices report using the HIway for care transitions
Providers prioritize investments in direct connection with primary trading partners (via private solutions) vs investment in statewide connectivity

Opt-in consent requirements are a barrier to patient enrollment. The Commonwealth currently offers only limited patient consent supports or best practices

Next steps

EHS will seek stakeholder input in the next 90 days to articulate current challenges and opportunities facing the HIway 

The goal of these meetings will be to identify specific approaches the agencies may take – individually or collectively – to accelerate implementation of enhancements to the HIway to better support the clinical and operational needs of providers, payers, and key government stakeholders. Specific deliverables should include:

Articulating prioritized use cases from the interagency and provider perspective (e.g., DPH reporting, ADT feeds, quality reporting etc)
Validating those prioritized use cases with key market stakeholders
Evaluating approaches from other state-based HIEs, including key lessons for Massachusetts
Outline 12mo, 24mo and 36mo goals for enhanced Hiway functionality 
Outline a roadmap to meet those goals, including required resources, policies and interagency collaboration

EHS will present synthesized findings and next steps to the HIT Council in September

Discussion Item 4: Massachusetts eHealth Institute Update

DRAFT FY16 Operating Plan Overview
HIT Council Review

Operating Plan Design Principles
•	Financial
–	Plan for resources to last through FY18
•	Stretched through extension of REC
–	Plan for only committed resources
•	Applied for the ONC HIE Grant (2 years, $3 million)
•	Initiatives
–	Continue the thrust of the June 2014 Strategic Plan
–	Major grant programs (eHealth eQuality and Connected Communities) remain the same
–	Added a small eHealth Innovation Opportunity

FY16 Initiatives
A diagram of each of the programs was provided with a list of deliverables under each 

Common Programs
•	eHealth Innovation Opportunity Fund
–	$250,000/year
–	Designed to provide flexibility to invest in high-value projects
•	HIT Index
–	Currently working on the 2015 Index/Survey
–	Documenting progress along Adoption, Use, Impact continuum
•	Grantee Forum
–	Planned for October, 2015
–	Opportunity to exchange information, highlight grantee success, and identify high-value projects to support HIT
•	Outreach & Operations
–	Communications and Marketing eHealth Services
–	Salesforce
–	Website

Connected Communities
•	Continuing Efforts
–	Complete Statewide eHealth Plan – publish late Summer 2015
–	Community Grants award and management - $3.5M, 5-8 grants
•	New Efforts
–	Patient Engagement
•	First steps towards satisfying our Consumer Engagement goal
•	Will require lots of partners in government and healthcare sectors
–	Vendor Engagement
–	eHealth Fellowship

eHealth eQuality FY16 Programs
•	eQIP
–	Currently: 18 BH grantees with 126 sites
–	Validating: 15 LTPAC applicants and 9 more BH applicants
–	We expect to obligate about ½ of the $6.7 allocated to this program in FY15, and will then determine the highest impact for the remainder
•	Behavioral Health Consent Workgroup
–	Supporting eQIP grantees
•	EHR Model Deployment and Adoption Support
–	Support for small providers to help them choose and implement EHRs 

eHealth Services & Support
•	Medicaid Meaningful Use Incentive Application
–	7 FTE + Operations/IT support
–	Priced to cover costs 
–	~$1.3M revenue and expenses
•	eHealth Services
–	Incorporates Regional Extension Center
–	Significant interest in the Physician Quality Reporting System Registry
–	Diversifies funding stream
–	May distract from the broader mission
–	We are continually looking at ways to best support these groups and fill the “support providers in achieving Meaningful Use” part of our mission
•	Next review in June to check progress and plans

eHealth Cluster Development- Evolving Approach 

Discussion Item 5: Operations Update 

HIway Participation Activity
New Participation Agreements completed in May:
•	Allergy and Asthma Center of MA
•	Doru Iancovici M.D.
•	Duffy Health Center, Inc.
•	Michael S. Levin M.D.
•	Newton Wellesley Orthopedic Associates
•	Maples Rehabilitation & Nursing Center, LLC.
•	Outer Cape Health Services
•	Physician Care West P.C.

New Connections completed in May
•	Allergy and Asthma Center of MA
•	Cape Cod Healthcare
•	Doru Iancovici M.D.
•	Holyoke Health Center
•	Michael S. Levin M.D.
•	Newton Wellesley Orthopedic Associates
•	VNA of Eastern MA

Progress Relative to SFY’15 with Revised 
Targets
The actively using dashboard was provided 

HIway Transaction Activity
The HIway transaction volume was provided 

HIway Transaction Analysis
The HIway transaction types were provided 

HISP to HISP Connectivity
HISP Connectivity status was provided 

DPH Update
An update on the DPH connections was provided 

2015 Mass HIway Incident Summary Dashboard May 2015
The incident dashboard was provided 

HIway Availability Trends

Query and Retrieve Pilot Updates
BIDMC PatientSite (patient portal) has gone live in the test environment during the week of 5/18 and will serve as the first entry point where patients can opt-in or opt-out to the Mass HIway.  There are no early returns as of yet to determine effectiveness. Processed 5,707 messages, representing  4,453 unique patients to the RLS
Atrius Additional ADT testing with the Mass HIway for patients thathave a consent on file continues. There are two outstanding questions from Atrius:Conversion of patient consent from Yes to No and the patient information revealed  when this change is made Confirmation of the accuracy of patient matching criteria
9/2014 – 5/2015 – 184,000 requests given to patients, 102,000 consents, 8,000 declines
Tufts (No change) Providing real-time ADTs to Q&R to test environment. Production status to be updated upon completion of the development work for patient consent changes (also noted by Atrius). Would like to see a high volume test of the patient matching algorithm to prove that the EMPI works because they have seen matching errors and blanks. Would like to see the code for the algorithm to use for test scenarios.
Holyoke The consent process has been finalized. Workflow analysis  continues for efficient capture of patient consent preferences  (date to be determined) . Once complete, Holyoke is production ready (No new update).

HIway RLS - Unique Patients
RLS Transaction volume was provided 

Discussion Item 6: HIT Council meeting frequency discussion

Proposed Meeting Schedule 
HIT Council meeting frequency discussion: 
•	The Council’s initial focus was on EHR adoption – the planning work here is complete with periodic check in on progress and minor course correction
•	The Council then turned attention to HIE - During the Mass HIway planning, design, and initial launch phase the Secretary and EOHHS leadership relied heavily on timely recommendations from the HIT Council and multi-stakeholder workgroups  on everything from technical design to policy to pricing – Conversely, the HIT Council provided an effective forum for timely dissemination of progress information - We are now 2 ½ years into Mass HIway operations and have worked through the majority of (but not all) the open questions and issues surrounding HIE
•	The Council continues to have obligations for periodic review of EOHHS and MeHI plans and for an annual report to the General Court
•	Given that the Council now has some “breathing room:” 
–	Should we turn some of our attention to other areas?
–	Should we reduce meeting frequency? (e.g., Quarterly HITC meetings)
•	Council meetings could be focused on substantive and interactive discussions of strategic policies, issues, etc.
•	Provides time for formulating and vetting proposals and recommendations before being brought to the full Council

Proposed Meeting Schedule Cont.
Section 3.1 of HITC Bylaws: 
•	Regular meetings of the Council for the transaction of any lawful business of the Council shall be held with such frequency as the Chairperson and the Council may determine, but at least once each calendar quarter. Notice shall be provided to the members as set forth in Section 3.3. Meetings of the Council shall be held at the principal office of the Council or such other place as may be designated in the notice of the meeting. Any regularly scheduled meeting of the Council may be cancelled or rescheduled by the Chair or by a vote of the majority of members at any prior meeting of the Council.

Proposed Meeting Schedule if we move to quarterly frequency:
–	Monday September 14, 2015
–	Monday December 7, 2015
–	Monday March 7, 2016
–	Monday June 6,  2016

*All meetings to be held from 3:30-5:00 pm at One Ashburton Place, 21st floor, Boston MA 

Thank you!