HEALTH INFORMATION EXCHANGE GRANTS CRITERIA

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1 1 HEALTH INFORMATION EXCHANGE GRANTS CRITERIA INTRODUCTION On August, 20 th, the federal Office f the Natinal Crdinatr fr Health Infrmatin Technlgy (ONC) released an pprtunity fr states t apply fr between $4 millin and $40 millin in funds fr planning and implementatin f health infrmatin exchange deplyment. The State f New Jersey intends t accelerate the develpment f health infrmatin exchange (HIE) using these funds available frm the American Recvery and Reinvestment Act f The State will be submitting an applicatin fr a statewide grant t the Office f the Natinal Crdinatr fr Health Infrmatin Technlgy that will reflect the current state-f-the-art in New Jersey and pririties set frth by the state s Health Infrmatin Technlgy Cmmissin and Office f e-hit. As such, the applicatin will include prjects frm arund the State that hld the prmise f establishing a mre effective, efficient, sustainable, and interperable exchange f clinically useful data acrss health-care prvider rganizatins, cities, and regins. This RFA slicits prjects t be incrprated int the State s applicatin. First and fremst, all prjects submitted by the State t the ONC must plan advancements in the exchange f clinical health infrmatin that imprve the quality and timely delivery f care. The State s applicatin will strive t establish a series f reginal health-infrmatin exchanges that will be integrated int a State-established, secure Master Patient Index that can be queried fr patient-specific health infrmatin. Ultimately, the State must, pursuant t the New Jersey Health Infrmatin Technlgy Act f 2007, create a private and secure, statewide, self-supprting interperable netwrk that will becme part f the Natinal Health Infrmatin Netwrk (NHIN). Thus, the State is seeking applicatins that will fulfill these statutry bligatins, will cmply with the criteria belw, and will prvide a plan fr sustainable healthinfrmatin exchange centered arund interperable health-infrmatin systems and imprved care crdinatin. Applicatins that simply seek t digitize health recrds currently n paper are nt eligible fr cnsideratin; nly thse prpsals that dcument

2 2 plans t leverage and elevate electrnic capabilities t increase care crdinatin acrss settings will be cnsidered. Selectin f prjects fr pssible funding will be determined thrugh the fllwing scring prcess and based n thrugh cmpletin f the Grant Applicatin. Actual funding levels fr selected prjects will depend n the funding that the State f New Jersey ultimately receives frm the Office f the Natinal Crdinatr fr Health Infrmatin Technlgy, which will be annunced n r abut Dec. 15, The State s applicatin will be fficially submitted n r befre Oct. 16, 2009 by the New Jersey Health Care Facilities and Financing Authrity, t which financial reprts will be due frm the awarded sub-grantees. Prject scring and selectin will be made by a Multi-Departmental Review Panel with each reviewer scring each applicatin independently. The Review Panel will be cmpsed f representatives f the Department f Health and Senir Services, the Department f Banking and Insurance, the Department f Human Services, the Department f Children and Families, and the Office f Infrmatin Technlgy. SCORING T determine which prjects will be a part f the State s applicatin t the Office f the Natinal Crdinatr, a scring system will be applied as fllws: The mandatry criteria carry a maximum f 75 pints. The ptinal elements carry a maximum f 25 pints. A thrugh plan fr the inclusin f any ne f the data elements listed in the ptinal criteria will add 9 pints t an applicatin s scre. A thrugh plan fr the inclusin f a secnd, third, furth, r fifth data element will each add 4 pints, fr a ttal f 25 pssible pints frm just the data elements. The ttal maximum pints a prject can receive is 100. Any prject with a ttal scre abve 80 will be deemed eligible fr funding and included in the applicatin t the Office f the Natinal Crdinatr.

3 3 Example: Any prject applicatin that cmpletely and thrughly fulfils nly the mandatry criteria will achieve a maximum scre f 75. Any prject applicatin that cmpletely and thrughly fulfils the mandatry criteria and prpses t exchange just ne f the data elements in the ptinal criteria will achieve a maximum scre f 84. Any prject applicatin that cmpletely and thrughly fulfils the mandatry criteria and prpses exchanges in all f the data elements in the ptinal criteria will achieve a maximum scre f 100. Describe the Prpsed Prject in a Prject Plan by Addressing the Fllwing Mandatry and, if applicable, Optinal Criteria. The Mandatry criteria reflect the Requirements Set Frth fr States by the Office f the Natinal Crdinatr fr Health Infrmatin Technlgy: OPTIONAL CRITERIA 25 pssible pints The fllwing data elements reflect the State s fcus amng ptential data elements t be included in a Health Infrmatin Exchange, as priritized by the New Jersey Health Infrmatin Technlgy Cmmissin: 1. Participatin in a Statewide Master Patient Index/Recrd Lcatr Service: New Jersey plans t implement an Enterprise MPI/RLS based upn an pen architecture. T fulfill this criterin, applicants must make electrnic recrds available t the statewide EMPI/RLS. Applicants shuld describe their plans t either: A. Purchase their wn reginal Master Patient Index and ultimately link it t the Statewide EMPI, r, B. Utilize the Statewide EMPI as the indexing resurce fr their reginal HIE plan;

4 4 2. Exchange f labratry results (including decisin supprt); 3. Supprt f transfers between settings thrugh exchange f basic discharge/transfer data, including demgraphics, allergies, advance directives, prblem lists, discharge summaries, and/r test results; 4. Exchange f radilgy images and ther clinical images, with related clinical ntes; r 5. Exchange f prescriptin drug data and develpment f cmprehensive medicatin histries. MANDATORY CRITERIA 75 pssible pints Intrductin 5 pssible pints A clearly stated missin f the prpsed prject stating the targeted ppulatin, the intended imprvement f health utcmes amng that ppulatin, and the incrpratin f rbust utilizatin f health infrmatin exchange in creating thse utcmes. Gvernance 14 pssible pints Cllabrative Gvernance Mdel The Prject Plan must describe a multi-disciplinary, multi-stakehlder gvernance entity including a descriptin f the membership, decisin-making authrity, and gvernance mdel. Applicants are encuraged t cnsider hw their gvernance mdels will align with emerging statewide and natinwide HIE gvernance. Prject Crdinatr The Prject Plan shall identify an HIE Crdinatr. The plan shall als describe hw the crdinatr will interact with the federally funded state health prgrams and als the HIE activities within the rest f the state. Accuntability and Transparency T ensure that the public benefits f HIE funding and prjects are fr authrized purpses and advance the stated gals, the Prject Plan shall address hw the prject is ging t address HIE accuntability and transparency. Onging Gvernance The Prject Plan must describe the nging develpment f the gvernance and plicy structures during the initial and lng-term implementatin phases. The nging gvernance descriptin shall include a plan fr demnstrating prgress in all aspects f implementing the prpsed prject thus far, if applicable; a mechanism that

5 5 includes structured gvernance and widespread stakehlder decisinmaking fr effecting nging changes t bth the technlgy and clinical gal-setting cmpnents f the prpsed prject as it evlves; and a precise timeline f the steps t achieve full implementatin f the prpsed prject. Finance 14 pssible pints Cst Estimates and Staffing Plans The Prject Plan must prvide a summary cst estimate fr the implementatin f the prject fr the time perid cvered by the Plan. In the Applicatin fr Grant Funds, applicants must include additinal detail abut the budget and csts, including a wrkplan describing the tasks and sub-tasks that need t be cmpleted in rder t enable HIE, alng with resurces, dependencies, and specific timeframes. Applicants shall prvide a staffing plan including prject managers and ther key rles required t ensure the prject s success. The implementatin descriptin shall specify prpsed reslutin and mitigatin methds fr identified issues and risks within the verall prject. Cntrls and Reprting The Prject Plan must describe activities t implement financial plicies, prcedures and cntrls t maintain cmpliance with generally accepted accunting principles (GAAP) and all relevant federal and State audit requirements. That descriptin must include a Tax ID Number fr the rganizatin in the exchange acting as lead financial agent, and the financial management and accunting capabilities and cntrls f that rganizatin and/r thers in the exchange. The rganizatin will serve as a single pint f cntact t submit prgress and spending reprts peridically t the New Jersey Health Care Facilities Financing Authrity, which will be the State s applicant and fiscal agent t cmpile and submit reprts t ONC. Sustainability Sustainability has been a majr challenge fr Reginal HIE natinwide. Applicants are therefre required t submit a detailed and viable plan fr financial and peratinal sustainability bth during the grant perid and beynd the life f the grant, t include a revenue surce r surces fr future annual csts fr hardware, sftware, licenses, and staff supprt. The State understands that nt all exchange prjects will be fully self-sustaining beynd the life f the grants frm ONC. Scring will be based n sustainability plans that maximize resurces and minimize csts s as t apprach breakeven status after the terminatin f the ONC grants. Technical Infrastructure 14 pssible pints

6 6 Standards and Certificatins The Prject Plan shall describe effrts t becme cnsistent with HHS adpted interperability standards and any certificatin requirements, fr prjects that are just starting; demnstrated cmpliance, r plans tward becming cnsistent with HHS adpted interperability standards and certificatins if applicable, fr thse prjects that are already implemented r under implementatin. In particular, the State f New Jersey wuld give preference t a strng explanatin f the prject s ability t match patients t their electrnic medical data based n a prbabilistic match f persnal data that reaches the highest reasnable level f certainty in accrdance with natinal standards. Technical Architecture The Prject Plan must describe hw the technical architecture will accmmdate the requirements t ensure widespread availability f HIE amng healthcare prviders, public health and thse ffering service fr patient engagement and data access. The technical architecture must include plans fr the prtectin f health data. This needs t reflect the business and clinical requirements determined via a multi-stakehlder planning prcess. If a prject plans t exchange infrmatin with federal health care prviders including but nt limited t Veterans Administratin, Department f Defense, Indian Health Services, their plans must specify hw the architecture will align with NHIN cre services and specificatins. Technlgy Deplyment The Prject Plan must describe the technical slutins that will be used t develp HIE capacity within the regin and particularly the slutins that will enable meaningful use criteria established by the Secretary f the U.S. Department f Health and Human Services fr 2011, and indicate effrts fr statewide and natinwide health infrmatin exchange. (Fr up-t-date publicly available infrmatin n meaningful use, see: Business and Technical peratins 14 pssible pints Current HIE Capacities The Prject Plan must describe hw the prject will leverage current HIE capacities, if applicable, such as current peratinal health infrmatin rganizatins (HIOs), including thse prviding services t areas in multiple regins. Reginal Shared Services and Repsitries The Prject Plan must address whether the applicant will leverage reginal- and state-level shared services and repsitries including, but nt limited t, hw HIOs and ther data exchange mechanisms can leverage existing services and data repsitries, bth public r private. Shared services t cnsider include (but are nt limited t): Medicaid data, public-health databases

7 7 and registries, Security Service, Patient Lcatr Service, Data/Dcument Lcatr Service, Terminlgy Service, and ptential future Reginal Extensin Centers. These technical services may be develped ver time and accrding t standards and certificatin criteria adpted by HHS in effrt t develp capacity fr natinwide HIE. Standard perating prcedures fr HIE (encuraged but nt required) The Prject Plan shuld include an explanatin f hw standard perating prcedures and prcesses and/r best practices fr HIE services will be develped and implemented. Legal/plicy 14 pssible pints Establish Requirements The Prject Plan shall describe hw the health infrmatin exchange will cmply with all applicable federal and State legal and plicy requirements related t health infrmatin exchange and cmpliance plans. This plan needs t include develping, evlving, and implementing the plicy requirements t enable apprpriate and secure health infrmatin exchange thrugh mechanisms f exchange cnsistent with cmpliance with HIPAA; New Jersey State law gverning privacy and security regulatins; the New Jersey Health Infrmatin Privacy and Security requirements; Identity Theft Law; and including a plan fr additinal patient cnsent, if applicable. The Operatinal Plan shuld specify the interdependence with the gvernance and versight mechanisms t ensure cmpliance with these plicies. Privacy and Security Harmnizatin The Operatinal Plan must describe plans fr privacy and security harmnizatin and cmpliance acrss rganizatins. State and Federal Requirements T the extent that states anticipate exchanging health infrmatin with federal care delivery rganizatins, such as the VA, DD, IHS, etc., r with state-perated facilities, such as psychiatric hspitals r behaviral-health centers, the Prject Plan must cnsider the varius federal and State requirements fr the utilizatin and prtectin f health data will be accmplished.

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