NC HIE Onbarding Prcess Last Updated: January 16, 2014 Welcme t the rth Carlina Health Infrmatin Exchange (NC HIE). Belw are the nine steps fr successful nbarding with NC HIE alng with a crrespnding flw chart: Onbarding New Participants/Facilities - Implementatin Planning Questinnaire BFR - Frm TECCA - Technlgy-Enabled Care Crdinatin Agreement Send t Prspect t Review t ensure cmpletin Send t NCHIE Technical Tean TECCA Subscriptin Agreement Create Integratin SOW Cnversatins w ith Prspect Technical Dcument s missing items in Wrk w ith NC HIE t prvide clarificatin White - NC HIE Yellw - Prspect Review Review Internally Clarificatin Needed Create Detail Architecture Design (DAD) Obtain Signatures Blue - NC HIE & Prspect 1. Frm (BRF) Determine the scpe f the prject as prvided in Exhibit A attached herein. 2. Implementatin Planning Questinnaire () Establish integratin prfile, determine cnfiguratin and integratin requirements as prvided in Exhibit B. 3. Detail Architecture Design (DAD) Determine the technical scpe f the prject. 4. Cntractual Agreements In parallel with the, the cntractual agreements are prvided fr review and discussin and subsequent executin, including the Technlgy-Enabled Care Crdinatin Subscriptin Agreement (TECCA). A Participant is als required t jin the Participatin Agreement by executin f a Jinder which is included in the TECCA as an exhibit. 5. Implementatin Cnfiguratin f interfaces between NC HIE and Participant s EHR system. 6. System Testing Testing, system refinement, and retesting f interface cmpnents between NC HIE and Participant s her. 7. Verificatin User acceptance testing by the Participant. 8. Training Clinical Prtal and Opt-Out training. 9. Prductin Rllut System is rlled ut fr use by authrized users f the Participant NC HIE enables prviders t efficiently share patient health infrmatin with ther prviders and trading partners, effectively assist with transitin f care, reduce the number f re-admissins and avidable Emergency Department (ED) visits, and imprve the quality f care cllabratin. In additin, we are enabling Healthcare Organizatins t
meet Meaningful Use attestatin requirements. Befre a prvider cnnects t NC HIE and begins participatin in the Health Infrmatin Exchange (HIE), NC HIE persnnel will wrk with the prvider t btain backgrund infrmatin and assess readiness fr integratin t HIE. NC HIE s nbarding prcess is divided int fur categries legal, technical, cmmunicatins, and training. T successfully nbard participants, NC HIE recmmends that a persn r grup be designated t lead each f these areas. Legal NC HIE and Participants will be party t the legal agreements described belw. These cntracts shall be prvided early in the prcess t ensure that the cntracting prcess can be achieved n a timely basis. 1. Technlgy-Enabled Care Crdinatin Subscriptin Agreement (TECCA) This agreement defines the business relatinship between NC HIE and the Participant. It prvides the Participant s rights t use and disclse data, the financial terms fr thse services, the Service Level Agreement (SLA) and ther rights and bligatins as agreed t by NC HIE and the Participant under which the services are prvided, and any ther bligatin f NC HIE r the Participant t each ther. 2. NC HIE Participatin Agreement This Agreement is a multi-party agreement and establishes the prvisins, rights and bligatins t which all Parties agree and t which Participants' Authrized Users agree. The Agreement sets frth the general terms and cnditins gverning hw patient infrmatin may be accessed, used r disclsed thrugh the NC HIE Netwrk. This is a nn-negtiable agreement that a Participant jins thrugh a jinder included in the TECCA. NC HIE has als established principles and plicies f which Participants shuld be aware. These dcuments are als available n the NC HIE website and shared with interested rganizatins befre any agreements are executed. NC HIE principles and plicies are als subject t change under NC HIE gvernance. These dcuments include: Fair Use Principles The Fair Use Principles (defined belw) alng with the NC HIE Privacy Plicy, establish the framewrk f the General Terms and Cnditins f the Participatin Agreement that binds the NC HIE and all participating entities in the HIE Netwrk. The Fair Use Principles include the fllwing principles f fair use f the HIE Netwrk: (1) Individual Access and Cntrl; (2) Cllectin, Use and Disclsure Limitatin; (3) Data Quality and Integrity Safeguards; (4) Cmmitment t Reciprcity and Timeliness; and (5) Accuntability. Privacy Plicy The NC HIE Privacy & Security Plicies gvern the use, disclsure and maintenance f health infrmatin available thrugh the NC HIE Netwrk in a manner cnsistent with the Health Insurance Prtability Accuntability Act, Privacy Rule and Security Rule, 45 C.F.R. 160, 164. Cnsent Management The NC HIE Cnsent Management Prcess ensures that individuals are prvided an pprtunity t elect t pt ut, r rescind a decisin t pt ut, f having NC HIE disclse the individual s health infrmatin maintained by r n behalf f (i) all Participants r (ii) by selected Participants thrugh the HIE Netwrk. NC HIE will prvide an educatinal brchure that utlines the benefits f NC HIE as well as an explanatin f their rights and methdlgy t pt ut f NC HIE by use f an pt-ut frm. NC HIE will make the pt-ut frm available n its website and thrugh its call center. Participants will make the frm available in their ffices r facilities. NC HIE will prcess pt-ut requests and emply technical measures t prevent the disclsure f any health infrmatin thrugh the HIE Netwrk. te that NC HIE may permit the infrmatin be disclsed thrugh the HIE Netwrk t prvide treatment fr a medical emergency cnditin r fr public health purpses.
Technical Onbarding New Participants/Facilities - Implementatin Planning Questinnaire BFR - Frm TECCA - Technlgy-Enabled Care Crdinatin Agreement Send t Prspect t Review t ensure cmpletin Send t NCHIE Technical Tean TECCA Subscriptin Agreement Create Integratin SOW Cnversatins w ith Prspect Technical Dcument s missing items in Wrk w ith NC HIE t prvide clarificatin White - NC HIE Yellw - Prspect Review Review Internally Clarificatin Needed Create Detail Architecture Design (DAD) Obtain Signatures Blue - NC HIE & Prspect The HIE Netwrk slutin is a set f infrmatin services cnfigured t supprt the diverse needs f the healthcare ecsystem. This slutin cnsists f a set f cre services that prvide the fundatin fr the exchange f infrmatin between Participants and enable the delivery f cre and value-added services t the Participant cmmunity. The cre services, IHE and HL7 standards-based, enable the exchange f infrmatin, integratin acrss multiple systems and semantic mapping f clinical cntent t simplify infrmatin viewing. Additinally, the cre services ffer a secure, web-based Clinical Prtal that prvides a clinician-cnfigurable hme page, a dynamic patient summary and a lngitudinal patient recrd regardless f the surce system. T kick-ff the technical integratin prcess, NC HIE assigns a prject manager t the implementatin and requires that the Participant als identify an implementatin lead. The team wrks tgether t establish a prject plan and timeline that is agreed upn by NC HIE, the Participant and the EHR vendr, if applicable. The Participant will jin regular planning calls t ensure a smth integratin. The table belw illustrates a general integratin and is subject t change based upn NC HIE s integratin queue and the cmmitment and timelines f the Participant s integratin team: Phase Activities Participant Resurces Timing Determine scpe f data t be integrated / sent t NC HIE Determine timing and phases (if applicable) f integratin Determine reprting/cqm/hie gals Distribute/ Integratin Questinnaire 1-2 Hurs f Executive Spnsr / Prject Lead 3-5 hurs f technical / vendr 2 hurs f business Implementatin Planning Questinnaire () Develp Integratin Prfile Review Integratin Prfile Dcument cnfiguratin and integratin 3-5 hurs f technical 1 hur f business 1-2
standards Cnduct Gap Analysis Define Cnceptual Architecture Design Functinal Design Data Design and mapping Baseline cnfiguratin Specificatin fr Acceptance Testing Implement Cnfiguratin f data interfaces between NC HIE and the external systems Develpment f new services Implementatin f SSO and integratin f prtal int EMR (if cntracted) 10 hurs f technical 20 hurs f technical 1-2 2-3 Test Testing f interfaces and new service cmpnents incrprating the NC HIE slutin and the external systems Validate Functinal Validatin User Acceptance Testing Regressin Testing User accunt setup / security rle assignment Training NC HIE trains super users n Prtal Functinality NC HIE trains relevant staff n pt-ut 16 hurs f technical 8 hurs f technical 8 hurs f business/ clinical 1-3 hurs fr super users 0.5 hur fr relevant staff 2-3 1 Week Migrate System will be rlled ut t Participant Cmmunicatins NC HIE has created a tlkit f materials t help Participants educate staff and patients abut the health infrmatin exchange and what it means fr them. Participants will want t ensure that staff is ready t educate patients abut the health infrmatin exchange befre cnnectivity t the HIE Netwrk. Belw is an verview f the tls prvided in this package and hw they are suggested t be utilized. Overall: NC HIE Cmmunicatin Plan Template: This plan includes key bjectives, audiences, messages and message vehicles t cmmunicate the rll-ut f NC HIE t internal and external audiences, and can be custmized by the Participant. NC HIE Cmmunicatin Materials Flder: This zip flder f e-files cntains templates t message NC HIE t staff, patients and ther stakehlders. Examples f dcuments include an emplyee newsletter, email annuncement t staff, talking pints fr executives, talking pints fr registratin staff and varius patient-facing materials. Legal Materials:
NC HIE tice f Privacy Practices Language: This is ptinal draft language t insert int yur tice f Privacy Practices. Please cnsult yur legal cunsel t ensure cmpliance with applicable law. NC Senate Bill 375: This law went int effect in 2011. It requires that the first time a patient visits a participating prvider after cnnectin t NC HIE, the patient must be ntified that the prvider participates with NC HIE. This bill may be viewed at http://www.ncleg.net/sessins/2011/bills/senate/pdf/s375v5.pdf On July 25, 2013, The rth Carlina Legislature (bth Huse and Senate) ratified NC Huse bill 834 (http://legiscan.cm/nc/text/h834) which mandated cnnectivity t NC HIE fr any hspital with an Electrnic Health Recrd system, and has tasked NC HIE with prviding demgraphic and clinical data t NC DHHS fr any patient where the services were paid by Medicaid funds. This legislatin was signed by the Gvernr int law n August 21, 2013. Patient Frms & Brchures Patient Educatinal Brchure: This brchure may be rdered frm NC HIE and placed in patient waiting areas. This is als available fr dwnlad n the NC HIE website. State law requires participating prviders t have these n hand. This infrmatinal brchure is available in bth English and Spanish versins. Opt-Out Frm: This frm can be accessed thrugh the NC HIE website and cntains an in depth explanatin f the Opt-Out prcess alng with answers t FAQs. If a patient wishes t pt ut, the patient r authrized representative must print the frm and mail it t NC HIE. Patients may als call NC HIE directly t pt-ut by using the tll-free number in the patient educatinal brchure. A Spanish versin f this frm is als available. Training NC HIE prvides Participants with a number f training s. Trainings typically ccur nline via webinar and may ccur in persn as necessary (usually in a classrm setting at NC HIE s ffices). In rder t cnserve s, mst f the materials are in digital frmat and ptimized fr dwnlading and printing. NC HIE utilizes a train the trainer apprach. Clinical Prtal Training During this training, attendees will learn abut the functinality f the NC HIE Clinical Prtal and abut the different levels f access (user rles) available t users. Attendees will be expected t train ther users at their practice r facility and help identify and assign user rles, which will be explained and demnstrated. In additin t the training sessins ffered, Participants will receive a NC HIE Prtal User Guide with specific instructins, as well as access t ther helpful training materials, including a basic verview f: Privacy and Security Assciate and Data Sharing Agreements Help Desk Cmpliance and Auditing User Access Rles Opt-Out Training All wrkfrce members at yur practice that will have access t the NC HIE Clinical Prtal need t attend an NC HIE "Opt-Out" training sessin befre accessing the HIE Netwrk. During this training, attendees will learn abut patient pt-ut ptins within the HIE Netwrk and the Participant's rle vs. NC HIE's rle in the pt-ut prcess.