esMD Pilots Workgroup

1. esMD Pilots Workgroup December 12th, 2013

2. Meeting Etiquette • Please announce your name each time prior to making comments or suggestions during the call • Remember: If you are not speaking keep your phone on mute • Do not put your phone on hold – if you need to take a call, hang up and dial in again when finished with your other call • Hold = Elevator Music = very frustrated speakers and participants • This meeting, like all of our meetings, is being recorded • Another reason to keep your phone on mute when not speaking! • Feel free to use the “Chat” or “Q&A” feature for questions or comments From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute  NOTE: This meeting is being recorded and will be posted on the esMD Wiki page after the meeting

3. Agenda

4. Pilot Site Introductions • Secure Exchange Solutions • PAHISP LLC • Ibeza LLC • MEA • Inpriva • MaxMD • eSolutions, Inc. • MRO Corporation • UHIN

5. Pilot Interest

6. HIMSS Interoperability Showcase Care Theme: esMD enables Providers and Payers with an electronic format to submit and receive digitally signed and attested medical documentation, allowing Providers to focus on delivery of care due to time and cost savings from utilizing electronic structured documentation for administrative purposes. Use Case: A provider registers to receive electronic medical documentation requests (eMDRs) from a payer and indicates their electronic address (electronic service information – ESI) via a point to their Provider Directory. The provider then submits a digitally-signed structured document that includes the clinical data elements capture using the appropriate e-clinical template to request prior authorization from a payer (for example for a Power Mobility Device). • Primary Goal: To enable providers to register to receive eMDRs from a payer and submit digitally-signed structured data to a payer to substantiate that the planned or completed services is medically necessary and appropriate. • Key Points: • Provider obtains a digital identity • Provider registers with a Provider Directory • Provider registers with payer • Provider generates structured data using the eClinical template for a Power Mobility Device • Provider uses HL7 DSTU Digital Signature standard to digitally sign and attest to the contents of the document • Provider submits the document to the payer or their agent and the digital signature is validated

7. HIMSS Interoperability Showcase Clinical Workflow 1) Provider obtains a digital identity 3) Provider registers with a Payer 2) Provider registers with a Provider Directory 6) Provider digitally signs the completed documentation for PMD 5) Provider generates structured data using the eClinical template for a PMD 7) Provider submits digitally signed documentation for PMD to the Payer/Payer Agent 8) Digital signature is validated by the Payer/Payer Agent 4) Provider evaluates patient and determines need for PMD • General Scenario • A provider obtains a digital identity • A provider registers with a Provider Directory • A provider registers with a payer to receive eMDRs • A provider is treating a patient deemed in need of a power mobility device (PMD). • The provider generates structured data using the eClinical template for PMD • The provider uses the HL7 Digital Signature standard to sign and attest to the information within the documentation for the PMD. • The provider electronically sends all signed clinical, required, and supporting documentation to a payer/payer agent • The Payer/Payer Agent validates the provider’s digital signature

8. HIMSS 2014 • February 23 – 27, 2014 at the Orange County Convention Center in Orlando, FL • Who’s attending?

9. Discussion

10. Next Steps • Complete Pilot Proposal documentation and submit to Sweta • Engage the esMD Community