Beacon Community and EHR Vendor Collaboration: A Catalyst for Interoperability and Exchange

ONC CMS Meaningful Use Stage 2 Exchange Summit March 18, 2013

Agenda

• Welcome and introduction to the Beacon Vendor Affinity Group

• Purpose the Affinity Group• Phase 1 Activities – focus on content• Pilots and Lessons Learned• Phase 2 Plans – focus on MU2 TOC transport• Questions

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Build and strengthen health IT infrastructure and exchange capabilities - positioning each community to pursue a new level of sustainable health care quality and efficiency over the coming years.

Improve cost, quality, and population health - translating investments in health IT in the short run to measureable improvements in the 3-part aim.

Test innovative approaches to performance measurement, technology integration, and care delivery - accelerating evidence generation for new approaches.

The Beacon Community Program: Where HITECH Comes to Life

17 communities each funded ~$12-16M over 3 yrs to:

17 Diverse Communities

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Hawaii County Beacon Community

Hilo, HI

Hawaii County Beacon Community

Hilo, HI

Southeast Michigan Beacon Community

Detroit, MI

Southeast Michigan Beacon Community

Detroit, MI

Crescent City Beacon Community

New Orleans, LA

Crescent City Beacon Community

New Orleans, LA

Delta BLUES Beacon Community

Stoneville, MS

Delta BLUES Beacon Community

Stoneville, MS

Keystone Beacon Community Danville, PA

Keystone Beacon Community Danville, PA

Utah Beacon Community

Salt Lake City, UT

Utah Beacon Community

Salt Lake City, UT

Beacon Community of Inland Northwest

Spokane, WA

Beacon Community of Inland Northwest

Spokane, WA

Great Tulsa Health Access Network Beacon

CommunityTulsa, OK

Great Tulsa Health Access Network Beacon

CommunityTulsa, OK

Southeastern Minnesota Beacon Community

Rochester, MN

Southeastern Minnesota Beacon Community

Rochester, MN

Rhode Island Beacon Community

Providence, RI

Rhode Island Beacon Community

Providence, RI

Greater Cincinnati Beacon Community

Cincinnati, OH

Greater Cincinnati Beacon Community

Cincinnati, OH

Southern Piedmont Beacon Community

Concord, NC

Southern Piedmont Beacon Community

Concord, NCSan Diego Beacon

CommunitySan Diego, CA

San Diego Beacon Community

San Diego, CA

Western New York Beacon Community

Buffalo, NY

Western New York Beacon Community

Buffalo, NY

Colorado Beacon Community

Grand Junction, CO

Colorado Beacon Community

Grand Junction, CO

Bangor Beacon CommunityBrewer, ME

Bangor Beacon CommunityBrewer, ME

Central Indiana Beacon Community

Indianapolis, IN

Central Indiana Beacon Community

Indianapolis, IN

Affinity Group Purpose

• Promote the adoption, use and interoperability of EHR technology to advance the care improvement goals of impacted communities

• Phase 1 use cases for CCD exchange (Nov 2011 – Jan 2013):– Update clinical registry or repository– Patient referral

• Phase 2 – Guidance on MU2 (March – August 2013) – Test required and option transports for Transitions of Care (TOC) and

View online, Download, and Transmit (VDT)– Explore implementation across trust exchanges both within and

between communities

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Phase I – Affinity Group (AG) Problems and Goals

• The AG articulated 6 high priority problems that the group was charted to address– Information Exchange and Interoperability (4)– EHR adoption and Meaningful Use (1)– Quality Measure Reporting (1)

• AG members laid out specific, time-bounded goals intended to address the identified problems

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Full Affinity Group Participants

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Beacon Communities EHR Vendors HIE Vendors

Bangor Beacon CommunityBeacon Community of the Inland Northwest

Central Indiana Beacon CommunityColorado Beacon Consortium

Crescent City Beacon CommunityDelta Blues Beacon Community

Greater Cincinnati Beacon CollaborationHawaii Beacon Community

Keystone Beacon CommunityMyHealth Access Network (Tulsa)Rhode Island Beacon Community

San Diego Beacon CommunitySoutheast Michigan Beacon Community

Southeastern Minnesota Beacon CommunitySouthern Piedmont Beacon Community (NC)

Utah Beacon Community/IC3Western New York Beacon Community

AllscriptsCerner

GE HealthcareGreenway Medical

NextGen HealthcareSuccessEHS

Vitera Healthcare Solution

CaradigmCovisint

InterSystemsMedicity

MirthOptum/AxolotlOrion Health

Affinity Group Governance

• ONC Beacon-EHR Vendor Affinity Group Co-Chairs• Executive Steering Committee– 5 Beacon and 5 Vendor Representatives that guide the

work of the Affinity Group– ONC Representative– Technical Support – Booz Allen Hamilton– Technical and Engagement Work Group co-chairs report

out to this group

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Phase 1 AG Accomplishments

Engagement Workgroup (Co-Chair David Smith & Dan Stoke)

Technical Workgroup (Co-Chairs David Groves & Tone Southerland)

Chronic Illness Training Template Beacon Technical Discovery Guide

Transitions of Care & Meaningful Use Document

Beacon User Stories Version 1 & 2• Update Clinical Data Repository and

Disease Registry• Patient Referral

User Group Guidelines Beacon Vendor C83 Data Element Analysis Version 1

Vendor Evaluation Matrix/ROI Workbook Work Product Descriptions/How to use guide for the C83 Data Element Analysis sheet

Vendor Fair Guidelines Glide path from HITSP C83 to CCDA –White Paper

Post Live Playbook Versions 1 (Version #2 in production)

Vendor Quality Measure Collection9

*This document provides an overview of each of the Beacon-EHR Vendor Engagement & Technical Work Group work products developed between January and December 2012

C83 Pilot Project Process

• Goals of the C83 pilots– Sharing 66 high priority data elements

• Ability to keep vendor IP confidential while providing value to the participants

• Moving towards Stage 2 Meaningful Use– CCD Workflow

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Phase 1 - C83 Pilot Metrics

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GRAND TOTAL (LIVE + PLANNED)

Beacon# of Practice

Locations# of Providers

# of Patients Impacted

Bangor 2 23 16,096 Cincinnati 3 8 4,200 Colorado 1 6 4,500 Crescent City 8 81 81,036 Inland Northwest 19 139 3,590 Keystone 14 43 76,000 Rhode Island 9 54 64,888 Southeast Michigan 7 22 62,151 Southeast Minnesota 29 231 184,300 Tulsa 121 1330 1,126,200 Utah 2 13 36,000 Western New York 1 5 1,402 Grand Total (Live+Planned) 216 1955 1,660,363

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Sample CCD Workflow

Phase 1 - C83 Pilot Project Results

• Recognized benefits of collaboration• Positive impact for patients• Willingness to continue towards MU2– Direct needs to become “Real”– Vendors/communities are struggling with

standards– Natural AG progression from MU Stage 1 focus

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Mapping Data Elements to MU2

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C-CDA Data Requirements21 of the 36 MU2 data

requirements are supported by the Beacon C83 data elements

(58%)

15 of the 36 MU2 data requirements are not supported

by the Beacon C83 data elements (42%)

Beacon C83 Data Elements55 of the 66 Beacon C83 data elements support MU2 data

requirements (83%)

11 of the 66 Beacon C83 data elements do not support MU2 data

requirements (17%)

Phase 1 - Materials/Case Studies

• Recent White Paper: Glide Path from HITSP C83 to C-CDA: Informed decision making for health information stakeholders: http://www.healthit.gov/policy-researchers-implementers/reports

• Direct URL: http://www.healthit.gov/sites/default/files/glidepath_hitsp_c83_to_ccda.pdf

• Vendors and Communities Working Together: A Catalyst for Interoperability and Exchange: http://www.healthit.gov/providers-professionals/vendors-and-communities-working-together-catalyst-interoperability-and-excha

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Phase 2 – Problems & Goals

• Problems will focus on required and optional transports for Transitions of Care and View online, Download, & Transmit as well as exchange across trust communities

• Goals• Educate others• Build off existing work of others• Leverage Beacon AG established work• ID and engage community partners• Support MU2 TOC and VDT member certification• Pilot/test end-to-end connectivity for TOC • Deliver feedback and “Lessons Learned”

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Affinity Group Participants

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Beacon Communities EHR VendorsHIE Vendors (as

invited by Beacon partners)

Bangor Beacon CommunityBeacon Community of the Inland Northwest

Colorado Beacon ConsortiumCrescent City Beacon CommunityDelta Blues Beacon CommunityKeystone Beacon Community

MyHealth Access Network (Tulsa)Rhode Island Beacon Community

San Diego Beacon CommunitySoutheast Michigan Beacon Community

Southeastern Minnesota Beacon CommunityUtah Beacon Community/IC3

Western New York Beacon Community

AllscriptsGE Healthcare (TBD)Greenway Medical

NextGen HealthcareSuccessEHS

Vitera Healthcare Solution

AxolotlMedicity

Orion HealthCovisint

InterSystemsMirth

Phase 2 - Affinity Group Governance

• Affinity Leadership Group– ONC Representative– Technical Support – Booz Allen Hamilton– 2 Co-Chairs (Beacon/Vendor) and 2 Vice-Chairs

• Full ONC Beacon-EHR Vendor Affinity Group– 13 Beacons and 6 Vendor Representatives that guide the

work of the Affinity Group

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Direct Model

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• Transport Options– Direct (Required)– Direct + XDR/XDM (Optional)– SOAP + XDR/XDM (Optional)

• TOC Alternative Query-based exchange → eHealth Exchange

Discussion

For more information on the Beacon Community Program, please contact Christina.Markle@hhs.gov and download Beacon Community Fact Sheets at http://www.healthit.gov/policy-researchers-implementers/beacon-community-program