AGENDA

1. Office of the State Coordinator for Health Information Technology Steering CommitteeAugust 11, 2011

2. AGENDA • Welcome and introductions • Minutes from June HITSC • Program updates • Bangor Beacon Program – Mac Hilton • Community College Programs – Paul Richardson, SMCC • Maine Primary Care Association – Kevin Lewis/Bob Kohl • HIN – Dev • Regional extension Center • Opportunities for Sustainability of HIE through 90/10 match - Dev • May 2011 State Medicaid Letter • IHOC – Joanie Klayman • HIX – Karynlee Harrington • MaineCare – Jim • Timeline of HIT implantation and major milestones • LD 1337 – Status of Opt-out form – Amy Landry, Dev culver, Jim Leonard • Process to date • Follow-up and responsibilities • LD 1467 – All Payor Claims Database Workplan - Jim • Discussion • Legal Work Group 2011 – 2012 focus - Jim • Definition and responsibilities of a State Designated Health Information • Clinical data and regulatory rules • Behavioral health streamlining reporting burden – Jim • Goals and workplan • Adjourn

4. HITECH Health Information Technology for Economic and Clinical Health Paul R Richardson

5. HITECH – Meaningful Use • Regulations and Incentives program for EHR adoption • Three Stages – Current Stage 1 – Runs through 2012 • Install and Meaningfully Use EHR system • 25 Meaningful Use objectives must be met • 15 Core – E-Prescribing (eRx), CPOE, … • 10 Menu Set – Patient centered involvement

6. For More information on Meaningful Use https://www.cms.gov/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf Blumenthal writes, "It is impossible to imagine a high-performing U.S. health system that does not take full advantage of the computing technology that has transformed virtually every other aspect of human endeavor."Read more: http://www.ihealthbeat.org/articles/2010/2/4/blumenthal-outlines-hitechs-ultimate-goals-in-nejm-perspective.aspx#ixzz1LylGoJl1

7. HITECH – Workforce Development • 82 Colleges and Universities • Train Workers to assist in meeting meaningful use • 6 Month certificate for Health or IT professionals • Runs through 2012 – Extension through 2013 expected • Two Tracks • Analyst/Consultant • IT/Engineer

8. Analyst/Consultant Track • Document the workflow and information management models of the practice • Conduct user requirements analysis • Develop revised workflow and information management models

9. Analyst/Consultant Track • Analyze and recommend solutions for health IT implementation • Advise and assist clinicians with technology • Ensure that the patient/consumer perspective is incorporated into EHR deployments

10. Analyst/Consultant Track • Apply project management and change management principles • Interact with office/hospital personnel to ensure open communication with the support team • Manage vendor-practice relations

11. Analyst/Consultant Track - Classes • Introduction to Information and Computer Science • History of Health Information Technology in the U.S. • Fundamentals of Health Workflow Process Analysis • Quality Improvement • Working in Teams

12. Engineering Track • Provide on-site support for EHR Systems • Execute implementation project • Incorporate usability principles

13. Engineering Track • Interact with end users to diagnose IT problems • Document IT problems and evaluate resolution • Support systems security and standards

14. Engineering Track - Classes • Intro to Health Care and Public Health in the U.S. • The Culture of Health Care • Installation and Maintenance of Health IT Systems • Configuring EHRs • Special Topics Course on Vendor-Specific Systems

15. Crossover Classes • Terminology in Health Care and Public Health • Health Management Information Systems • Working with Health IT Systems • Networking and Health Information Exchange • Usability and Human Factors • Professionalism/Customer Service

16. Curriculum Developed Nationally • Johns Hopkins University • Duke University • Columbia University • University of Alabama • Oregon Health and Science University

17. Online Blackboard System • All classes are taught online • 2-3 Units (Lessons) per week • Each class runs 2-5 weeks • One quiz per unit • Commitment of 12-15 hours per week – MINIMUM!

18. National Certification Exam The HIT Pro™ exams assess the competency of health IT professionals to: • Assess workflows • Select hardware and software • Work with vendors • Install and test systems • Diagnose IT problems • Train practice staff on system http://www.hitproexams.org/

19. Program Update • Students Enrolled in S. Maine and NH: 200 • Full Scholarships • Goal by 2012: 450 • Incumbent Workers: 75% • Graduates: 25

20. Contact Paul RichardsonProgram Director - Health Information TechnologySouthern Maine Community College2 Fort RoadSouth Portland, Maine 04106207 741 5870email: prichardson@smccME.edu web: smccME.edu/HIT

22. Maine Primary Care AssociationHIT Program Update

26. MaineCare HIT Initiative Program Status Update August 11, 2011

27. MaineCare HIT Initiative May – December 2011 Project Plan Overall Status: On Target to Meet Go-live Timeframe MaineCare EHR Incentive Program Timeline June 2011 July 2011 Aug 2011 Sept 2011 Oct 2011 Nov 2011 Dec. 2011 Jan 2012 Status Summary CMS Approves State HIT Plan Develop State System • June--Maine’s Health Information Technology (HIT) Incentive Payment Plan and funding approved by federal government (Center for Medicare and Medicaid Services (CMS) • July—State’s Office of Information Technology (OIT) developed and passed CMS tests for the State’s application/payment system. • August/September--OMS, OIT, Audit, and Finance Divisions finalizing audit and payment processes and State rule • August/September—OMS conducting pre-application outreach to hospitals and professionals, and health care organizations to walk them through the process and what information they need to apply. • Communication efforts and activities, including timely updates to OMS HIT website; newsletters to providers; coordination with other HIT efforts (Tele-health, ConnectME Broadband, Quality Organizations.) CMS Testing Oct. 3rd Launch Incentive Program Accept Applications Program Operations By 12/31/11 State Issues Incentive Payments Communications – Pre-Application Outreach Project Management - Operations Program Management Planning At A Glance

28. MaineCare EHR Incentive Program Implementation Plan SMHP approved 5/3/11

30. Opt-Out Form Requirements • Info about HIN including benefits and risks of participation. • Description of how and where to get more info or contact HIN. • Opportunity for the patient to opt-out. • Declaration that patients can’t be denied treatment based on provider's or patient's decision not to participate. • Information about how patients can do the following both on HIN’s website and without Internet access: • How patients can request a report of who has accessed their HealthInfoNet record and when the access occurred. • Opt-out and opt back in if they've previously opted out.

31. Consumer Advisory Committee Opt-Out Form Feedback and HIN Actions The following feedback was gathered from discussions at the CAC meeting on July 12th. The committee reviewed both the mandated form and a companion brochure that HealthInfoNet is encouraging providers to give patients as well. Below is a summary of the feedback and the action HIN took in response. HIN provided the committee with the revised form and brochure by email and gave members 9 days to review. There was no further feedback from the group. The following people were in attendance: Poppy Arford (consumer), Kate Healy (legal), George Hill (women’s health), Dr. Kolawole Bankole (minority health), Stefanie Trice Gill (health literacy), Andrea Littlefield (Beacon Community), Alysia Melnick (MCLU), Jennifer Putnam (HIV Advisory Committee), Chris Simons (mental health), Bill Sullivan (consumer), Kawika Thompson (education), Dr. Hugh Tilson (public health) and Dawn Gallagher (state government).

32. Feedback Action • Put everything in the second person narrative, using “you” instead of “patient”. • These changes were made throughout the form and companion brochure.Include a statement that informs that patient that their demographic information is retained when they opt-out and why. A statement was added to both the form and the companion brochure. • Tell the patient that they will not be discriminated against when seeking treatment based on their decision to participate or not. • A statement was added to both the form and the companion brochure.Increase the font size and use bullets on the opt-out form.The font size of the bottom half of the form was increased to match the top half. HIN decided that increasing further and adding bullets on the opt-out form wouldn’t work due to space constraints.

33. Feedback Action • Translate into most read languages in Maine and properly prep the form for accurate translation. • HIN worked with members experienced in this area to set up the form to be translated and will continue to consult with them to ensure final translation is accurate. • Remove the “Please note” and the word “deleted” when referencing health information as it may make this section sound threatening. • This section was incorporated after the bold text “Participation is voluntary” and the word “deleted” was changed to “removed”.Add a statement informing the patient that their personal health information (PHI) will not be sold. A statement was added to both the form and the companion brochure. • Define “opt-out” prior to using the termWe added ‘you may choose not to participate (“opt-out”)’ to define the term. • We did the same for “opt-in”.Use more active, personal language after bolded statement “Keeps records private and secure” Made this change. For example changed to “we encrypt your information” vs. “information is encrypted”Include why Social Security is asked for.This was included under that line

34. Provider Opt-Out Form Feedback and HIN Suggested Response The following feedback was gathered from practicing physicians who serve on HealthInfoNet’s Technical and Professional Practice Advisory Committee. The committee reviewed both the mandated form and a companion brochure that HealthInfoNet is encouraging providers to give patients as well. Below is a summary of the feedback and HealthInfoNet’s proposed response. The following people provided feedback: Dr. Donald Krause, Dr. John Vogt, Dr. Scott Patch, Dr. Ed Ringel, Dr. Mike Palumbo, and Dr. Paul Klainer