ehealth Collaborative Office (ehco) HIE Planning Project Charter

Transcription

1 Appendix E ehealth Collaborative Office (ehco) HIE Planning Project Charter Note: This is the first of several concurrent and subsequent charters under the ehco Program. I. Background Health information exchange (HIE) provides the capability to electronically move clinical information among geographically and functionally disparate health care information systems while maintaining the meaning of the information being exchanged. Starting in 2009, the Commonwealth of Pennsylvania sought and received federal funding via the Office of the National Coordinator (ONC) to implement HIE. With a change in administration in 2011, the Commonwealth executive branch has directed a re-launch of the HIE effort under the supervision of the State HIT Coordinator. This effort will start with a new iteration of the strategic planning effort, with heightened attention to transparency and with a commitment to stakeholder inclusiveness. II. Mission Statement This project will create a plan for the future of health information exchange (HIE) efforts in the Commonwealth of Pennsylvania based on the input and recommendations of stakeholders representing diverse Commonwealth government, commercial, and private interests in accordance with the Pennsylvania ehealth Collaborative Executive Order. This plan, upon approval of the Commonwealth, will serve as the foundation of subsequent HIE implementation projects. III. Business Case Health care costs in the United States continue to rise at a rate far faster than general inflation. This is in part due to the rapid proliferation of newer, more complex, and thus more expensive treatments and in part due to demographic changes which have increased the overall societal disease burden (e.g. aging, the rise of obesity, etc.). It is also, however, partly due to the slow implementation of modern information technology to the fragmented healthcare delivery system. For example, clinicians often must rely on patient provided anecdotal information rather than first hand access to records from previous medical encounters and care. This can lead to redundancy (e.g. repeated diagnostic procedures) and in some cases expensive errors (e.g. misdiagnosis/inappropriate medication prescription) which could be prevented if providers had access to better information. Further, the same inefficiencies can degrade the quality of administered care. Thanks to various Federal (HIPAA, HITECH) initiatives, providers have considerably accelerated the adoption of modern technology (e.g. electronic medical records - EMR). These systems facilitate capabilities which not only improve administrative efficiency, but can, if properly integrated into clinical workflows, significantly reduce the chances for clinical error. For example e-prescribing, the use of EMR to write prescriptions, enables automated checks of the prescribed drug against the patient s known conditions, allergies, and other medications, immediately calling contraindications to the physician s attention. The system then automatically

2 transmits the prescription to a pharmacy, reducing the possibility of errors due to poor handwriting. The task remains, however, to create pathways (HIE) to connect disparate medical records systems and other technologies such that the full potential of such systems can be realized. Under the auspices of the ONC, resources have been made available to Pennsylvania to encourage and facilitate HIE adoption, and thanks to the aforementioned increase in the adoption of EMRs and related technologies, Pennsylvania is now positioned to leverage these resources to implement HIE and improve both the economic efficiency and quality of healthcare for all commonwealth citizens. IV. Strategic Scope A. Engage diverse (geography, industry) range of stakeholders to identify type of functions stakeholders desire from the state-level HIE, along with priorities for implementation. i. There are no limits on the functions the stakeholders may identify for consideration, but the ehco will present a starting list for consideration that is as comprehensive as possible. ii. Form stakeholders into working committees to further clarify requirements, and to address such issues as privacy, security and financial sustainability. iii. Create an Advisory Committee comprised principally of stakeholders, but also including the State HIT Coordinator. B. Use the stakeholder input to formulate a plan for subsequent activities that includes: i. High-level functional and technical requirements ii. Legal and regulatory framework iii. Governance framework iv. Evaluation and performance framework v. Communications planning (patients, providers and other impacted entities) vi. Impact on the ONC Direct Project, meaningful use, and other state and federal ehealth initiatives vii. Privacy and security framework viii. Financial sustainability planning ix. Procurement processes C. Planning for subsequent projects, to include creation of project charters and plans, is within scope for this project, but no actual execution of these follow-on projects may occur under this planning project. D. This project includes the creation and management of a website to enable document sharing and collaboration among stakeholders. i. All final work products of the project and of the working committees are public domain and will be shared via the website. Page 2 of 5

3 V. Applicable Regulations and Standards A. Pennsylvania ehealth Collaborative Executive Order VI. Assumptions A. All material support (e.g. office space and supplies) will be provided by the ehco. B. This project is the priority project for the ehco during July, August and September and staff will be available for this project at 75% or more. C. ehco will complete hiring of permanent and contract staff (see Resources below) at or before the times they are required to fulfill this project s objectives. D. ehco will contract and pay for meeting space for kickoff meetings. E. There will be sufficient participation from stakeholders (kickoff meeting and committee meeting attendance) to approximate the diversity of opinions, view points, and interests of the citizens and various professional communities of the commonwealth. F. Stakeholders will take sufficient ownership of this project, to include active participation in risk assessment, planning and mitigation. G. This effort has the support of the Governor and the Legislature as determined by their inclusion of funding, in the state budget, related to this project. H. State Agencies will provide required support for ehco in the execution of this project per the Governor s Executive Order. Where conflicts exist between any state agency initiatives and this project, the agency in question and ehco will identify and implement good-faith compromises. I. There will be no delays or interruptions in the appropriation of promised federal grant funding, nor in the appropriation of state-level match funding. VII. Constraints A. The budget for this project is constrained by moneys allocated according to federal and state budgeting process. B. This project will operate within the context of CWOPA standards, directives, and policies until such time as a longer term governance infrastructure is developed and implemented for the ehco program. C. This project must operate within the emerging project framework of the ehco and PA OA/OIT PMO. D. This project may not utilize contracted labor beyond that already provided by ehco. E. Stakeholder participation, including committee work, is on a voluntary basis and will not be compensated. Page 3 of 5

4 F. Drafts, working documents, and similar documents may be restricted to ehco personnel and/or committee members, but all meeting minutes and finalized work products will be made available to the general public. G. ehco efforts for this project must be coordinated, via the State HIT Coordinator, with related efforts throughout the commonwealth. H. All deliverables of this project should receive the endorsement of the Advisory Committee. VIII. Known Risks A. Ongoing and sufficient ownership and participation by owners, sponsors, key stakeholders, governing entities, supporting agencies, and program managers is critical to project success. B. This process may result in a determination that stakeholders do not want Pennsylvania to participate in activities that are required in order to receive federal funding through the Office of the National Coordinator. If this occurs, later activity on the project may be curtailed or cancelled. C. Federal or state entities which have allocated funding for this effort may cancel such funding. If this occurs, later activity on the project may be curtailed or cancelled. D. This project may result in stakeholder requirements that are beyond the capacity of currently identified sources of funding for subsequent projects. If the project team and committees are unable to identify funding sources for implementation and sustainability of particular functions, those functions may not be included in the Future Plan report. E. This project may result in stakeholder requirements that are in conflict with Commonwealth HIT efforts underway outside the ehco. The State HIT Coordinator will, with the support of the project team, identify and resolve such conflicts as they occur. F. Due to the requirement for transparency, the project team will need to monitor and may be required to respond to inquiries from the general public or stakeholders not directly involved in the effort. G. Committees of volunteers, even with the support of ehco staff may not have the ability to meet ONC Grant schedule expectations. The State HIT Coordinator and Program Director will develop a plan to address if this occurs. IX. Known Milestones/Phase Gates A. Stakeholder Kickoff Meeting, July 26 and 27, 2011 B. Committee Kickoff Meeting, August 16, 2011 C. Draft Future Plan due date, October 14, 2011 D. Final Future Plan due date, November 11, 2011 X. Major Deliverables Page 4 of 5

5 A. Stakeholder Findings Report B. Plan for the Future of HIE in the Commonwealth of PA (future plan) C. Project Charters for subsequent projects D. Inputs to Program Operations Plan and Budgeting XI. Organization Structure A. Sponsor Robert Torres, State HIT Coordinator B. Owner Alexandra Goss, Program Director, ehco C. Project Manager David Grinberg D. Matrix structure XII. Resources A. This project shares resources in matrix structure with other ehco projects and operations. B. Human resources include the program director, project manager, four subject matter experts/committee managers, four business analysts, and one administrative affairs manager. The State HIT coordinator is also available on a limited basis. Administrative support from other OA offices may be available on request. Committee members are available for committee works and some may be available for additional writing/editing support. C. All equipment and facilities available to the ehco are available to this project on a matrix basis. D. The Commonwealth has been approved for $17.1m in federal funding, through February 2014, from the Office of the National Coordinator to support this project. The PA legislature also approved $804,000 to support this project in Pennsylvania s 2011 fiscal year budget. Page 5 of 5