1. Strategy and Innovation Workgroup May 5, 2015 David Lansky, chair Jennifer Covich, co-chair

2. Membership 1 First NameLast nameMember TypeOrganization DavidLanskyChairPacific Business Group on Health JenniferCovichCo-chaireHealth Initiative KelvinBaggettMemberTenet Healthcare Corporation KynaFongMemberElationEMR SandraHernandezMemberCalifornia HealthCare Foundation RichardPlattMemberHarvard Pilgrim Healthcare Institute MichaelPainterMemberRobert Wood Johnson Foundation MarkSavageMemberNational Partnership for Women and Families GeorgeHripcsakMemberColumbia University JohnHoustonMemberUniversity of Pittsburgh Medical Center BrianDeVoreMemberIntel Corporation PaulTangMemberPalo Alto Medical Foundation JonathanNebekerEx OfficioVeterans Affairs

3. Today’s Agenda Federal Health IT Strategic Plan – Transmittal Letter Health IT Policy Committee Workplan 2

4. Linkage to Federal Health IT Strategic Plan 3 Topics identified for further analysis over the coming 12-24 months – Long-term roles of government and private sector – Data infrastructure for value payment – Policies to facilitate research and innovation – Long-term architecture requirements

5. Long-term roles of government and private sector Philosophical agreement that the federal government should play the least intrusive, regulatory role possible while assuring continued progress towards an infrastructure that supports the Triple Aim and the public’s interest Uncertainty around the future shape of program such as – meaningful use – quality measures used for MIPS – physician payment and hospital payment – data reporting requirements for FDA drug and device surveillance – structure of governance in support of widespread interoperability The appropriate roles of government, private industry self-regulation, and the open market are unclear in these programs 4

6. Long-term roles of government and private sector: HITPC Suggestions HITPC suggestions – Develop a framework for evaluating the government’s role in health IT – Identify these and other use-cases – Listen to diverse stakeholder perspectives – Recommend both principles and specific structures to clarify where and how the government should be active in the health IT marketplace and infrastructure 5

7. Data infrastructure for value payment Both HHS and private industry have made specific and bold commitments to value payment over the next five years “Value” payment will depend upon improvements in how we measure quality, and most purchasers – public and private – recommend a greater focus on outcomes. The Federal Health IT Strategic Plan called out the central role of government payment methods in driving interoperability. Outcomes measurement is likely to require 1.A longitudinal health record 2.A greater use of patient-reported measures 3.Successful linkages of patient records across multiple provider platforms. Value payment is also likely to require coordination between financial, clinical, and patient- generated data 6

8. Data infrastructure for value payment: HITPC Suggestions HITPC could work with payers, purchasers, providers and other stakeholders to – understand the data requirements for the new payment methods – articulate an architecture to meet those requirements – begin discussion of the policies and programs needed to support migration to that architecture 7

9. Facilitating research and innovation HITPC Suggestions – Evaluate and harmonize federal and state policies that impede research and innovation – Evaluate consumer participation in research and innovation 8

10. Long-term architecture requirements Identification of standards Longitudinal health record in cloud HIPAA and access challenges Interfacing between claims and patient reported data Governance challenges HITPC Suggestions – articulate an architecture to meet long-term requirements – Discussion of the policies and programs needed to support architecture 9