HIE Ready - A New Alternative to Meaningful Use?
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1 An Initiative of California Health equality (CHeQ) FREQUENTLY ASKED QUESTIONS 1. What is HIE Ready? 2. Why is HIE Ready needed? 3. Do all EHRs have HIE Ready capabilities? If so, why aren t they in use? 4. Why is the Buyers Guide needed? 5. Why would there be an extra cost if HIE Ready capabilities already exist? 6. Is HIE Ready downloadable software? 7. What are the advantages of using an EHR with the features promoted by HIE Ready? 8. Is HIE Ready a replacement for Meaningful Use or EHR certification? 9. I ve heard about the EHR HIE Interoperability Workgroup. Is HIE Ready a replacement? 10. Can t healthcare providers and organizations already exchange health information between any certified EHRs? 11. Won t the Direct Project solve this problem? 12. Are the Regional Extension Centers (RECs) in California participating in HIE Ready? 13. Is participation in HIE Ready available outside of California? 14. What does it cost to participate in HIE Ready? 15. If I represent a vendor, how do I get involved? 16. If I represent an HIO/HIE, how do I get involved? 17. How were HIE Ready standards developed? 18. How are the HIE Ready capabilities assessed? 19. How are the HIE Ready relative costs computed? 20. What does it mean if the capability and/or price scoring for a product changes? June 11, 2013 HIE Ready Frequently Asked Questions Page 1 of 5
2 1. What is HIE Ready? HIE Ready is a set of consensus standards and specifications that are available in many Electronic Health Records (EHRs) and Health Information Exchange (HIE) systems today that enable them to exchange health information critical for care delivery. HIE Ready is consistent with Stage 1 Meaningful Use and the current version of the Office of the National Coordinator for Health Information Technology Authorized Testing and Certification Bodies (ONC-ATCB) for EHR technology. Moving forward it also will be consistent with Stage 2 Meaningful Use and 2014 ONC-ATCB certification criteria. 2. Why is HIE Ready needed? The cost and time it takes to implement bi-directional interfaces with EHRs is a major hurdle for healthcare providers. Meaningful Use provisions for Stage 1 and Stage 2 require various HIE capabilities. However, those requirements are limited and do not cover the full range of interoperability and interface features needed for robust HIE. Therefore, specifying a certified EHR is not enough to ensure it can also exchange the information needed. HIE Ready provides a way for healthcare providers to examine what capabilities a vendor s product has, what capabilities a Health Information Organization (HIO) offers, and/or permits healthcare providers to specify that they want full interoperability with their EHR. 3. Do all EHRs have HIE Ready capabilities? If so, why aren t they in use? While most EHR systems may include the capacity to share the information specified in HIE Ready, it may be available through a complex list of optional components. HIE Ready gives healthcare providers a clear way to specify the EHR features needed for health information exchange. It also helps healthcare providers know how much interoperability will cost. 4. Why is the Buyers Guide needed? The Buyers Guide helps healthcare providers choose an ambulatory EHR, inpatient EHR, HIO service, or HIE supplier best-suited to their practice environment. The Buyers' Guide also provides information to accurately compare essential interoperability features among the EHR vendors participating in HIE Ready. 5. Why would there be an extra cost if HIE Ready capabilities already exist? Some EHRs include HIE capacities as a standard part of their products. Some EHR vendors, however, include interoperability as an option. HIE Ready specifies what full HIE capabilities are, but it does not require that a vendor include them in their product for free. June 11, 2013 HIE Ready Frequently Asked Questions Page 2 of 5
3 6. Is HIE Ready downloadable software? No, HIE Ready describes a set of interfaces, based on HL7 standards, that should be active in an EHR system to enable essential HIE capability today. Participants in HIE Ready identify which elements among those CHeQ has specified are currently included in their EHR product and the cost of those elements to their customers. 7. What are the advantages of using an EHR with the features promoted by HIE Ready? HIE Ready provides a set of uniform requirements for interoperability. It reduces variation of interface requirements, reduces the time required to deliver customized interfaces, and reduces the cost of those interfaces. 8. Is HIE Ready a replacement for Meaningful Use or EHR certification? No. HIE Ready is consistent with Stage 1 and Stage 2 Meaningful Use provisions, and certification criteria for the ONC-ACTB certification program. However, it specifies additional important standards and capabilities that are not spelled out in Meaningful Use or EHR certification. 9. I ve heard about the EHR HIE Interoperability Workgroup. Is HIE Ready a replacement? No. The EHR HIE Interoperability Workgroup is a collaboration of states and vendors specifying the next generation of health information exchange standards. This is important work, but won t be available in products for some time. HIE Ready concentrates on current standards and on what vendors are offering today. 10. Can t healthcare providers and organizations already exchange health information between any certified EHRs? Not necessarily. Having a certified EHR does not necessarily lead to true HIE. A certified EHR may be able to share some important health information only by faxed or scanned documents. Other certified EHRs offer a large menu of electronic exchange options. HIE Ready provides clear information on the interoperability and interface features that should be in place to facilitate HIE today and are available in vendor products listed. It also gives healthcare providers a simple way to ask for the interfaces they need by specifying HIE Ready. June 11, 2013 HIE Ready Frequently Asked Questions Page 3 of 5
4 11. Won t the Direct Project solve this problem? The Federal government s Direct Project offers healthcare providers a way to quickly connect, and enables them to send and receive point-to-point health information, regardless of whether they have an EHR. While useful and a critical part of ONC s HIE initiative, the Direct Project is limited to pushing information out, but does not actually establish HIE beyond transferring documents via secure Are the Regional Extension Centers (RECs) in California participating in HIE Ready? Yes. HIE Ready was developed in collaboration with CalHIPSO, which shares the HIE Ready goals and specifications with its preferred vendors and asks them to participate. We are moving forward with California s other RECs, HITEC-LA, etc., as well. 13. Is participation in HIE Ready available outside of California? Yes. Contact us at cheq@ucdmc.ucdavis.edu, with a subject of HIE Ready, and we will be in touch! 14. What does it cost to participate in HIE Ready? HIE Ready is a volunteer program. It does not cost anything to join. 15. If I represent a vendor, how do I get involved? Contact us at cheq@ucdmc.ucdavis.edu, with a subject of HIE Ready, and we will be in touch! 16. If I represent an HIO/HIE, how do I get involved? Contact us at cheq@ucdmc.ucdavis.edu, with a subject of HIE Ready, and we will be in touch! 17. How were HIE Ready standards developed? The Centers for Medicare and Medicaid Services defined Meaningful Use and ONC defined the certification program for EHR technology through rulemaking. The HIE Ready specifications represent an analysis of the technical requirements derived from Stage 1 and Stage 2 Meaningful Use, in line with ONC-ATCB certification requirements, and experience with the capabilities of current certified EHR systems. CHeQ took input from HIE leaders in California, members of the REC programs, and EHR and HIE vendors in creating the HIE Ready standards. June 11, 2013 HIE Ready Frequently Asked Questions Page 4 of 5
5 18. How are the HIE Ready capabilities assessed? Each vendor or organization participating in HIE Ready fills out a matrix listing which of more than 50 interoperability capabilities its product(s) supports. These capabilities are grouped and categorized into the capability categories found in the Buyers Guide. A score for a category is calculated by computing the percentage of supported capabilities in each group, averaging the percentages for all groups in a category, and scaling the result from zero to four bullets. For example, there is one group of five inbound capabilities and one group of five outbound capabilities for the ADT/Demographics category for ambulatory EHRs: If a product supports three of the inbound and four of the outbound capabilities, its score would be the average of 60% and 80%, which is 70% = three bullets. 19. How are the HIE Ready relative costs computed? Each vendor or organization participating in HIE Ready lists the price for the HIE Ready capabilities they support. Some vendors include HIE Ready as part of the base cost of their offering, and their cost is $0. However, HIE Ready carries some additional cost for many products. For these vendors, the number of dollar signs is calculated by taking the mean price for all vendors as a score of 2.5, and subtracting one for each standard deviation below the mean, or adding one for each standard deviation above the mean, and rounding to the nearest whole value. A small number of vendors decline to set a specific price for HIE Ready, and their relative price is listed as NP (not provided). 20. What does it mean if the capability and/or price scoring for a product changes? The HIE Ready Buyers Guide is updated each time a new vendor or organization joins HIE Ready, or each time a vendor or organization updates their product capabilities. If a capability score changes, it means a vendor s product has changed. If a relative price score changes, it may mean that the vendor has changed its pricing or that new vendors have been added to the Buyers Guide changing the mean cost, which potentially changes each vendor s score June 11, 2013 HIE Ready Frequently Asked Questions Page 5 of 5
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