Denis ise Webb State te Health h IT C Coordinato ator April - - PowerPoint PPT Presentation

Denis ise Webb State te Health h IT C Coordinato ator April 2011

 The Age of Meaningful Use – Message from

• Dr. David Blumenthal, National Coordinator

for Health IT (HIT)

 Medicaid EHR Incentive Program  Regional Extension Center Program  HIT Workforce Development Program  State Health Information Exchange (HIE)

Program – WIRED for Health

 Q & A

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 Incentive Program to reward providers and

hospitals

 Creation of a national infrastructure  A vision for the use of information to support

health and health care improvement

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 Targeting Summer 2011 to begin accepting

registrations and issuing the incentive payments

 Working with CMS to receive approval of

Patient Volume Methodology to be used by Wisconsin Providers

 Conducting communication and outreach

activities, including webinars on the requirements to participate in the Medicaid EHR Incentive Program

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 Wisconsin HIT Extension Center (WHITEC)

• Organization
• Purpose
• Provider and hospital recruitment status
• Value Vendor selection

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 Technical Assistance Menu of Services

• HIT coordinator
• Meaningful Use assessment
• Incentive eligibility
• Change management/provider engagement
• General MU education
• Statewide best practices
• Current and future workflow redesign
• Public relations
• Privacy and security best practices and assessments

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 Purpose: to rapidly create HIT academic programs at

Community Colleges or expand existing ones

 One Community College Consortium in each of five

regions received an award

 Region C: Wisconsin, Nebraska, Kansas, Minnesota,

Iowa, Missouri, Illinois, Michigan, Indiana, and Ohio

 Cuyahoga Community College is leading the Region C

consortium and has 17 member colleges, including Madison and Milwaukee Area Technical Colleges

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 Program Expectations

• Milwaukee and Madison will train 600 students by

2012

 Trained to support EHR implementation and meaningful use requirements  Provide trained resources for HIT RECs and provider practices

 Funding

• Milwaukee’s allocation: $849,104
• Madison’s allocation: $759,822

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 Six-month intensive certificate program

• Nationally developed curriculum (Duke, Columbia, Johns Hopkins, Oregon

Health & Science University, and University of Alabama)

 Four roles covered by the two Wisconsin colleges:

• Practice workflow and information management redesign specialists
• Implementation support specialists
• Implementation managers
• Technical/software support staff

 Convenient online and evening courses  Grant funding offsets/scholarships

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 Hire already qualified professionals to meet

your EHR/MU practice needs

• Graduates have extensive healthcare, project

management, and/or information technology work experience

• Most Graduates have previous college or equivalent

experience with a majority holding other professional certifications (MSCE, MCSA, RN, RHIT, PMP)

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 $9.441M federal grant award for HIE planning

and implementation

 WIRED for Health Board and its committees

developed Wisconsin’s HIT Strategic and Operational Plan, April – August 2010

 ONC approved plan 12/21/10 and released

remaining grant funding

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 WIRED for Health Act  Conducted a competitive process to select a permanent state-level

HIE governing entity, i.e. a State Designated Entity (SDE)

 DHS Secretary accepted WIRED for Health Board recommendation to

designate the Wisconsin Statewide Health Information Network (WISHIN), Inc. as the SDE for Wisconsin, 10/25/10

 DHS executed a formal contract with WISHIN, 12/30/10

• Officially transitioned governance authority from the WIRED for Health

Board to WISHIN’s Board

• Made WISHIN the principle State HIE Cooperative Agreement Program

sub-recipient

• Delegated programmatic authority to WISHIN to implement

the approved HIT Strategic and Operational Plan

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Promote and improve the health of individuals and communities in Wisconsin through the development of health information exchange that facilitates electronic sharing of the right health information at the right place and right time. Develop and sustain a trusted, secure statewide health information network and HIE services that provide value to participants. Vision Mission

 Founded by WHA, WMS, WCHQ, and WHIO

• CEO – Joe Kachelski

 Not-for-profit (Chapter 181) Wisconsin corporation

incorporated 12/21/110

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

Founder ers

• Susan Turney, MD - Chair

Wisconsin Medical Society

• Chris Queram – Vice Chair

Wisconsin Collaborative for Healthcare Quality

• Julie Bartels - Secretary

Wisconsin Health Information Organization

• Steve Brenton - Treasurer

Wisconsin Hospital Association



Statuto tory

• Brett Davis

Medicaid Director

• Henry Anderson, M.D.

Acting State Public Health Officer

• Denise Webb

State Health IT Coordinator



Elected ted

• Craig Samitt, MD

Dean Health System

• Ken Letkeman

Marshfield Clinic

• John Foley

Anthem Blue Cross Blue Shield

• Sheila Jenkins

Network Health Plan

• Dianne Kiehl

Business Health Care Group (BCHG)

• Chuck Nason

Worzalla Publishing

• Jane Cooper

Patient Care

• Patti Brennan

UW School of Nursing/College of Engineering

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 Standing Committees

• Governance, Executive, Finance, Audit,

Compensation

 Advisory Committees

• Policy

licy, Chair: Matthew Stanford, Vice Chair: Julie Bartels

• Techni

hnical cal, Chair: Dave Lundal, Vice Chair: Ken Letkeman

• Comm

mmuni unicati cations

• ns, Chair: Peter Thompson (Invited),

Vice Chair: Jane Cooper

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 Six HIE Meaningful Use Requirements in Stage 1

and Wisconsin’s status

• e-Prescribing (Core)
• Patient clinical summary exchange among providers and patient

authorized entities (Core)

• Structured lab results
• Reportable lab results to public health (Menu, Hospitals only)
• Immunization data to public health (Menu)
• Syndromic surveillance data to public health (Menu)

 Ensure all providers have at least one option for

meeting the HIE requirements

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 e-Prescribi

escribing ng (Co Core) e)

(Data ta currentl rently y bei eing rev eview ewed/vali ed/validated ated by DHS and WISHIN) N)

Category Count Percentage Pharmacies Currently Accepting Electronic Prescriptions and Refill Requests 1,201 95% Pharmacies Not Currently Accepting Electronic Prescriptions and Refill Requests 45 4% Pharmacies (Closed (3), Declined Participation (1), Veterinary Pharmacies (4), or No Response (10) 18 1% Total 1,264 100%

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 Patient clinical summary exchange among providers and

patient authorized entities (Core)

 About 50% or more of 12,755 physicians in the state

have access to HIE through one or more of the following networks:

• EPIC Care Everywhere Network
• Marshfield-Ministry HIE
• Kiara Clinical Integration Network (KCIN)—affiliated with

Heart Sisters Hospital System (HSHS)

• Community Health Information Collaborative (CHIC)
• Wisconsin Health Information Exchange

(WHIE)

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Clinical Care Summary Exchange between Unaffiliated Providers*

* Within identified HIE networks

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 Structured lab results (Menu)  ~767 potential reference labs in Wisconsin (Data a currently ntly being g reviewed/ wed/va valid lidate ated by DHS a and WISHIN)  Narrowed focus to labs doing testing for entities

• utside lab’s parent organization

Category Count Percent Labs Sending Results Electronically 527 69% Labs Not Sending Results Electronically 168 22% Labs Unknown – No response or Declined participation 63 8% Labs Other (Labs sent out, no lab, or closed) 9 1% Total 767 100%

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Electronic Lab Results Delivery

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 Public Health requirements

• Reportable lab results to public health (Menu, Hospitals
• nly), October 2011
• Immunization data to public health (Menu), April 2011
• Syndromic surveillance data to public health (Menu)

 Existing or currently planned ADT feeds to the WHIE may satisfy requirement

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 Includes architecture and core

HIE services to help eligible professionals and hospitals meet meaningful use requirements

 Near-term plan is to enable

providers use of Direct secure messaging services in 2011

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Principles: es: Network-of-networks approach Statewide deployment roadmap Standards-based architecture Use of existing assets Technical services to support Stage 1 HIE MU Core/Menu Set Requirements Exchange with Public Health for Stage 1 HIE MU Menu Set

 Plan for 2012 is to have infrastructure and HIE services to

support robust query-retrieve HIE—―push and pull‖ health data

 WISHIN contracted with WHIE to serve as the Technical Manager

to manage and lead the technical aspects of the WIRED for Health project, i.e., implementation of the Statewide Health Information Network and HIE services

What is Direct? Secure Directed Exchange via the Internet

The Direct Project specifies a simple, secure, scalable, standards-based transportation mechanism that enables participants to send encrypted health information directly to known, trusted recipients over the Internet.

b.wells@direct.aclinic.org h.elthie@direct.ahospital.org

»

• Simple. Connects healthcare stakeholders through universal addressing using simple

push of information. »

• Secure. Users can easily verify messages are complete and not tampered with en route.

»

• Scalable. Enables Internet scale with no need for central network authority that must

provide sophisticated services such as EMPI, distributed query/retrieve, or data storage. » Standards-based. Built on well-established Internet standards, commonly used for secure e-mail communication; i.e.,. SMTP (or XDR) for transport, S/MIME for encryption, X.509 certificates for identity assurance

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Why is Direct needed? To facilitate Meaningful Use

» Patients:

• Discharge instructions
• Clinical summaries
• Reminders
• Other Health information

» Public Health:

• Immunization registries
• Syndromic surveillance
• Laboratory Reporting

» Other Providers/Authorized Entities:

• Clinical information
• Labs – test results
• Referrals and other transitions in

care – summary of care record b.wells@direct.aclinic.org

D I R E C T Direct Project facilitates the communication of many different kinds of content necessary to fulfill meaningful use requirements.

Examples of Meaningful Use Content

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✔ Being shared through Direct implementations today

✔ ✔ ✔ ✔ ✔ ✔

What is needed to implement Direct? Participant Perspective

Directed Exchange Participants, e.g., Physicians, Labs, Registries, etc.

• Create an account with a Health Information Services Provider (HISP):
• Provides a Direct Address, e.g., “b.wells@direct.aclinic.org”
• Obtains and often manages a security certificate (may be provided by an

independent “Certificate Authority”)

• Manages HIPAA-level security by, for example:
• Providing pass-through routing of encrypted documents, or
• Encrypting documents on participant’s behalf, through a business

agreement

• Use a Direct-enabled client for sending and receiving Direct messages, e.g.,:
• Direct-enabled email client, e.g., Outlook or Webmail
• Direct-enabled EHR
• Web portal, often powered by the HISP
• Obtain the Direct addresses for other healthcare participants with which to

exchange clinical data:

• Participants can be providers, labs, PHRs, state agencies, etc.
• Obtain Direct address through “in-band” mechanism (e.g., provider

directory) or “out of band” mechanism (e.g., phone)

• Provider directories not required but certainly add value
• Messages between participants must be sent to/from Direct addresses

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

WISHIN’s plans to support Direct Secure Messaging through its Technical Manager, WHIE in 2011

• HIE technical assistance for providers and labs
• Provide eligible professionals and hospitals access to a

Direct gateway with authentication and directory services via state-level HISP

• Provider Directory: Unified source of all licensed

health care professionals and facilities in Wisconsin

 Leveraging WMS provider directory

• Certificate Authority (CA) services to authorize and

authenticate Direct users

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 Policy and legal framework to Enable HIE

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 Wisconsin HIE Policy Focus for 2011

• Consent framework for HIE and legislation
• Participant and data use agreements
• Process for selecting and enforcing HIE standards

 Interstate Policy Focus for 2011

• Upper Midwest State Health Policy Consortium Project, initiated in

July 2010

 Participants: MN, IL, WI, ND, SD, IA  WI Lead: Kathy Johnson, DHS  Subject matter expert/advisor: Beth DeLair  Deliverables: Standard common interstate consent form, recommendations for converting form into an electronically capable format, use cases for interstate HIE, and concepts or language for HIE Interstate Agreement

 Medicaid EHR Incentive Program

• https://www.cms.gov/EHRIncentivePrograms/

 Wisconsin Medicaid EHR Incentive Program

• http://www.dhs.wisconsin.gov/ehrincentive/
• dhsehrincentiveprogram@wi.gov

 Medicaid EHR Incentive Program Listserv

• http://lists.wi.gov/read/all_forums/subscribe?name=dhs-

ehrincentiveprogram

 ONC list of Certified EHR Technology

• http://onc-chpl.force.com/ehrcert

 Wisconsin HIT Regional Extension Center (WHITEC)

• http://whitec.org/
• jwang@metastar.org

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 Milwaukee Area Technical College

• http://matc.edu/healthinfotech
• 414.297.7146
• kohell@matc.edu

 Madison College

• http://matcmadison.edu/hit
• 608.246.6101
• jkarls@matcmadison.edu

 Midwest Community College Consortium

• http://www.mwhit.org/

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 WIRED for Health SharePoint

• http://wiredboard.wisconsin.gov/Reference/index.htm

 eHealth Listerv

• http://lists.wi.gov/read/all_forums/subscribe?name=wiehealthnotices

 Wisconsin Statewide Health Information Network (WISHIN),

Inc.

• http://www.wishin.org
• wishin@wishin.org

 Wisconsin Department of Health Services, eHealth Program

• http://dhs.wisconsin.gov/ehealth
• ehealth@wisconsin.gov

 State HIT Coordinator

• Denise Webb, denise.webb@wisconsin.gov

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