Request for Applications for CareAccord s Electronic Health Record (EHR) Direct Secure Messaging Integration Pilot

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1 Request for Applications for CareAccord s Electronic Health Record (EHR) Direct Secure Messaging Integration Pilot Key Applicant Dates: June 30: Request for Application Release Date July 7: Informational Webinar July 17: Pilot Applications Due July 22: Review of Applications July 24: Notification of Pilot Participants July 27-31: Agreements Signed between CareAccord and Participants August: Pilots begin CareAccord Contact: Christina Romeo and Jessi Wilson CareAccord Engagement Specialists Mail: 500 Summer Street, E-52 Salem, OR Phone:

2 I. Introduction A. Background CareAccord is administered by the Oregon Health Authority (OHA) and is a nationally accredited Health Information Service Provider (HISP), supporting the secure exchange of Direct secure messages. Direct secure messaging is used through a web-portal or a Direct-enabled Electronic Health Record (EHR), and is a HIPAAcompliant way to electronically exchange patient information between organizations and care teams for improved care coordination. Every organization that would like to send or receive Direct messages must have a HISP. HISPs enable the transport of Direct secure messages from one Direct user to another Direct user. CareAccord's goals are to 1) improve communication among Oregon s health care providers and organizations for better individual and family care coordination through electronic health information exchange (HIE), 2) improve access to HIE by providing support to providers facing barriers to implementing Direct secure messaging, and 3) improve interoperability through statewide Direct secure messaging. CareAccord currently offers HISP services via a web-portal, and manages Direct secure messaging addresses, digital certificates, encryption, message routing, and message delivery confirmation on behalf of organizations who need to be Direct enabled. Currently, CareAccord supports more than 120 organizations and 1,200 web-portal users. CareAccord users are interoperable with other users of Direct, including hospitals, providers, and health information exchanges (HIEs) like Jefferson HIE. In addition to providing Direct secure messaging services, CareAccord also manages a Flat File Directory, which is Oregon s combined address book for Direct secure messaging. This tool enables participants throughout Oregon to discover Direct addresses outside their own organizations. CareAccord is dedicated to providing solutions for health care organizations that face barriers to utilizing HISP services and enabling Direct secure messaging. CareAccord s web-portal Direct secure messaging facilitates care coordination but does not assist those trying to attest to Meaningful Use Stage 2. B. Pilot Overview CareAccord is seeking to pilot with five (5) to ten (10) health care organizations in the state of Oregon to enable trusted exchange of Direct secure messaging from within their 2014 certified EHR. EHRs that are Direct-enabled are interoperable across organizational and geographical boundaries, improving care coordination among care teams and helping simplify workflows (reduce paper processes, integrate messaging). Many Oregon providers need to use Direct secure messaging from their EHR to electronically send patient care summaries for transitions of care, a requirement for one of the Meaningful Use (MU) Stage 2 measures. This pilot will expand CareAccord s Direct secure messaging services (beyond web-portal) and afford participants the opportunity to begin health information exchange with other users of Direct secure messaging. For all pilot participants, this pilot will provide a means to turn on the Direct secure messaging functionality from their EHR and begin the electronic exchange of patient information with other Direct users. In addition to supporting care coordination in Oregon, CareAccord hopes to enable pilot participants to meet Meaningful Use Stage 2 requirements for transitions of care, to better understand the impact of EHR integration and use of Direct secure messaging on participants, and to obtain the necessary level of effort (cost, time, and resources) for EHR integrations. During the pilot, CareAccord will provide the following for participants: HISP services necessary for becoming Direct-enabled from a 2014-certified EHR Connectivity for Direct secure messaging Direct addresses Digital organizational certificates Access to the Flat File Directory for monthly upload into the each participant's EHR The pilot will begin summer 2015, and conclude September 30, 2016

3 C. Cost For the purposes of this pilot, CareAccord will provide HISP services to the applicant at no cost. Applicants must provide resources for costs incurred on their side, such as any integration costs to their own vendor. State Innovation Models (SIM) funding has only been provided for CareAccord s vendor (Harris and Mirth) costs. D. Limited Duration for Pilot Activities CareAccord HISP services for Direct secure messaging will be offered at no cost until the end of the SIM grant, September 30, 2016; at this time, pilot participants may be given the opportunity to continue with CareAccord. Pilot participants will receive notice 120 days prior to the conclusion of the pilot regarding what fees if any may be incurred if participants choose to remain with CareAccord as their HISP. II. Who May Apply A. Minimum Eligibility Criteria In order to be considered for this pilot opportunity, your organization must meet all of the following general requirements: Fully implemented 2014-certified EHR An Oregon-based organization Does not currently have a HISP service integrated into your EHR facilitating Direct secure messaging 1 Flexibility to begin pilot in 2015 *Please note: Participants must also be able to sign participation agreements (Identity Verification Form, User Agreement and Service Level Agreement) and follow CareAccord program requirements: (see https://www.careaccord.org/getting-started/overview.shtml) B. Potential Provider Types CareAccord's pilot opportunity is not limited solely to organizations that are seeking to attest to Meaningful Use. CareAccord would like to integrate their EHR/HISP services across a broad sample of health care organizations. Potential pilot provider types include: Behavioral and mental health services Primary care and medical specialists Ambulatory care providers Hospitals: Rural and critical access Other: Dentists, long-term care facilities, substance abuse services, IPAs hosting member EHRs, etc. 1 CareAccord anticipates making HISP/EHR integration services available for a fee later in 2016.

4 III. Other Pilot Details A. Selection Criteria Applicants must meet the minimum eligibility requirements (see "Who May Apply" A. Minimum Eligibility Requirements) to apply for pilot participation. The following criteria will be used to evaluate applications: 1. Need for Direct secure messaging Clearly communicate the level of need for Direct secure messaging. How does implementing Direct assist in meeting specific organizational goals? 2. Readiness/Capacity to begin implementing pilot Is staffing, technology and EHR vendor in place to implement and support pilot activities? If not, what is the timeline to have each of those items in place? Some activities to be considered when thinking about implementing Direct secure messaging: Work with CareAccord to identify technical steps with timelines for the integration Work with CareAccord staff to create Direct address assignment if the organization EHR does not assign the Direct addresses Work with CareAccord to implement and test Direct secure messaging from the participant s EHR Ongoing support of Direct secure messaging for internal staff Provision of an initial summary capturing level of effort, work flow changes, resources, cost, time, and lessons learned to CareAccord 60 days after Direct is operational 3. Anticipated use case(s) for Direct secure messaging Does the organization have identified use cases for electronically exchanging health information and improving care coordination? With whom will health information be exchanged? What types of health information will be exchanged (summaries of care, labs, referrals, etc.)? How will Direct secure messaging be used to bring value to the organization? 4. Barriers - What barrier(s) does the organization face in implementing a HISP and enabling Direct secure messaging services from an EHR? Barriers may include, but are not limited to: a. Financial - Barriers to implementing a commercial HISP to enable Direct secure messaging functionality from organization's 2014 certified EHR technology b. Technological Lack of internal resources (IT support staff) to deploy and support necessary technology; or, limited availability of technology in a service area c. Geographical - Differences in infrastructure and HIE needs between regions. Access to care may be limited and available only through provision of telemedicine. CareAccord will make a final determination on pilot participants using application evaluations and taking into consideration CareAccord s intent to pilot across Oregon s geographical landscape and with a diverse sample of EHR vendor types. B. Additional Applicant Requirements Pilot participants will be requested to host an EHR demonstration for OHA staff. The information will be used to better understand the varying types of EHRs and their capabilities. At the pilot conclusion, some organizations may be asked to participate in a presentation of lessons learned to OHA.

5 IV. Application Instructions A. Informational Webinar Applicants have the opportunity to sit in on an informational webinar about the pilot prior to application. The webinar will be offered Tuesday, July 7 th at 10:00 am. Questions are encouraged to be submitted by prior to the webinar: The following link will take you to the webinar registration page: https://attendee.gotowebinar.com/register/ B. Review and Award Process Applications received by OHA will rated by a panel using the eligibility criteria specified in III. A. Those applicants selected to participate in the pilot will be informed by July 24, At that time, pilot anticipated start dates and participation agreement documents will be provided. C. How to File If your organization meets the minimum eligibility requirements, and has interest in participating in this pilot program, please complete the following application and submit by 5:00 PM July 17, 2015 to the following: *Applications received after this time may not be considered. The review period for the applications will be brief. Applicants will receive a response from the selection committee by Friday, July 24, Disclaimer: OHA reserves the right to not select applicants or to issue a second call for submissions. For questions regarding the pilot program or application process, please contact CareAccord: Phone:

6 Pilot Candidate Application for CareAccord HISP Services Point of Contact Information Name Phone Title Organization Information Name of Organization Street Address City State Zip Phone Number Organization Category 1. Ambulatory Care 2. Behavioral/Mental Health 3. Health System 4. Hospital 5. Dentist 6. Other: Are you a Medicaid Provider? 1. Yes 2. No 3. Not sure EHR System in Place 1. Epic 2. NextGen 3. Greenway 4. Athenahealth 5. GE Healthcare 6. Allscripts 7. eclinicalworks 8. McKesson 9. Other: EHR Version in Place: Attestation Stage for Meaningful Use 1. Stage 1 2. Stage 2 3. Not sure Does your 2014 Certified EHR assign Direct addresses? 1. Yes 2. No 3. Not sure If yes, are there restrictions as to who can have Direct addresses assigned? 1. Yes 2. No 3. Not sure Anticipated number of Direct secure messaging users:

7 Applicant Responses My Organization Meets the Pilot s Minimum Eligibility Requirements (all apply) We are a health care organization that operates only within Oregon We have a fully implemented 2014 Certified EHR technology with Direct secure messaging capability We do not currently have HISP services integrated into our EHR facilitating Direct secure messaging We have flexibility to begin piloting as early as August 2015 to as late as December 2015 For questions regarding eligibility, please contact CareAccord at Instructions Use the spaces below to respond to each question. Your responses are limited to 8,000 characters per question (about two pages). Describe your organization's need(s) for Direct secure messaging. Describe how Direct secure messaging addresses your organization's goals (Meaningful Use attestations, simplification of workflow, cost savings, etc.): Describe your organization's readiness to begin implementing the pilot (staff, technical, and EHR vendor capacity). Refer to the Selection Criteria section for other readiness considerations:

8 Describe how your organization would like to use Direct secure messaging to improve care coordination (to whom would you be sending messages, whom would you be receiving messages from, for what uses, types of information sent, etc.): Describe any and all barriers your organization faces in implementing a HISP to enable Direct secure messaging (financial, technological, geographical): Thank you for taking the time to complete this application. Your responses will be evaluated carefully, and you will soon be notified of our decision. Sincerely, CareAccord Team CareAccord Use Only Date Application Received CareAccord Signature

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