The Road to Interoperability: DoD, VA and Private Sector Data Sharing

Transcription

1 Dr. Lauren Thmpsn, Directr DD/VA IPO 2015 Defense Health Infrmatin Technlgy Sympsium The Rad t Interperability: DD, VA and Private Sectr Data Sharing 1

2 DHA Visin A jint, integrated, premier system f health, supprting thse wh serve in the defense f ur cuntry. 2

3 IPO Missin The missin f the DD/VA Interagency Prgram Office (IPO) is t lead and crdinate the tw Departments adptin f and cntributin t natinal health data standards t ensure seamless integratin f health data between DD, VA and private health care prviders. 3

4 Learning Objectives Prvide a high level verview f the natinal health IT landscape Highlight the imprtance f cntinued engagement with Office f the Natinal Crdinatr (ONC) and ther rganizatins Discuss the prgram's respnsibilities and recent accmplishments Summarize the prgram s FY15/FY16 prgram bjectives 4

5 Agenda DD/VA IPO General Overview Natinwide Health Infrmatin Exchange Natinwide Adptin f EHRs and Health Infrmatin Exchange ONC Interperability Radmap The Learning Health System Federal Health IT Strategic Plan Interperability Challenges and Effrts t Imprve Standards Guidance and DD/VA IPO Activities DD/VA IPO FY15 Accmplishments Future Pririties 5

6 DD/VA IPO The DD/VA Interagency Prgram Office (DD/VA IPO) leads and crdinates the tw Departments adptin f, and cntributin t, natinal health data standards, ensuring seamless integratin f health data amng DD, VA, and private health care prviders. DD 1,230+ Care Lcatins 9.5M Eligible Beneficiaries VA 1,400+ Care Lcatins 22M+ Eligible Beneficiaries DD/VA IPO 6

7 DD and VA Landscape Prviding high quality healthcare fr current Service members, their families, and ur Veterans is amng ur natin s highest pririties. Health infrmatin exchange between EHR systems in the DD, VA, and the private sectr serves as the fundatin fr a patient-centric healthcare experience, seamless care transitins, and imprved healthcare delivery. Department f Defense 1,230+ Care Lcatins Including care lcatins n ships and submarines 9.5M Eligible Beneficiaries DD primarily cares fr the yunger, active duty ppulatin and their families 60% Private Sectr Care A majrity f the DD ppulatin receives sme r all f their care in the private sectr 70+ Electrnic Healthcare Systems As EHR functinality evlved DD incrprated new systems int the prtfli t meet functinal requirements Department f Veterans Affairs 1,400+ Care Lcatins Including care lcatins in each state 22M Eligible Beneficiaries, 9M Enrllees VA primarily cares fr a ppulatin that has lng term medical claims 60% Private Sectr Care A significant percentage f the Veteran ppulatin receives sme r all f their care in the private sectr 1 Electrnic Healthcare System with 100+ Mdules As EHR functinality evlved VA incrprated new mdules int VistA t meet functinal requirements 7

8 Natinwide Adptin f EHRs and Health Infrmatin Exchange State adptin rates have increased frm 2008 t Figure 2: State percent f nn-federal acute care hspitals with adptin f at least a Basic EHR system cmpared with prir years. Three-quarters f hspitals electrnically exchanged health infrmatin with utside prviders in Since 2010, mst states experienced grwth in electrnic health infrmatin exchange amng hspitals and utside prviders. Hspital t hspital electrnic health infrmatin exchange increased by 55% between 2013 and Clinical care summary exchange amng hspitals and utside prviders increased in 49 states and in the District f Clumbia between 2010 and

9 Natinwide Health Infrmatin Exchange Electrnic health infrmatin exchange allws health care prviders and patients t access and securely share a patient s medical infrmatin electrnically Currently there are three key methds f exchanging data electrnically: Directed Exchange: Ability t send and receive secure infrmatin electrnically between care prviders t supprt crdinated care Query-based Exchange: Ability fr prviders t find and/r request infrmatin n a patient frm ther prviders, ften used fr unplanned care Cnsumer Mediated Exchange: Ability fr patients t aggregate and cntrl the use f their health infrmatin amng prviders Blue Buttn Initiative: Allws individuals t dwnlad their health recrds nline With rigins in the VA, the Blue Buttn initiative quickly expanded beynd the public sectr. Encmpasses mre than 650 public and private rganizatins and has increased cnsumers access t their health infrmatin frm a variety f surces, including prviders, health plans, labratries, and pharmacies. 9

10 ONC Interperability Radmap In late 2014, ONC released its 10-year radmap t interperability fr public cmment. ONC accepted public cmments and key cmmitments n the draft Radmap fr apprximately 60 days which ended n April 3, The ONC Interperability Radmap fcuses n actins that will enable a majrity f individuals and prviders t send, receive, find and use pririty data elements at the natinwide level by the end f The draft Radmap prpses critical actins that need t be taken by bth private and public stakehlders t advance the natin twards a mre cnnected, interperable health IT infrastructure. 10

11 DRAFT Shared Natinwide Interperability Radmap 3 Year Agenda ( ) 6 Year Agenda ( ) 10 Year Agenda ( ) Send, receive, find and use a cmmn clinical data set t imprve health and health care quality Expand Interperable health IT and users t imprve health and lwer cst Achieve a natinwide learning health system 11 11

12 ONC Principles f Interperability DD and VA are cmmitted t applying the ONC's interperability principles within their effrts t achieve interperability with each ther and the private sectr. 12

13 ONC s Tp Areas f Interest Interperability Radmap: Outlines the way t make electrnic health infrmatin available when and where it matters mst. ONC is als releasing an pen draft f the 2015 Interperability Standards Advisry, utlining a list f best available standards and implementatin specificatins. Infrmatin Blcking: Occurs when entities knwingly interfere with the exchange r use f electrnic health infrmatin. ONC s April 2015 reprt t Cngress detailed their findings n the extent and nature f health infrmatin blcking and prvided criteria fr differentiating blcking frm ther interperability barriers. It als described steps fr the federal gvernment t take t deter this cnduct. Delivery System Refrm: The HITECH Affrdable Care Act has increased industry cmmitment t finding better ways t deliver care, pay prviders, and share and utilize infrmatin. Electrnic health recrds likely will help speed the adptin f many ther delivery system refrms, by making it easier fr hspitals and dctrs t better crdinate care and achieve quality imprvements. 13

14 ONC s Tp Areas f Interest (Cnt d) MACRA Implementatin: On July 8, 2015, the Centers fr Medicare & Medicaid Services (CMS) issued a prpsed rule that updates payment plicies, payment rates, and quality prvisins fr services furnished under the Medicare Physician Fee Schedule (PFS) n r after January 1, This is the first PFS prpsed rule since the Medicare Access and CHIP Reauthrizatin Act f 2015 (MACRA) repealed the Sustainable Grwth Rate (SGR) frmula. Precisin Medicine: An emerging apprach fr disease treatment and preventin that takes int accunt individual variability in genes, envirnment, and lifestyle. Despite significant advances, the practice is nt currently in use fr mst diseases. Precisin Medicine Initiative (PMI): New enterprise unveiled by President Obama t revlutinize medicine and generate the scientific evidence needed t mve precisin medicine int every day clinical practice. 14

15 The Learning Health System 15

16 Federal Health IT Strategic Plan Gal 1: Advance Persn-Centered Health and Self-Management Gal 2: Transfrm Health Care Delivery and Cmmunity Health Objective A: Empwer individual, family, and caregiver health management and engagement Objective B: Fster individual, prvider, and cmmunity partnerships Objective A: Imprve health care quality, access, and experience thrugh safe, timely, effective, efficient, equitable, and persn-centered care Objective B: Supprt the delivery f high-value health care Objective C: Prtect and prmte public health and healthy, resilient cmmunities Gal 3: Fster Research, Scientific Knwledge, and Innvatin Objective A: Increase access t and usability f high-quality electrnic health infrmatin and services Objective B: Accelerate the develpment and cmmercializatin f innvative technlgies and slutins Objective C: Invest, disseminate, and translate research n hw health IT can imprve health and care delivery Gal 4: Enhance Natin s Health IT Infrastructure Objective A: Finalize and implement the Natinwide Interperability Radmap Objective B: Prtect the privacy and security f health and sensitive infrmatin Objective C: Identify, priritize, and advance technical standards t supprt secure and interperable health infrmatin Objective D: Increase user and market cnfidence in the safety and safe use f health IT prducts, systems, and services Objective E: Advance a natinal cmmunicatins infrastructure that supprts health, safety, and care delivery 16

17 Enhancing the Natin s Health IT Infrastructure: The IPO s Rle Finalize and implement the Natinwide Interperability Radmap Cllabrate with industry and public stakehlders t advance cre technical standards fr terminlgy and vcabulary, cntent and frmat, transprt, and security Publish guidance that defines high-level principles fr plicies and business practices that advance trust and interperability Identify, priritize, and advance technical standards t supprt secure and interperable health infrmatin Increase use f cmmn standards amng federal agencies, private industry, and the bimedical research cmmunity Encurage cnsistent standards implementatin, reduce implementatin variability, and imprve mdularity in health data standards fr terminlgy and vcabulary, cding, data cntent and frmat, transprt, and security Advance standards fr cmmn data elements t enable capture and use fr clinical decisin supprt, clinical quality measures, research, and reprting Encurage the adptin and use f priritized sets f cmmn standards thrugh health IT certificatin, federal regulatins and prgrams, and funding mechanisms 17

18 Interperability Challenges and Effrts t Imprve The DD and VA have made great strides in standards-based data exchange. Hwever, numerus technical and plicy barriers persist and remain a challenge. Achieving seamless data integratin is dependent n cmmn data standards, nt a single system slutin. Challenges Technlgy Standards Transprt Standards Veterans and Cmmunity Health Partner Exchange Impact t Clinical Wrkflw Effrts t Imprve Aligning t Natinal Data Standards Imprving the Jint Legacy Viewer (JLV) Develping Lng- Term Interperability Imprvements Upgrading Supprting Infrastructure 18

19 Implementing Standards Guidance The Departments DHMSM (DD): Acquiring an Enterprise EHR thugh a single award, multiyear cntract that meets peratinal requirements IPO Guidance Health Data Interperability Management Plan (HDIMP) External Stakehlders VistA (VA) : Based n pen standard/pen surce VA Architecture, leveraging successful VA legacy systems t mve t the future Health Infrmatin Interperability Technical Package (I2TP) Jint Interperability Plan (JIP) 19

20 DD/VA IPO FY15 Accmplishments Cntinued t strengthen relatinships with ONC and ther external partners Interperability Radmap Federal Health IT Strategic Plan Standards develpment rganizatins Federal Health Architecture Cnvened key experts in the Departments Hsted first Health Interperability Enterprise Architecture (HIEA) Wrking Grup meeting Metrics Summit ISDCCB (spell ut Cnfiguratin Cntrl Bard) Cntinued adherence t stakehlder and Cngressinal reprting requirements Jint Executive Cuncil and Health Executive Cuncil Briefings Executive Cmmittee Briefings Briefings t Cngressinal staff 20

21 Standards and Interperability Key Guidance The DD/VA IPO has three fundatinal dcuments that prvide key strategic and technical guidance t its stakehlders, enabling and facilitating implementatin, gvernance and planning fr health data interperability. All three f the belw were recently updated: Infrmatin Interperability Technical Package (I2TP) Versin 4 (25 June) Implementatin guide with IPO required and recgnized natinal health data interperability standards Guides DD/VA mdernizatin effrts; technical requirement fr DD acquisitin and key reference in VistA Evlutin Interperability Plan Will cntinue t evlve and guide the Departments mdernizatin effrts as applicable standards mature and Department implementatins are realized. The next release f the I2TP is scheduled fr Octber 2015 Health Data Interperability Management Plan (HDIMP) (8 July) Dcuments IPO s strategy and rle in supprting the Department s interperability management and gvernance effrts Outlines necessary gvernance and prcesses t supprt health data exchange and terminlgy standardizatin Will exist as a living dcument and be updated annually t incrprate changes t rganizatins, plicies, technlgy, and stakehlder bjectives Jint Interperability Plan (JIP) Versin 3 (28 July) Guide fr Departments technical visin fr interperability and plans fr achieving seamless data integratin Plan addresses interperability use cases, near-term deliverables, and lng-term verview Next iteratin f the JIP will fcus n Interperability Use Cases. The next update t the JIP is scheduled fr January

22 Future Pririties Update key technical deliverables t supprt interperability and mdernizatin, including the Health Data Interperability Nrmalizatin and Cmpliance Reference Guide, the HIEA Wrking Grup Charter and the Jint Explratry Team Fast Healthcare Interperability Resurces Prfiles Technical Reprt Assist with Health Executive Cuncil (HEC) Health Data Sharing Business Line Subgrups Cntinue t develp interperability use case framewrk and clinical interperability scenaris (CIS) that identify clinical dmain data element and messaging standards Cntinue t engage and enhance relatinships with Departments, ONC, and ther external partners Develp interperability metrics and prvide quarterly updates t Data Dmain Dashbard 22

23 Questins? 23

24 Evaluatins Please cmplete yur evaluatins 24

25 Cntact Infrmatin DD/VA Interagency Prgram Office (703) Dr. Lauren Thmpsn, SES DD/VA IPO Directr Mr. Brian Burns, SES DD/VA IPO Deputy Directr 25