Tuesday, October 6, 2009

Next Steps for Healthcare Information Exchange in Massachusetts

Tomorrow, I'm running a retreat of the New England Healthcare Exchange Network (NEHEN) Board of Managers and several invited stakeholders to discuss our 5 year plan for enhancing HIE functionality in the state. What are our guiding principles?

1. Create functionality that supports the workflow of our stakeholders

NEHEN's Board includes payers, providers, and patient advocates. As we think of the capabilities and functions supported by an HIE, we must meet the business needs of our stakeholders. Meaningful use is designed to foster healthcare information exchange and we want to facilitate meaningful use, but not at the expense of ignoring the needs of our stakeholders who have compliance, strategic, and customer driven needs.

2. Develop a framework of reusable functional components

In 2009, we've received 19 requests for new HIE projects. Each project is a "one off" with its own unique workflow and data exchange requirements. It is not scalable, sustainable or affordable to take on ad hoc projects that differ across each community. Ideally we'll be able to break down all our requests into a series of reusable capabilities that can be reassembled without significant IT effort to address the new project requests. Here's a list of candidate capabilities that we'll review:

Communicate Ambulatory Prescriptions
Communicate Structured Documents
Communicate Unstructured Documents
Communicate Clinical Referral Requests
Communicate Lab Results Messages
Communicate Lab Results Documents
Communicate Imaging Information
Communicate Quality Measures
Update Immunization Registry
Retrieve Immunization Registry Information
Communicate Emergency Alerts
Communicate Resource Utilization (hospital resource availability in a disaster or outbreak)
Communicate Benefits and Eligibility
Communicate Referral Authorization
Manage Consumer Preference and Consents
Access Control Service
Security Audit/Disclosure Service
Patient Identification Management Service
Knowledge and Vocabulary Service
Healthcare Document Management Service
Query for Existing Data Service
Administrative Transport to Health Plan Service
HL7 Messaging Service
Emergency Message Distribution Service

3. We need to prioritize these capabilities to guide our development efforts of over the next 5 years.

Given the business priorities of our stakeholders to achieve Medicare Part D incentives, Meaningful Use, ICD-10/5010 transition, and support Healthcare Reform, we'll develop a 5 year rollout plan for these services that will meet the greatest needs for the great number.

The outcome of this retreat will provide a foundation for the Massachusetts eHealth Institute's (our state government procurement organization for healthcare IT) ONC planning grant application.

I look forward to the retreat.

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