Vermont Health Information Technology Plan Workgroup

1. VERMONT INFORMATION TECHNOLOGY LEADERS Vermont Health Information Technology Plan Workgroup January 10, 2007

2. Agenda • Preliminary Plan Recap • Discuss Timeline for Final Plan • Next Steps: • Three ways of looking at the Plan: Stakeholders, Sections, Issues • Discuss options for organization of work • Review preliminary task list • Selected discussion topics: strategy/objectives; plan participation/feedback; education.

3. Preliminary Plan • Submitted January 1, 2007 • Development Process: • What went right? • What could be improved? • Presentations • Feedback

4. Timeline for Final Plan • Due: July 1, 2007 • Less than six months • Consider timeline for Preliminary Plan; need more time for: • Decision making • Outreach • Review and feedback

5. Next Steps • Discuss organization of work: at Workgroup level; subcommittee level; or create new groups to tackle Plan tasks? • Develop Final Plan development timeline. • Walk through a list of issues gleaned from the Preliminary Plan. • Start to build a list of tasks by topic.

6. 3 Ways of Looking at Plan: Stakeholders

7. 3 Ways of Looking at Plan: Sections • Executive Summary • Vision • Strategy/Objectives • Environment • Standards • Technology/Architecture • Privacy/Security/Data Ownership • Education • Funding • Governance/Accountability • Implementation • References

8. 3 Ways of Looking at Plan: Issues • Some issues fit nicely into Plan Sections; other issues are cross-cutting. • Either way, they represent questions that need to be answered by the Plan.

9. 3 Ways of Looking at Plan: Issues (cont.) Examples of issues associated with Plan sections: • What is the fully-developed Vision of the Plan? • How will we measure success? • What is the relationship between the Plan and the current HIT environment in Vermont and nationally? • What standards will the Plan establish/promote and how? • What technical architecture is proposed for the HIEN? • What are the requirements related to Privacy/Security in HIT/HIE and what steps should be taken to help meet those requirements?

10. 3 Ways of Looking at Plan: Issues (cont.) Examples of issues associated with Plan sections: • How will the Plan itself promote EHI, and what is the strategy for educating stakeholders on the related issues? • What funding and financing is recommended to help achieve the vision? • What governance structure will be established related to Plan recommendations, and to manage the evolution of the Plan itself? • What is the timeline for implementation of Plan recommendations?

11. 3 Ways of Looking at Plan: Issues (cont.) Examples of cross-cutting issues: • How does the Certificate of Need process fit into Plan recommendations? • How do HIT initiatives such as the Blueprint fit into the Plan? • How does the plan propose to increase the level of provider HIT adoption? • How will the plan spur and help guide institutional HIT investment? • What is the Role of VITL across the Plan recommendations? • What does Patient Centeredness mean in the EHI context?

12. 3 Ways of Looking at Plan • As we move beyond the Preliminary Plan, we have work to do across all three areas: Stakeholders, Issues, Sections. Over time, cross-cutting issues and stakeholders will need to be folded into the Sections.

13. Initial List of Tasks • Some initial tasks follow, organized under section, stakeholder, or cross-cutting topic. This is not a complete list but a way to get us thinking about how to organize our work and solicit volunteers:

14. Section: Executive Summary • Consider whether the Executive Summary will roll-up recommendations from Plan sections

15. Section: Vision • Develop Use Cases • Medication History • Chronic Care • ELR • EMR • Other domains? • Should touch on outcomes: quality of care improvement, greater efficiency, better control of costs, reduction in redundancy of services delivered to patients • Should touch on the eight stakeholders • Leverage the use cases to develop a more comprehensive description of the vision across the stated domains/outcomes.

16. Section: Strategy & Objectives • Develop Metrics/Benchmarks • Outcomes: “all with measurable observations if possible” • Consider the idea of seeking a single metric that can help measure the success of the Plan • Develop other metrics • Consider how “Strategy” relates to other sections of the Plan. Does it feed the other sections or is it derived from the other sections? Is it just a summary of recommendations from the other sections, a lead-in to those sections? Or should “strategy” be deferred to the individual sections and then detailed in “Implementation”? • Develop lists of Needs of and Interdependencies between Stakeholders • Document barriers (beyond just HIT adoption in practices; consider barriers to investment, stakeholder participation, etc.)

17. Cross-cutting Topics: HIT Adoption/Investment • Resume working on strategy • CON considerations

18. Section: Environment • Monitor ongoing initiatives • Monitor national pilot projects (NHIN prototypes) • Monitor AHIC workgroup progress • Monitor HITSP • Monitor CCHIT • Monitor RTI • Monitor state initiatives • Identify points in HCR 5-year plan that potentially overlap Plan issues • Consider potential for interfacing with other HIENs/RHIOs

19. Section: Standards • HL7: Develop a strategy for dealing with HL7 in the Plan. • PHIN and MITA: Strategy/overlap? • What other standards should be addressed in the Plan • ONC/HITSP Standards • Vocabulary Standards • Standards to support privacy and security • Proposals related to promoting/requiring standards adoption

20. Section: Technology/Architecture • Develop architecture: Consider HIE Component Architecture in Sec. 1.2, Blueprint Architecture Model 5b, current GE design, Technical Architecture Methodology • Select NHIN prototype or AHRQ project architectures for focus and comparison • Technology/Architecture to support privacy and security • Authentication and Authorization (user identities) • Map business needs to the architecture • OVHA • Blueprint • Other projects? • Other stakeholders? • Networking/Communications infrastructure?

21. Section: Privacy/Security/ Data Ownership • Read Preliminary Plan Section 4.3, 4.4.1, and Principles 1-6 (“I. … secure and private and accessed appropriately”) and RTI documents on project website. Establish scope and task list for this section.

22. Section: Education • Develop Education strategy (also see “Role of VITL”) • Establish scope and task list for this section. • Connection to Privacy and Patient Centeredness Issue • White paper strategy

23. Cross-cutting Issue: Role of VITL • As HIEN • As Educator • Related to HIT adoption/investment • Related to CON • Related to Plan Governance

24. Cross-cutting Issue: Patient Centeredness • Patient Centeredness: what does this mean in the HIT/HIE context? Consider Preliminary Plan section 4.4.1.

25. Section: Governance & Accountability • Plan participation and feedback • Increase Plan participation • Establish strategy

26. Section: Funding/Financing • Determine scope of this section and how it relates to funding recommendations in other sections. Should this section be addressed specifically to the legislature?

27. Section: Implementation & Roadmap • Too soon to tell exactly what this will look like, but don’t lose sight of this section.

28. Next Steps • Discuss organization of work: at Workgroup level; subcommittee level; or create new groups to tackle Plan tasks? • Develop Final Plan development timeline. • Walk through a list of issues gleaned from the Preliminary Plan. • Start to build a list of tasks by topic.

29. Don’t forget to visit the website! https://www.hln.com/clients/vitl