Connecting EHRs to HIEs: A Collaboration of States and Vendors Driving Toward Common Adoption HIE Specifications

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1 Connecting EHRs to HIEs: A Collaboration of States and Vendors Driving Toward Common Adoption HIE Specifications Anuj Desai, MBA Director of Business Development New York ehealth Collaborative 1/12/

2 New York ehealth Collaborative NYeC is a not-for-profit organization, working to improve healthcare for all New Yorkers through health information technology. 1. Promote the adoption and use of electronic health records Educate the public on the benefits of EHRs Assist providers transitioning from paper to electronic records Assist providers to qualify for Meaningful Use reimbursements 2. Build the SHIN-NY (State Health Information Network New York): a secure network for sharing electronic medical records across the state Allow providers to share information Promote collaborative care so doctors work as a team to benefit the patient 3. Develop statewide policies regarding HIT Convene stakeholders and build consensus Collaborate with NYS Department of Health

3 SHIN-NY: The Network of Major Healthcare Providers within NY Through the HEAL grant program, the NY State Department of Health helped create 12 regional health information organizations (RHIOs) in New York. Each RHIO has built a local health information exchange network and is in the process of connecting the healthcare providers in their community SHIN-NY 1.0 SHIN-NY 2.0 will connect together all of the individual RHIOs into a statewide network Every state in the country is developing a similar health information exchange network. 3

4 Background The State HIE programs have been given significant dollars around creating statewide networks for the building of Statewide Networks; but the adoption has been limited HIE connections are a major barrier to adoption of HIE services, each interface is unique. Existing standards such as Direct Project, IHE and other federal and statewide standards have been developed but have not been consistently implemented. Each regional HIE does not have enough leveraging power with the vendor community to drive towards a common implementation of the standards, resulting in high cost of connection. The industry is asking for more uniform and scalable interoperability capabilities, but this is not proceeding with enough urgency or consistency for the State HIE Program goals Common Goal: Define plug and play connections that eliminate the barrier of interface development between EHRs and HIEs

5 Vendors Win-Win-Win Strategy for All Stakeholders Differentiate product in highly fragmented market by developing a product that is superior to competitors, and that offers plug and play to HIE standards for multiple states. Build interface once, use for many different HIEs and EHRs. Better utilize limited resources to focus product functionality improvements and customer adoption. State HIE Ability to rapidly deploy connected capabilities by having standard interfaces. Minimize costs associated with connection fees by individual EHRs each time a new connection is made. Providers Increase value proposition of individual EHRs. Eliminate HIE connections as prohibitive barrier for adoption. 5

6 Interoperability Strategy Mission: Establish a strong marketplace of integrated EHR connected capabilities to HIEs Phase I: Develop Implementation Guides Form workgroup with states and vendors Create priority list of capabilities Develop functional & technical specs Collaborate with state policy advisory groups to ratify specifications Harmonize with ONC Phase II: Develop Mechanisms for Compliance to Specifications Engage broader vendor community for adoption of specifications Develop accredited vendor program with Regional Extension Centers (REC) based on compliance to specifications Create mechanisms to promote use of standards in connecting EHRs to HIEs

7 Founding Workgroup Members States EHRs HIEs California Allscripts Axolotl Colorado eclinicalworks InterSystems Maryland emds Medicity Massachusetts Greenway New Jersey McKesson New York NextGen Oregon Sage Siemens Workgroup now has 8 states, 14 EHR vendors, and 9 HIE vendors Additional states and vendors being on-boarded 7 States represent ~ 30% of US Population 11 Vendors are leading EHR and HIE vendors with significant market share 7

8 Terms of Participation Agreed to by All Stakeholders State Responsibilities Actively participate and obtain buyin with state policy groups Agree to develop compliance process for interfaces within state Ensure that specifications developed are utilized in their state. Market to the healthcare provider community the value of using EHRs and HIEs that pass the plug and play compliance testing Vendor Responsibilities Actively participate in workgroup Work collaboratively with potential competitors Utilize off the shelf standards Commit that upon final approval of the specifications to develop product that meets such specifications within 1-2 major product releases

9 Major Functional Needs Addressed 1. Statewide Send and Receive Patient Record Exchange Utilize Entity-Level or Individual-Level Provider Directory (ELPD or ILPD) for routing information including finding a DIRECT address via NHIN Direct protocols Leverages capabilities from IHE Profiles: HPD, XDM, XDR, ATNA 2. Statewide Patient Data Inquiry Service: Defines a patient inquiry and record retrieval service utilizing message record routing, master patient index, authorization framework and identity management Leverages capabilities from IHE profiles: XDS.b, PIX/PDQ, ATNA, XUA, XCPD 3. Continuity of Care Document (CCD): Priority was assigned to development of a consistent implementation of the HITSP C32 CCD specification which could be implemented in a repeatable manner between EHRs and HIEs. 9

10 Specs Completed and Released Nov 8 th Fantastic Response from the HIT Marketplace 400 Document Downloads; 90 Membership requests from States, EHR Vendors, HIE Vendors, and others

11 Connectathon Demonstration Allow participants that have successfully passed Connectathon testing for one or more of the underlying IHE profiles to move to higher level of HIE project demonstration specificity that includes DIRECT and EXCHANGE. Be allowed to participate in the HIMSS Interoperability Showcase with the label EHR/HIE Interoperability Workgroup Demonstrator. Shake-out technical specifications and find any issues prior to formal compliance testing

12 Next Steps for Workgroup Market WG deliverables to additional states and vendors to increase adoption Develop specification compliance strategy Align with Regional Extension Centers to form accredited vendor program and include compliance requirements into preferred contract language Identify ways to more formalize workgroup structure

13 Questions? For More information on the EHR/HIE Interoperability Work Group, to download specifications, and to become a member go to: Anuj Desai, Director Business Development New York ehealth Collaborative adesai@nyehealth.org