Draft MeHI Planning Elements

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Draft MeHI Planning Elements May 27, 2009
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Purpose of Planning Elements Document

• Document created to provide annotated planning
  elements to HIT Council for review and comment.
• RFP for MeHI planning process did not require
  response for specific planning approach so
  Planning Elements Document is being provided to
  consulting firms with specific questions to
• Determine how firm would conduct overall planning
  process including description of approach,
  specific deliverables, approximate timeline, etc.
• Determine their level of understanding of the
  various elements of the individual plans and
  their ability to clearly articulate how to
  leverage existing efforts in the Commonwealth and
  nationwide.
• Set clear expectation that we need an actionable
  strategic plan/s with necessary level of detail
  to move rapidly from planning to operations.

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Purpose of Planning Elements Document (cont.)

• Not meant as an outline or proposed structure for
  plan/s.
• Goal of MeHI planning process is to support
  delivery of quality health care in Massachusetts
  while promoting cost containment through the
  effective deployment of Health Information
  Technology (HIT).
• Some key definitions required to complete the
  plan/s have not been finalized by federal
  government requiring the use of planning
  assumptions to begin planning process. For
  example for MeHI planning process did not
  require response for specific planning approach
  so Planning Elements Document is being provided
  to consulting firms with specific questions to
• Meaningful use definition for EHRs
• Interoperability standards for HIEs
• Role of Research and Extension Centers
• Specific content of Public Health and Quality
  Reporting
• Essential to leverage work completed in the past
  including 2008 BCG plan for eHealth Rollout and
  Massachusetts experience in deployment of EHRs
  and HIEs.

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Planning Element Categories

• EHR Deployment recommendation for approach
  including number of IOs, etc.
• Hospital and ambulatory EHRs.
• Updating environmental scan in Commonwealth to
  confirm number of providers with no EHRs and
  capturing lessons learned from past efforts.
• Ensure community engagement in process.
• Leverage HIT Council meetings and BCG interviews.
• Other ways to engage the community?
• Key questions
• How will we prioritize deployment of EHRs in the
  context of goals of Chapter 305 to address
  medically underserved areas?
• How do we ensure sustainable of EHRs following
  deployment and how should the governance/funding
  be structured?
• How many physicians need EHRs to achieve
  meaningful use?
• How do we ensure the currency of clinical
  decision support and other features?
• Deliverables will include actionable strategic
  plan with RFP for IO/s.

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Planning Element Categories

• Role of Consumer in Health Care Delivery Process
  - to ensure optimal clinical value and active
  patient engagement in own care.
• Chronic disease management and other relevant
  functions.
• Role of PHRs may also be included in EHR and HIE
  deployment plans.
• Stand alone and integrated options.
• Deliverables will include specific
  recommendations for engaging consumer and best
  practices for supporting PHRs.
• HIE Implementation
• Update environmental scan in Commonwealth to
  determine current status of HIE efforts in
  Massachusetts and nationwide.
• NEHEN, EMHI, CHAPS, hospital-specific efforts,
  operational HIEs in other states
• Review governance models, sustainable funding
  options, etc.
• Evaluate architectures and technologies to
  support interoperability, etc.
• Key question How do we ensure long-term
  sustainability?
• Deliverables may include a plan with specific
  recommendations for a State-Wide HIE including
• Governance
• Technical architecture
• Funding models
• RFP for IO/s

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Planning Element Categories

• Governance and management may include
• Process for oversight of contracted IOs providing
  deployment services including Program Management
  Office (PMO), tracking metrics, etc.
• Role of HIT Extension Centers identified in
  HITECH Act to assist providers with
  implementation of EHRs to be defined.
• Deliverables to include specific recommendation
  for governance, management and tools for
  overseeing state-wide efforts.
• Funding and loan processes for hospitals,
  community health centers and community-based
  providers
• Utilize state, federal and stakeholder funding
  sources.
• State funding Chapter 305
• Use for matching requirement for federal EHR
  loans?
• HITECH Act funding includes
• 2 B for ONC, standards adoption, improved
  privacy and security, grant and loan funding,
  etc.
• 36 B in Medicare and Medicaid incentives for
  office-based providers and hospitals.
• Determine specific loan requirements for each
  segment e.g., hospitals.
• Deliverable MTC/MeHI will develop plan for
  implementation of funding and loan process.

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Planning Element Categories

• Development of sustainable state-wide HIE model
  leveraging state, federal and stakeholder
  funding.
• Review of successful state-wide HIEs in US.
• How are they funded?
• Expanded privacy and security standards.
• Deliverable Consulting firm to evaluate options
  and make recommendations for
• HIE/s in Massachusetts.
• Management and oversight of all deployment
  efforts in Massachusetts.
• Interoperability standards
• Definitions not finalized in HITECH Act.
• Review current standards and actively monitor
  federal efforts to ensure that plan
  recommendations conform to new standards.
• New standards to be established by two committees
  under ONC
• HIT Policy Committee (HITPC) will recommend areas
  in which standards are needed.
• HIT Advisory Committee (HITSC) will review and
  recommend standards.
• Deliverable will include specific recommendations
  in RFPs for IO/s.

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Planning Element Categories

• Public Health and Quality Reporting
• No final definitions for either report type or
  content.
• Must closely monitor to ensure we meet federal
  reporting requirements when defined.
• Assume the use of existing reports for planning
  purposes including bio-surveillance.
• One possible approach
• Create inventory of reports for DPH, CMS, CDC,
  payer-specific reporting (P4P), etc.
• Rationalize and map reporting requirements to
  appropriate sources including EHRs, HIE data
  repositories, etc.
• Deliverable to include a recommendation for
  supporting reporting requirements on a state-wide
  level.