hie policy board special session on sustainability august ... policy board_meetin… · 24/08/2017...

HIEPolicyBoardSpecialSessiononSustainability

August24,2017

HIEStakeholderOutreachFindings&SMHPUpdate

Agenda:StakeholderOutreach&SMHPUpdate

• CalltoOrder(5minutes)– RollCall– AnnouncementofQuorum

• ReviewSpecialSessionMeetingGoals(10minutes)– DCHIEMissionandPurpose– SetGoalsforObtainingMemberFeedback

• PresentSummaryofStakeholderFindings(45Minutes)– BackgroundandMethodology– KeyFindingsfromInterviewsandFocusGroups– DiscussiononFindings

• DiscussSMHPPlan(45Minutes)– SMHPOverviewandStatusUpdate– PreviewSMHPOrganizationandHITRoadmap– GoalsforSeptember21HIEPolicyBoardMeeting

• PublicComment(10minutes)

• NextStepsandAdjournment(5minutes)

2August2017

DCHIE:Vision&MissionStatements

VisionToadvancehealthandwellnessforallpersonsintheDistrictofColumbiaby

providingactionableinformationwheneverandwhereveritisneeded.

MissionTofacilitateandsustaintheengagementofallstakeholdersinthesecure

exchangeofusefulandusablehealth-relatedinformationtopromotehealthequity,enhancecarequality,andimproveoutcomes intheDistrictof

Columbia.

3August2017

StepsTowardsManagingPopulationHealthRisk

4August2017

OurGuidingPrinciplestoIncreasetheValueofHealthcareintheDistrict

• ExpandAccess– Ensureappropriateandadequateaccesstoservicesacrossalleight(8)wards.– Improvepatient-centeredcarecoordinationforallMedicaidbeneficiaries.Thisincludes

effortstocoordinatephysical,behavioral,andlong-termhealthcare,andsupportpreventivehealth.

• ImproveQuality– Enhancehospitalqualityandoutcomes.– PromotepartnershipsbetweenDChospitalsandprimarycareproviderstoimprovecare

deliveryandoutcomes.

• PromoteHealthEquity– DevelopprogramsandservicesfortheDistrict’shigh-needpopulations,particularly

thosewithahigh-burdenofchronicillness,andhomeless.– NeedtounderstandlifecircumstancesbettertoimprovehealthintheDistrict.

• EnhanceValueandEfficiency– Payforvalue,notforvolumeofhealthcareservices.– Promoteefficiency,transparency,andflexibilityofDHCF’sprograms

5August2017

Goals:Monitor4ComponentsofHIE

• Infrastructure:Accesstoanduseofelectronichealthdata

• Exchange:AbilitytoTransmitandReceiveHealth-RelatedData

• ImprovedService atthePointofCare

• HealthImprovement:BetterCare,SmarterSpending,HealthierCommunities

6August2017

HIEP

BOngoingTa

sks&

Roles •SetPriorities

•Gatherfeedbackfromkeystakeholders•Provideresourcesandconnections,includingguestpresenters•ServeasambassadorsofDCHIEprograms

HIEP

BActiv

ities&Deliverables • SMHPand

EnvironmentalScan(September‘17)

• HIEdesignationlegislationguidance&report(July-September‘17)

•MyHealthGPSDatasubgroup&report(ongoing)

• SustainabilityCommitteeoutreach&report(November‘17) HI

EPBRe

commen

datio

ns •Mission,vision,andlong-termgoals(Oct’16)•FY17priorities(Nov’16)•DCHIEdesignationrequirements(Feb’17– July‘17)•FeedbackonHIEToolDDI(April&July2017)•SustainabilitySpecialSession(August’17)•Coresetofusecases(September’17)•FY18/19IAPDprojects(September’17)•Long-termStakeholderEngagementPlan(December‘17)•High-levelSustainabilityPlan(December‘17)

7

ProposedFY17BoardActivitiesandDeliverables

August2017

SMHPisOneOpportunitytoReframetheConversationonHIT/HIEintheDistrict

8

HIT/HIEImplementation

(Process)

PracticeTransformation&Improvement(Outcomes)

August2017

EnvironmentalScan

CommunityNeeds

Assessment

StakeholderOutreach

HITAdoptionSSC&SMHPInterviews FocusGroups

DCHIEHistoricalTimeline:KeyMilestones

9

Children's IQ Network (CIQN) Launched

CIQN Launched -January 2009

Via DC Government Grant for EHRs in Six

Safety-Net Clinics

6 Clinics Live with eCW –

October 2008

DC Hospitals Connectto CRISP HIE –February 2014

DC HIE Policy Board Established by Mayoral Order

DC HIE PolicyBoard Established –

February 2012

Orion Rhapsody Implemented to Connect

Providers to DC DOH (Public Health). IZ, ELR,

SS, Cancer Registry

DC DOH Connection -October 2013

.

Over 800 PCPs Achieve Meaningful Use –

March 2014

eHealthDC Program Reports over 800 Primary Care Providers Achieving

Meaningful Use

DC HIE Grant –March 2017

Capital Partners in Care -Community Health Information Exchange (CPC-HIE) launched connecting Community Health

Centers to Hospitals

CPC-HIE Launched –February 2015

DC HIE Hospital Connection Program Supports 6 DC Hospitals to Connect to

CRISP to Support ADT and ENS -- Encounter

Notification, Encounter Reporting, Provider Portal

DC HIE Grant Awarded to expand CRISP and CPC-HIE Capabilities with development of: 1) Dynamic Patient Care

Profile2) Obstetrics/Prenatal

Specialized Registry3) Electronic Clinical Quality

Measurement Tool and Dashboard

4) Analytical Patient Population Dashboard; and

5) Ambulatory Connectivity and Support

August2017

WhatDoWeNeedfromYouToday?

• DiscussandProvideFeedbackonStakeholderFindings– DothesefindingsalignwithyourknowledgeoftheDChealthsystem?– Areanykeystakeholderperspectivesmissing?– Whereshouldweprioritizethenextstageofstakeholderoutreach?

• DiscussandProvideFeedbackSMHP&RoadmapApproach– Arethereadditionalchallengesandopportunitiestoaddress?– Havewehighlightedtherightopportunitiesbaseduponwhatwe’veheard

fromstakeholderstopreparefortheSeptembermeetingtodiscussFY‘18UseCases?

• ProvideInputtotheSustainabilitySubcommittee– WhatelseisneededtodevelopaLong-TermStakeholderEngagementPlan?– WhatelseisneededtodevelopaHigh-LevelSustainabilityPlan?

10August2017

STAKEHOLDERFINDINGSANALYSIS

SustainabilitySubcommitteeBackground

• TheGoalsoftheSubcommitteeareto:– determineastrategyforDCHIEfinancial

sustainabilitybeyondthesun-settingofHITECHfunds,and

– identifyvalue-driversthatcouldincentivizepublicandprivate-sectorstakeholderstosupporthealthinformationexchangeintheDistrict.

• ObjectivesforStakeholderOutreach:– InformtheBoardaboutthewaysaDCHIE

couldaddvalueforcorestakeholdersintheDistrict.

– Generatestakeholderspecific(e.g.,payer,hospital,clinic)use-casesdemonstratingvaluetotheseorganizations.

• SubcommitteeMembers:– ScottAfzal(CRISP)– AndersonAndrews(DCDepartmentofHealth)– ErinHolve(DCDepartmentofHealthCareFinance)– SamHanna(GWU)*– LaQuandraNesbitt,MD(DCDepartmentofHealth)– JustinJ.Palmer,MPA(DCHospitalAssociation)– DonnaRamos-Johnson(DistrictofColumbiaPrimary

CareAssociation)– AlisonRein(AcademyHealth)– Chair– ClaudiaSchlosberg(DCDepartmentofHealthCare

Finance)– PeteStoessel(AmeriHealth)– AllisonViola(KaiserPermanente)**HIEPBnon-members

12August2017

StakeholderOutreachMethodology

• Concurrentstakeholderoutreachefforts– HIEsustainabilityandSMHPeffortsmerged– ExpandedoutreachtostakeholdersidentifiedbyHIEPolicyBoard

• Utilizedconsistentinterviewguide– OutreachquestionsdevelopedbytheSustainabilitySubcommittee

wereusedasthefoundationforallSMHPinterviews– InterviewswithstakeholdersidentifiedbytheSustainability

Subcommitteeinvolvedamemberofthesubcommitteeortheboard

• Interviewteamincludedaprimaryinterviewer&notetaker– Majorityofinterviewswereconductedin-person

• QualitativeanalysisusingNvivotocodeinterviewfindings

13August2017

StakeholderSummary

TotalCompletedTo-Date:23 interviewsand3 focusgroups*Remaining:2interviewsand2focusgroups

14

Stakeholder SSC SMHP FG Stakeholder SSC SMHP FG

Academic 1 Health Systems/Hospitals 2 2

Associations 1 2 LTPAC 2

Beh.HealthProviders 1 1* MCOs 1

CaseManagers Providers - Large 2

CommunityServices 4 1 Providers- Small 1*

DCAgencies 2* 2 Residents/Patients 2

HIE Organizations 2 CommunityHealthCenters 1

HomeHealthAgencies 1* *TobecompletedinAugust/September

August2017

OutreachTopicsandObjectives

• CurrentState– Strategicgoalsandpriorities– Dataexchangeandpartners– ExamplesofHIEvalue– SDHcollected– Barriersexperienced

• FutureState– Prioritiesfornext5years– Additionaldataexchangeneeds– GreatestopportunitiesforHIEinDC– Anticipatedbarriers

• Conclusion– Othertopicsandrelevantneeds– Otherindividualstocontact

15August2017

Determine:1. Whathealthinformation

needstobeexchanged?2. Whoneedstobeengaged

inthecommunity?3. Whoneedstechnical

assistance?

KeyTakeaways

• HowDoProvidersandCarePartnersFeelAboutDCHIE?– HIEisvaluableandcriticaltodeliveringsafe andeffectivecare– FrustrationwithpriorunfulfilledHIEinitiativesandseekstrongleadershipandresults– Stakeholdersrepeatedlyasked,“WhatisDCHIE?”

• HowDoResidentsandPatientsFeelAboutHIE?– PatientsexpectHIE,butsocialdeterminantsdatacausesconcernsabouttreatmentbias– Someseemultipleproviders,othershaveseentheirsinglephysicianforyears

• WhatDataNeedstobeConnectedtoHIEforMedicalProviders?– Encounter:Consult/VisitNotes(CCDs);DischargeSummaries;OperativeNotes;BMI– Medications:Compliance,Dose,andDateFilled;PharmacyContactInformation– School:AbsenteeismRatesandInjuries– Other:InsuranceEligibility;CareTeamMembers

• WhatDataDoesthePayer/MCOCommunityNeedand/orContribute?– Alleviateburdentobothprovidersandpayersforchartauditsandreporting– MCOcaremanagersseekaccesstoclinicalencounterandHIEdata

16August2017

KeyTakeaways

• WhatCarePartnersNeedtobeConnectedtoHIE?– BehavioralHealth,Long-TermCare,Fire/EMS(FEMS),CommunityServices

• WhatSpecialFocusAreasareNeededforDCPriorityPopulations?– SocialDeterminantsofHealth,Telemedicine,Registries

• WhatIssuesExistwithCurrentInformationExchange?– NoHIEinfrastructuretosupportcaretransitions– exchangeofconsult/visitnotes– ProvidersareresistanttouseHIEtoolswithoutSSO/contextsharingorEHRintegration– ENSanddatacompletenessvariesacrosshospitalsduetodifferentrulesandtriggers– Claimsdatavaluedforanalytics,butcanbeincompleteorinsufficientinqualityforcare

• WhataretheBarrierstoHIE?WhoNeedsAssistance?– HIEoperationalcosts(e.g.,licensefees,connections)andmaintenancefeesarebarriers– MedicaidproviderswhoresistEHRadoptionneedlow-costHIEalternatives– Providersseekingworkflow&resourcessupporttoeffectivelyuseHITandHIE

• WhatIsNeededtoMakeHIEDataUsable?– Analyticsisnotacurrentfunctionorservice– Someorganizationsseekdataliquiditytoperformanalyticsinhouse,othersseektools

17August2017

HealthInformationExchangeFramework

Access

• Accessibleelectronicallyinproviderworkflowforcaredeliveryandpatients/residentsfordecision-making

Exchange

• Secure,electronicexchangeviastandardizedmessages,documents,andtransportprotocols

Use

• Supportsanalytics,qualitymeasures,alerts,decisionsupport,&value-basedpurchasing

Improve

• Supportsongoingmeasurement&monitoring;canbeusedtoimproveefficiency,caredelivery,andhealth

Canyoucaptureoraccessdata

electronically?

Canyousend &receive data? Canuse thedata? Canyouusedatato

improve health?

18August2017

HealthInformationFramework:Access

Discussion

• DothesefindingsalignwithyourknowledgeoftheDChealthsystem?• Areanystakeholderperspectivesmissing?• Arethereadditionalstakeholderstomeetwith?

Canyoucaptureoraccess healthinformationelectronicallyusingestablishedstandards?

Findings

AmbulatoryEHRAdoptionandHIETechnicalAssistance• Safety-net,healthsystems,largepracticesareadvancedEHRadopters.• HealthITandHIE(maintenanceandoperating)costshinderadoptionforsmallandmediumpractices.• Smallpractices/solopractitionersinunderservedareasareunlikelytoadopt.• Socialdeterminantsofhealthdatacaptureisnascent,butnotstandardized.Long-TermCare• SomeEHRearlyadopters,butmostarenotoncertifiedEHRs.SeekingtechnicalassistancetoconnecttoHIE.BehavioralHealth:• Credible/iCAMSEHRworkflowchallengesandlackofinformationexchange.LackofEHRadoptionorEHRs

capableofexchangeinsomesettings.• ClinicalandbehavioralhealthprovidersseekingclarityonBHinformationexchangepolicy.

19August2017

HealthInformationFramework:Access

Discussion


Canyoucaptureoraccess healthinformationelectronicallyusingestablishedstandards?

FindingsRespondentswithoutHIEaccess• ProvidersreluctanttoimplementoruseHIEportal(s)/systemswithoutEHRintegrationorSSOwithsharing

ofuserandpatientcontext.• Socialworkers,casemanagers,andpayercarecoordinators(MCOs)seekaccesstoHIEdata.• FEMSisimplementingnursetriagelineandinterestedinusingpatientcareprofileandpatientpopulation

dashboard.FEMSisabletosend/receiveinformationusingDirect.RespondentswithHIEaccess• ProvidersreportchallengeswithCRISPinterfaceusability(responsetime,navigation).• MedStarHealth(inpatient)implementedintegratedCernerviewofCRISPencounterinformation.• MyHealthGPSprovidershaveaccesstobasicdatatosupportcarecoordinationacrossmedicalcare.• CRISPCCDdataavailablegoesback6weeks;providersdesiregreaterhistoryandreal-timeexchange.• Providerswantaccesstobehavioralhealth,long-termcare,andVirginiahospitaldata.

August2017 20

HealthInformationFramework:Exchange

Discussion


Canyouelectronicallysendandreceive(exchange)high-qualityhealthinformation?

Findings

HIENeeds• Providerswantconsultnotes/CCDexchangedwithintheirEHR.• SomeprovidershavetheabilitytoexchangeinfoviaDirect,butdon’tknowhowtosendittoothers.• Behavioralhealthdataexchangeislargelyconductedbyfax;CCDsfilteroutinformation.• Integratedelectronicplatformsforcommunityservicesthatsupportsbi-directionalexchangewithproviders.ExchangeImprovements• Providerswantsinglealertonpatientadmission,ortransfer,ordischarge(notinternaltransfer).• ProvidersperceiveMarylandhospitaldataasmoredetailedandcompletethanDChospitals.• Providerswantaquickly-established,consensus-drivenprocessondatasharingpractices.• ConsentandpoliciesforbehavioralhealthandSDHdataconfuseprovidersandpatients.• HIPAArequirementsareofteninterpretedstrictly,restrictinginformationexchange.

21August2017

HealthInformationFramework:Use

Discussion


Whatdoyouneedforexchangedhealthinformationtobeusable?

FindingsHIENeeds• CurrentHIEismovinginformationfromPointAtoPointB– it’snotanalyticsordataforanalytics.• StakeholdersexpressedmixedconfidenceinconsistencyandcompletenessofENSandclaimsinformation.• ProviderswantHIEtofacilitatetransitionsofcareandrelatedreportingforMU/MACRAprograms.• Providersdesiresocialdeterminantsofhealthdatatobetterinformcareplans.• Clinicalexchangedataforcaredelivery.Claimsdatadesiredforregistries,qualitymeasures,analytics.• Claimsdataisnotalwaystimely;mayobtain80%ofthedatawithin2weeks.ExpectedUses• Healthsystemsandlargeprovidersareindividuallypursuinganalytics,withvaryingdegreesofreadiness.• Smallerorganizationsseekanalyticstoolsandresources,largerorganizationsseekdirectaccesstothedata.• DCHospitalAssociationseekingadditionaldatatosupportanalyticalneedsandreportingofmembers.• MCOsseeanopportunitytoreducechartaudit,utilizationreview,andreportingburdenviaHIE.

August2017 22

HealthInformationFramework:Improve

Discussion


Whatdoyouneedtousedatatoimprove efficiency,caredelivery,andhealth?

FindingsExamplesforImprovementviaHIE• “ThereareoverlappingorduplicativecarecoordinationeffortsbetweenDistrictagencies(i.e.,DHCF,DBH)

andtheMCOs.Interagency coordination andinformationexchangecansupportbettercarecoordination.”• “Ourshelterproviderscoordinatewith911servicesandDHCFtolookat90-daydata.Wereallyneeda1-year

lookbackperiod.Thepeoplewhocomein/outin6monthincrements,theygetlostinthisdatalapse.”• “WeneedtobeabletoseethatapatientwhopresentedatED,wasprescribedmedicationXtopickupfrom

pharmacy,butdoesNOTgetthemed.Weneedthepharmacydatatotrackthismedicationcomplianceinformation.“

• “Wheredohomelesspatientsusuallygo?Whoistheirdoctor?Ourprovidersneedthisinformationtocoordinatecare.”

• “Wehavetoredefinepeople’sjobssotheycanaskthequestionsforhigherriskpoolstobettermanagetheirpatients.Theprocess/datahastogobeyondthecarevisit.”“VitalsdataoutsidetheencounterBP,weight.”

• “Needtoshiftfrommovingdataaroundtoexchangingonlydatathatisimportantorrelevant.”BenefitsandImprovementsviaHIE• “Clinicalcarecoursewasalteredinabsenceoffamilyandwereabletogetcorrectinformation.”

August2017 23

SMHPOVERVIEW&DISCUSSION

SMHPOverviewandStatus

• SMHP=StateMedicaidHealthITPlan• StrategicplanningdocumentforStateMedicaidAgency

healthITinitiatives• EnsuresthatDHCF,CMS,andHIT/EStakeholdershavealigned

goalsandpriorities• EstablishesaRoadmapandplanforHIT/Eprojects• Informedbyaformalenvironmentalscanandstakeholder

engagementprocess– Dataandstatistics(CommunityHealthNeedsAssessment,metrics)– Stakeholderinterviewsandfocusgroups– Analysisofconnectivity,readiness,&resourcestoparticipateinHIT/E

• RequiredbyCMStobeupdatedeverytwoyears

25August2017

OrganizingStructureforSMHP

26

E X P A N DA C C E S S

P R O M O T EH E A LT H E Q U I T Y

I M P R O V EQ U A L I T Y

E N H A N C EV A L U E &

E F F I C I E N C Y

August2017

GuidingPrinciplestoIncreaseValueofHealthcareintheDistrict

Principle#1:ExpandAccess

27

E X P A N DA C C E S S




E F F I C I E N C Y

PRINCIPLE #1LEVERAGE HIT & HIE TO EXPAND ACCESS

C U R R E N T A C T I V I T I E S• Increase use of EHRs in physical and behavioral health• SDH screenings in EHRs (e.g., PRAPARE)• Optimizing and improving EHR-enabled workflows

N E A R - T E R M A C T I V I T I E S• Expand adoption of patient-provider secure messaging• Clinical decision support to support preventive health• ENS Alerts and referrals for follow-ups and care reminders• Increase use of EHRs in long-term care• Online access to community resources and electronic referrals• Timely exchange of complete and accurate health information• Consensus and processes for viewable/accessible SDH data• Tools to support provider-to-provider communication and exchange

(e.g., Provider Directory, improve Direct workflows)• Develop use cases and identify opportunities for telehealth

L O N G - T E R M A C T I V I T I E S• Increase use of telehealth and telemental health • Increase availability of mobile technology and tools• Enhance use of technology for patient access to information

T O D AY ’ S C H A L L E N G E S• Health care services are not consistently

timely and available at accessible locations (HPSA, MUA/P)

• Person-centered care – SDH, cultures, diverse care preferences

• Despite health insurance coverage rates, not all DC residents can afford services.

• Insurance renewal and continuity

T O M O R R O W ’ S O P P O R T U N I T I E S

August2017

Principle#2:ImproveQuality

28

P R I N C I P L E # 2LEVERAGE HIT & HIE TO IMPROVE QUALITY

C U R R E N T A C T I V I T I E S• Increase standardized electronic data through EHRs and HIE• Increase capture/reporting of eClinical Quality Measures (eCQMs)• Expand tools and dashboards for eCQM reporting (CAliPHR)• Access to claims information to supplement clinical history• Expand tools to support comprehensive and longitudinal views of

patient care for highest-risk and vulnerable populations (Dynamic Patient Care Profile, Analytical Patient Population Dashboard)

N E A R - T E R M A C T I V I T I E S• Improve and optimize data quality of DC HIE data (ADTs, CCDs)• Enable access to claims data for measure calculation• Refine clinical and claims data to standardize and exchange• Routine exchange of ADTs other clinical documentation• Identify and implement data warehouse architecture to support

registries for high-risk patients, tools for MCOs• Expand HIT and HIT for behavioral health and long-term care

L O N G - T E R M A C T I V I T I E S• Quality measures to report to DHCF and the public• Government agency, health care provider, and community

organization consent and trust to share data

T O D AY ’ S C H A L L E N G E S• Providers deliver care without access to

patient history or access to care teams• Quality of care varies across organizations• Quality measure capture and reporting is

a burden for providers and struggle to make it actionable and credible

• Payers need data to operate efficiently and achieve strategic goals (e.g., MCOs, DHCF)

T O M O R R O W ’ S O P P O R T U N I T I E SE X P A N DA C C E S S

P R O M O T EH E A L T H E Q U I T Y



E F F I C I E N C Y

August2017

Principle#3:PromoteHealthEquity

29

P R I N C I P L E # 3LEVERAGE HIT & HIE TO PROMOTE HEALTH EQUITY

C U R R E N T A C T I V I T I E S• Medicaid EHR Incentive Program (MEIP) support for EHR adoption• Tools for providers to manage patients with multiple chronic

conditions (My Health GPS toolset)• Implement Obstetrics/Prenatal Specialized Registry• SDH screenings in EHRs (e.g., PRAPARE)

N E A R - T E R M A C T I V I T I E S• Identify and develop tools and programs focused on maintaining

health vs. treating illness – registries for high-needs populations• Ease and improve display of evidence to inform care • Online access to community resources and electronic referrals• HIE to support transitions of care for high-needs populations• Implement and expand HIT/E to support care transitions with

behavioral health, long-term care, and FEMS• Patient and provider preferences, rights, and education needs to

develop policies and protocols for SDH exchange

L O N G - T E R M A C T I V I T I E S• Resident consent to exchange SDH data • Government agency, health care provider, and community

organization consent and trust to share data

T O D AY ’ S C H A L L E N G E S• Access to services is varied• Disparities in priority populations: severe

mental illness, chronic conditions, homeless, FEMS super-utilizers, high risk moms/babies, sickle cell, asthma

• Evidence is not routinely used to treat conditions for priority populations

• Widespread and routine attention to social determinants of health lags and varies





E F F I C I E N C Y

August2017

Principle#4:EnhanceValue&Efficiency

30

P R I N C I P L E # 4LEVERAGE HIT & HIE TO ENHANCE VALUE & EFFICIENCY

C U R R E N T A C T I V I T I E S• Ongoing technical assistance and education to providers and

support workflow redesign (MEIP, improve SLR)• DC Govt systems coordination (MITA/DHS/DOH/DBH/BoMed)

N E A R - T E R M A C T I V I T I E S• Tools and workflows to exchange basic information with provider

populations that are unlikely to fully adopt EHRs • Expanding tools for broader audiences, MCO/payer mixes, etc. • Improve and enhance ADTs, other clinical documentation display for

existing and expanded providers (e.g., SSO, EHR integration, APIs)• Address provider trust, engagement, and usage of HIE • Registries and electronic tools to monitor and report trends• Investigate policy levers for HIE participation• Analytics tools/package to support ACO participation• Implement and expand HIT/E to support care transitions with

behavioral health, long-term care, and FEMS

L O N G - T E R M A C T I V I T I E S• Govt, provider, and community consent and trust to share data• Quality measures to report to DHCF and the public• Enhanced tools to support VBP expansion and ACO participation

T O D AY ’ S C H A L L E N G E S• Paying for volume vs. prevention • Lags in EHR adoption impact delivery of

efficient care – small practices/solo practitioners in underserved areas resistant

• Data quality and completeness of exchanged data needs improvement

• Seeking integrated tools vs. more tools• Need for robust tools for quality

measurement, monitoring and reporting





E F F I C I E N C Y

August2017

DevelopingaDCHIERoadmap

31

• Ambulatory, Hospital EHRs• DC HIE Hospital Connection• ENS Notifications• Public Health HIE Integration• Organizational/Community

HIEs Established

ACCESS EXCHANGECARE TRANSITIONS

• Care Profile• CAliPHR for CQMs• Pt Population Dashboard• OB/Prenatal Registry• Medicaid Claims Data• Ambulatory EHR

Technical Assistance

ACCESS& EXCHANGE

EXCHANGE & USEBASIC ANLAYTICS

IMPROVEEXPANDED VBP

USEADV. ANALYTICS

PAST‘15-’17

TOC

TODAY’17-’18

FY ‘18 FY ‘19 FY ‘20 FY ‘21

• Improve Data Quality• LTPAC, Behavioral Health,

FEMS Connectivity• Document Exchange• SDH Planning• Registry Planning

• Expand DC HIE Tools to LTPAC, Beh Health, FEMS

• Analytics Tools for ACOs• Implement and Connect

to Registries• Collect & Exchange SDH• Telemedicine

• Advanced Analytics and Tools for Providers, Payers, and Patients

• HIE Policy Levers• Integration of DC Govt

Systems Data

ExamplesOnly– RequiresAnnualProcesstoDeterminePrioritiesandIAPDRequests

• Expand Advanced Analytics and Tools

• Data Liquidity• TBD Projects

TOC

August2017

FY’18Planning:DCHIERoadmap

P L A N N I N GS E P T E M B E R 2 4 P O L I C Y B O A R D M E E T I N G

• Discuss shift from work to-date (supporting exchange, access, and care coordination) to supporting care transitions

• Transitions of Care (TOC) Use Cases• Behavioral Health• Long-Term Post Acute Care• Fire/EMS• Enabling Document Exchange

• Data Quality and Population Health Use Cases• Improving HIE Data Quality• Social Determinants of Health • Registries

FY’18

32

TOC

TOC

TOC

August2017

SeptemberHIEPolicyBoardMeeting

• Use-Cases

• FFY18/FFY19IAPDRequests

• Materials&SMHPDrafttoHIEPBonSept14

• HIEPBMeetingonSept21– FeedbackDueSept21

• SMHPUpdateTeam/CGHOfficeHours

• SMHPComments/Questions:[email protected]

33August2017

NextStepsforSustainabilitySubcommittee

• Concludinginitialoutreachtounderstandcurrentstateandneeds

• Maintainrelationshipsandcontinueoutreach

• Definecore/commoninfrastructureneeds

• DeliverableDue:December2017– Long-TermStakeholderEngagementPlan

– High-LevelSustainabilityPlan

34August2017

PUBLICCOMMENT

NEXTSTEPS

BOARDACTION– MotiontoAdjourn

• VotetoAdjournToday’sMeeting

37August2017

NEXTMEETING:SEPTEMBER21,20173PM– 5PM

APPENDIX

DCResidentFocusGroupQuestions

Firstsetofquestions:• Whathealthandwellnessgoalsmattermosttoyou?toyourfamily?toyourneighborhood?• Whatfactorsmakeadifferencethosegoals?Whatfactorsstandintheirway?• Forthechallengeswejusttalkedabout,whichonescouldbemosteasilyfixed?Whichonesarehardto

fix?Why?

Secondsetofquestions:• Whatdoyouexpectyourdoctortoknowaboutyouwhenyouarriveatthedoctor’soffice?• Whatkindofinformationaboutyourlifeandyourneighborhooddoyouwantyourdoctortoknowand

havewrittendowninyourelectronichealthrecord?• Fortheinformationwejusttalkedabout,whatinformationdoyouthinkisOKfordoctorsandhospitalsto

sharewithotherdoctorsandhospitals?• Doyouhaveanyquestionsabouttheinformationwejusttalkedabout?

40August2017

SafetyNetProviderFocusGroupQuestions

Firstsetofquestions:• Whatpracticetransformationinitiativesandgoalsmattermosttoyourorganization,nowandinthenext

fiveyears?• WhatroledoeshealthITplayinsupportingyourorganization’sinitiativesandgoals?• HowcouldHIEsupportyourorganization’sgoalsandinitiatives?

Secondsetofquestions:• Arethereanysocialdeterminantsofhealth(SDoH)informationthatismissingfromthislistthatyou

currentlycollect?[listprovidedforfocusgroupparticipants]• [inreferencetotheDHCFcompilationofSDoH]Whatinformationisactionableandmakesadifferenceto

patientcareprocessesandpatienthealthoutcomes?• Doyoushare(ordoyouwanttoshare)SDoHandclinicalinformationwithotherorganizationsinsideor

outsidetheDistrict?• HowcouldanHIEinfrastructureintheDistrictsupportelectronicexchangeofSDoHandclinical

information?• ArethereanyothertopicsrelatedtoSDoHandHIEthatwehavenotyetaddressedinthisforum?• Whatshouldweaskyourpatients?

41August2017

StakeholderInterviewQuestions

CurrentState:1. What areyourorganization’scurrentstrategicgoalsandprioritiesthatcanonlybeachievedthroughthe

effectiveuseofdatacaptureandexchange?– Wheredohealthdataexchangeandanalyticsfitintoyourorganization’sstrategy?

2. HowwouldyoucharacterizethecurrentstateofHIEwithintheDistrictofColumbia?– Whattypesofdataareyousharingand/orreceiving?– Whichorganizationalpartnersand/orserviceprovidershavebeenpartofyourdata

sharing/receivingefforts?3. Canyoudiscuss2to3currentexamplesofvaluegeneratedbyHIEanddatasharingeffortstoyour

organization?4. Which,ifany,socialdeterminantsofhealthdatadoesyourorganizationcollect?

– Howdoyoucapturethisinformation?– Howisitused?

5. [forDCgovernmentalagenciesonly]Howdoesinformationexchangeimpactyouragency’sstrategicgoals,reportingandmanagementrequirements,andabilitytoperformservicesfortheDistrictresidentsyouserve?

6. WhatarethebarrierstoinformationexchangewithinyourorganizationandacrosstheDistrict?

42August2017

StakeholderInterviewQuestions

FutureState:1. Whatareyourprioritiesforinformationexchangeinthenext5years?

– Whatinfrastructuredoyouneedtosupportthesegoals?– Whatareyouplanningtoimplementwithinyourownorganization?– WhereandhowcouldDistrict-levelHIEsupportyourorganization’sstrategicandinformationexchange

goals?WhatarethebarrierstoinformationexchangewithinyourorganizationandacrosstheDistrict?2. Wherewouldadditionaldataexchangehelpyoutosolvecurrentand/oranticipatedchallenges?

– Whatareyourcurrentpainpointsthatcouldpotentiallyberemediatedthroughbetterdatasharing?– Inthelastfewyears,givenrecentreforminitiatives,how,ifatall,doyouseeyourhealthinformation

exchangeneedsevolving?3. WheredoyouseethegreatestopportunitiesforexpandedhealthinformationexchangewithintheDistrictof

Columbia?– Forexample:behavioralhealth;mentalhealthandsubstanceuse;carecoordinationforhigh-riskpatients

andpatientswithmultiplechronicconditions;qualitymeasurement;patientengagement;coordinationwithFire&EMS

4. WhatdoyouanticipateasbarrierstoinformationexchangewithinyourorganizationandacrosstheDistrict?

Conclusion:1. Arethereanytopicsyouwishtodiscussthathavenotbeenraisedinthisdiscussion?2. Isthereanyoneelseyourecommendwespeakwithaboutcurrentandfuturehealthinformationexchange

needswithinyourorganization?

43August2017

KeyTakeaways- Detail

• HIEworkflowintegrationforprovidersiscritical.Providertrust,engagement,andusageofHIEwillbetiedtovalue,whichiscurrentlyaconcern.– Ambulatoryproviderswantaccesstonotes(consult,d/csummaries,etc.)withintheirEHR.– Safety-netprovidersaremostinterestedindatatosupportcarecoordination,primarilyconsultnotes.(Others

includeddischargesummaries,CCDs,meds,labs.)– AwealthofinformationmaybeavailableviavariousHIEviews,butcliniciansareseekingaccesstothisinformationin

amoreusablemanner.

• Hospitaldatacanprovidevalue,butisinconsistentandincomplete.– RulesandtriggersforsendingdatatoCRISPlikelyvariesacrosssendingorganizationsanddataislikelysentbeforeitis

available(e.g.labordersthathavenotresulted,notesthathavenotyetbeencompleted/signed,diagnosesnotavailable,medicationsmaynotbepopulated).

– Sending/suppressingofdataisbaseduponeachorganization’sownguidelines– thereisnotconsensusorrulesonwhatissharedandwhenandwithwhom.

• Safetynetproviders,communityorganizations,DCresidents/patientsrecognizetheimportanceofdocumentingandexchangingSDH.– Consensusrequiredtoestablishsharingparametersfor(1)whentoshareand(2)whattoshare(actionabledata).– DisparitiesarewideamongsthealthsystemreadinesstomovetowardsroutineHIEforsupportingVBP.

• Currentsystemsaremovingdatafrom“pointatopointb”.Analyticsisnotacurrentfunctionorservice.– Largerproviderorganizationscannotperformanalyticsin-housewithoutaccesstoclaimsdata.– CRISPdatadoesn’tcomeinawayforthemtoattributeoranalyzeit.Dataforoutcomes,healthcaredelivery,VBPis

largelyunavailable.

• Thereisatendencytocollecteverything,regardlessofwhetheryoucandosomethingaboutit.– FQHCprovidersweresupportiveofcollecting“moredata”bynon-physicians:encouragingfrontdesk,MA,nurses,

NPs,caremanagerstocollect/maintainthisdata.

44August2017

KeyTakeaways- Detail

• SomeMedicaid(ambulatory)providersarenotgoingtoadoptEHRs– needlow-cost,easy-to-usetoolsforthispopulationtoparticipateinHIE.

• Clinicalcommunityandhospitalsareseekingforavenuetohaverealconversations (candidandinformally)amongsteachother(includingDCgovernment)aroundHIEanddataforVBP.

• Stakeholdersarefrustratedbypriorunfulfilledinitiativestoexchangehealthinformationandneedstrongleadershipandresults.– Thereisastrongdesiretohaveconsensusanddirectionvs.conversation.Thesentimentamongmanyisto,“Puta

stakeinthegroundandseehowthatgoes.Thenchangeasneeded.”

• HealthITReadinessofbehavioralhealth,long-termcare,Fire/EMSforHIEislow.– Directassistanceisneeded,asaccesstoinformationiscitedascriticalandthedemandforthisinformationandtools

isthere.– Behavioralhealthdataaccessinparticulariscitedbysafety-netprimarycareprovidersandhealthhomeprovidersas

themostimportantinformationgap.Behavioralhealthdataintegrationishighpriority,butcomeswithahighneedforeducationandconsensusforexchange.

• PatientsandprovidersexpectHIE– theydonotwanttoreportthesameinfoeverytimeateverylocation.• DCgovernmentinterestishigh,coordinationandcollaborationhistoryislow.

– LotsofvaluabledataacrossDHCF/MMIS,DOH-publichealth,DBH,DHS,etc.– Thereisaneedforstrategyandaroadmapfordataavailabilityandexchange.

• Stakeholdersareseekingclarityandunderstandingabout“WhatisDCHIE?”.– WhatdoesitmeantobeaDCparticipantinanotherstate’sHIE?Whoisit?Whatisit?IsthereaDCHIE?– ShouldparticipantsbesigningagreementswithDCHIE?OrwithCRISP,CIQN,&CPC-HIE?Whatdoes“DC”own?

45August2017

8categories ofgroupedcodestosummarizefindings(appendix)

DataNeeds HIEIssues&DataQuality

HIEPartnersand

Organizations

HIEBarriersandCosts

HIEData:Use

DCResidentsandPatients

SocialDeterminantsofHealth

Special FocusAreas

(BH,LTC,FEMS)

60discretecodes appliedtoqualitativeanalysis

ADT/ENS CIQN-HIE DataAccessibility

DataMiningandMapping Direct HIEOutsideDC Infrastructure

ParticipationService

AgreementsReporting StrategicGoals

andPriorities

BehavioralandMentalHealth CPC-HIE DataAnalytics DataValidation DOH HealthIT

ReadinessImpactofData

Exchange Partnerships ResourceAvailability Telemedicine

CareCoordination CRISP-HIE DataCapture,

ExchangeDataSharingPartners

EHRVendorsandAdoption

HealthITSustainability Interoperability Patient

MatchingSchoolSystemInformation

TransitionsofCare

CaseManagement

DataAccessibility

DataCompleteness DataTypes Funding

HIEValueCaseandBusiness

Case

Laws,Policies,and

Regulations

PrivacyandSecurity


UseCase

ClaimsData ChallengesandBarriers DataIntegrity Data

Warehouse Governance HospitalConnectivity MeaningfulUse PublicHealth Stakeholder

EngagementValueBasedPurchasing

Costs CultureData

Integration DBH HealthDisparities

ImpactofDataExchange

OpportunitiesforExpanded

HIE

QualityandHealth

OutcomesStandards Workflow

MethodtoPresentStakeholderFindings

46

Mappedto4HIEFrameworkCategories(TODAY)

Access Exchange Use Improve

August2017

Observations• Providersunabletoaccesslabresultsfrom

hospitals duetodifferingsystemsandinterfaces.• Claimsdataisnotup-to-date.• Providersdonothaveaccesstopatientsummary

dataforallhospitals.• Entirecareteamrecordscannotbeaccessed

readily.• Dischargedataonlyusedtotellifpatientwasin

thehospital.• ENSnotificationsareusedfrequently,but

inconsistent,nottimelyandsometimesinaccurate.

• Challengeishowquicklytousedatatopreventandtreat(nothowtogetthedata).

Needs• Dischargesummaries;BMIdata;Claims;

Diagnoses;Operativenotes;Patientprofile;Absenteeismratesandinjuries;Insuranceeligibility;Lastoutpatientprogressnote;LastEDvisit;Medications;Medicationcompliance,dose,anddatefilled;Pharmacycontactinformation;Careteam.

• Real-timeintegrationforprovidersandsocialworkers.

• SSO forsinglesignonandsharingofpatientcontext.

• Datasegmentationforbehavioralhealth.• Timely,clean,accurate,complete data for

delivery,reimbursementandoutcomesopportunities.

• Dataneedstobeactionable.• Results(lab,rad)thatarepartoftheChildren’s

HealthNetwork.Wedonothaveaccesstothisinformation.

DataNeeds

AnalysisCodes:DataAccessibility;DataCompleteness;DataIntegrity;DataTypes;Claims;andADTsStakeholders: HIE,Associations,DCAgencies,HealthSystems,Providers,LTPAC

47August2017

Observations• Importanttoevaluatedataintegrity,filterandget

intotherightworkflow forthosewhowilluseit.• EnhancedHIEToolsdonotprovidealldata,but

includesbasicdataneeds.• Providersarechasingdataandneedtoclosethe

loopwithconsultnotes.• Real-timeEHRquerywouldassistdataexchange.• Complicateddealingwith3states(DC,MD,VA).• Forsome,CRISPpullsdataautomaticallyfromEHR

orwhat’ssentisn’tfiltered(suchasBHinfo).• “Admissiondiagnosisisnotcomingoverwith

initialADTalertfromCRISP;Itmaybeacoupleofdayslater.WhenwetalkedwithCRISP,theysaidsomeoftheinterfaces atdifferenthospitalswereolder.WithHoward,forexample,ourdatahasmoreblanksandweweretoldtheirdatamappingisnotuptodateandthatiswhysomedataisbeinglostintransmission.”

Needs• Decisiontrees,proceduresandpracticesfor

externaldatacomingintoEHR.• Policiesontimelydatacollectionand

transmission.• Avoidanceofunintentionaldatasiloswhen

collectingdatasetsonpatients.• DeterminationofbenefitandROItoavoid

informationoverload.• ENSalertsthroughmobiledevices,smartphone.• Datadrivensolutionsareneeded.Needtodefine

workflowandinformationexchangestandards.• Pediatricscreeningquestionstransferredto

schoolsfromprovideroffices• Patientmatchingiscriticalandimportantthatno

duplicatechartsexist.

HIEIssuesandDataQuality

AnalysisCodes:CaseMgmt;CareCoordination;TransitionsofCare;DataMiningandMapping;OutsideDC;ValueStakeholders:CommunityServices,Associations,DCAgencies,Providers,LTPAC

48August2017

Observations• Integrationisachallengewithamultitudeof

systemsinthemarketplace,andHIEencompassesmanyvendorproducts.

• Communityservicesproviderslacktheabilitytocommunicatewithproviders;converselyelectronicreferralstocommunityservicesisnotavailable.

• ExtensiveburdenofdataexchangebetweenproviderorganizationsandMCOs(e.g.,NCQA,HEDIS)coulduseHIEtoleverageburdenandexchangedatadirectlydirectlywithMCOs.

• FQHCQIdepartmentresourcesspentrespondingtoauditrequests;individualpatientinformationrequests– MCOshavecasemanagersthatarecallingandaskingfordata.Theyask“how’sthispatientdoing”becausetheycan’tseethedata.

• MCOsinterestedinaccesstodatatoalleviatecasemanagerandutilizationreviewburden.

Needs• Establishingdatagovernancetoeliminate

redundantsystemsoradditionalsystems.• Consolidateandcoordinateeffortstomaintain

electronicreferralsandcommunicationstocommunityservices(foodbanks,housingservices,faith-basedorganizations,etc.)

• ContinuedconversationsandcollaborationswithMCOs toreducedataexchangeburden.

• ENS/CRISPprovidesalotofdata- needtoidentifywhatis“important”.Suchas,“WhendoweneedtohavetheCareManagerfollowup?”

• OpportunityfortheDistricttoincludeadditionaldataelementsasstandardcomponentsincareplans thatarepartofHealthHomesmodelswithpayers.

HIEPartnersandOrganizations

AnalysisCodes:DataSharingPartners;Governance;HIEValueandBusinessCase;PublicHealthStakeholders:HIE,CommunityServices,DCAgencies,HealthSystem,Hospitals,Associations,MCO

49August2017

Observations• SomeprovidersarenotgoingtoadoptEHRsdue

tocostsandprimarilyMedicaidpatientvolume.• Providersseekingworkflowsupporttoeffectively

send,receive,anduseHIEdata.• CostsofHIEareconsideredabarrier.• CostversusROIisimportanttoemphasize.• Fundingto support socialservices,case

management,andcarecoordinationisscarce.• Adoption ofcertifiedhealthITinbehavioral

healthandLTPACvaries.OrganizationsthathaveEHRsarechallengedtofundtheirHIEconnections.

• Clarityaroundmentalhealth/behavioralhealthdatasharingpoliciesisneeded.

• HIPAAisofteninterpretedtoostrictlywheninformationneedstobesharedamongstcarepartners.

• WehaveaccesstoDirect,butit’seithernotenabledforotherprovidersorwedon’tknowhoworwheretosendittothem.

Needs• Wantaforumformoredialoganddiscussions

aboutHIE:whatishappening,whatareothersfinding,howtotackleissues.

• MedicaidproviderswhoresistEHRadoptionneedlow-costHIEalternatives

• TheoperationalcostsofHIE(e.g.,licensefees,connections)requirefundingforclinicalandnon-clinicaltradingpartners.

• Abilitytofilter forthedesireddata.LargeprovidersgettensorhundredsofthousandsofENSalertseachmonth.Needtobeabletofilteronthosethatarerelevant.

HIEBarriers&Costs

AnalysisCodes:Cost,FundingStakeholders:HIE,Associations,Providers,CommunityServiceProviders

50August2017

Observations• Analyticsareimperative,butrare.• Everyhealthsystemisworkingonitsown

analyticsstrategy.• Notalldatareceivedisuseful.• UseofhealthdataforVBPwillrequire

participantstopayfordata/serviceslong-termsustainability.

• Goalistoreducecostsaroundqualityimprovement.

• HIEinformationisusefulintrackingfrequentusersofhospitals– eliminatedphonetimetotrackdowninformation.

• Someprovidersexcitedtouseclaimsdata,othersfeelitisnotalwayscompleteandisbestusedforanalyticsandstrategicinitiatives.

• Donothaveasystemtoeffectivelymanagechroniccarepatientsandneedadata-drivensolutionforthis.Wanttohavetoolstorisk-stratifypatients.

Needs• Payerdatatopopulateregistries.• Claimsdatatointegratewithpatientpanelsand

provideinformationforqualitymeasures.• HIEtofacilitatereportingMeaningfulUse

measuresforTransitionsofCare.• Multipledatasourcesforvaluebasedpurchasing.• Informationexchangewith communitygroupsfor

coordinationofservicesisveryimportant.• Mapdataelementsonschoolhealthformsto

includementalhealthinformationtosharebetweenschoolsandproviders.

• Datamappingfor qualitymeasures.

HIEDataUsability

AnalysisCodes:DataAnalytics;DataCapture,ExchangeandTransmission;DataMiningandMapping;SustainabilityStakeholders: HIE,MCO,Providers,HealthSystem,DCAgencies,Associations

51August2017

Observations• PatientsexpectHIEtobeoccurringanddonot

wanttorepeattheirclinicalhistory.• Residentsexpressedmixedviewsonsocial

determinantsofhealth(SDH)captureandexchange

• ManyfocusgroupparticipantsacknowledgedthatSDHaffecttheirhealth,butcommunicatedconcernthatthedatacouldbeusedagainstthem.

• SomeresidentsexpectprimarycareproviderstoknowSDHinformationbasedontheirpatient-providerrelationshipandhistory.

• Residentsexpecttheirphysicianstoknowiftheywerehospitalized,butalsowantthechancetotell“theirside”oftheencounter.

• VeryfewpatientshaveoptedoutofHIE (FromSafetyNetProviderFocusGroup).

Needs• ConsensusprocessestodecideSDHtocapture

andexchange• Visibleoutreachandeducation• Strongconsentprocessesandforms• Continuedoutreachandpatientengagement• MCOsandproviderorganizationshaveexisting

patientgroupsandengagementforumstoleverageonanongoingbasis.

• “Ifyouhavemultipledocs,yourprimarydocshouldgetalltheinformationfromtheotherdocs.Somedoctorswillnotforwardthatinformationtoyourprimarycaredoctor.Wehavetodothatforthem.Onetime,Ihadtoremindoneofmydoctorstosendtheinformationtomyprimarydoctors.WhenIwenttomyprimarydoctormeeting,hetoldmeheneverreceivedit.Igotonthephonetomyspecialistandhadhimfaxtheinfotomyprimarycarethesameday.Thatisademandyoushouldhave.“

DCResidentsandPatients

AnalysisCodes:StakeholderEngagementandBuy-InStakeholders:DCResidents,CommunityServiceProviders

52August2017

Observations• Mentalhealthdata,income,transportation,

utilities,dataprovidestheabilitytodiscustheseissueswiththepatientduringtreatment.

• SDHdataexchangeoccursviafaxorviaphone.• InteragencyCouncilonHomelessnessare

trackinghomeless data.• Someinformationiscapturedinassessments

(PRAPARE)orasunstructureddata,butnotallpatientsarewillingtoshareinformation.

• CertainSDHinformation(likehousingstatus)changesfrequently.

• ImportantSDHtocapture:– Housing– Food– Transportation– Insurancecoverage/enrollment– Language– Countryoforigin(documentation)– Stress– Crime– Discrimination– Financialstability

Needs• WorkflowsandbestpracticesforcapturingSDH

informationandvalidatingitregularlywithpatients.

• HIEshouldhaveauditing anddatasegmentationcapabilities.

• Organizedandroutinelyupdatedcommunityservices information.

• Participationagreementsondatasharingdefinitionsandtimeframes.

• ConsensusondischargeplanningprocessesinconsiderationofSDH.

• BuildSDHandHIEintoexistingsystems;takeadvantageofreferralsandportalmessagetechnology.

• HIEcanbeconnectedtoCMSandSSAtodetermineincomethresholdsordisadvantagedstatus.

• Leveragetelemedicine,remotemonitoring,toalleviatetransportationissues.


AnalysisCodes:SocialDeterminantsofHealthStakeholders:HIE,Providers,CommunityServiceProviders;SchoolSystems;MCOs;Govagencies;Associations

53August2017

SDHDataNeeds:MAPingSummit

MAPing(Measuring,Assessing,Planning)theUseofSocialDeterminantsofHealth(SDH)DataintheDistrictonApril18th and19th

54

0

5

10

15

20

25

30

35

40

MAPingMeeting4/19 MCACHealthSystemRedesign5/3 DCPACT5/24

August2017

Observations• Datafromoutsidethehealthcaresystemis

importantforcareplanning,butdifficulttointegrateintoHIEworkflows.

• Behavioral/Mentalhealthdataissiloed acrossCredible(iCAMS),SADO,DataWits,andothersthatstoreredundantinformation.

• DCInteragencyCouncilonHomelessnessisdevelopingstandardstoprovideservicestohomelesspopulations.

• PertheDCNA,patientportalwasunsuccessfulasmostpatientsdon’thaveaccesstocomputers.

• OpendatapolicyisfocuswithOCTO andmayor’sofficetounderstanddatasetsthattheagencieshavecanbepublicvs.confidential.

• FEMSandDCPSandotherstakeholderscommittedtotelehealth solutions.

Needs• FEMS patientcareprofileanddashboard.• LTPACexchangeinfrastructure• Exchangeandconsentpoliciesonbehavioraland

mentalhealthdata.

SpecialFocusAreas

AnalysisCodes:Cost,Funding;Infrastructure;Laws,PoliciesandRegulations;TelemedicineStakeholders:HIE,Associations,Providers,CommunityServiceProviders

55August2017

LTPACTransitionsofCare(TOC)Examples:OtherStates

DataSource:https://www.healthit.gov/playbook/pdf/factors-contrib-hie-ltpac.pdf

56August2017

hie policy board special session on sustainability august ... policy board_meetin… · 24/08/2017...

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