1. 1 Vermont Health Information Technology Plan Workgroup January 10, 2007 VERMONT INFORMATION TECHNOLOGY LEADERS

2. 2 Agenda 1.Preliminary Plan RecapPreliminary Plan 2.Discuss Timeline for Final Plan 3.Next Steps:Next Steps –Three ways of looking at the Plan: Stakeholders, Sections, Issues –Discuss options for organization of work –Review preliminary task list –Selected discussion topics: strategy/objectives; plan participation/feedback; education.

3. 3 Preliminary Plan Submitted January 1, 2007 Development Process: –What went right? –What could be improved? Presentations Feedback

4. 4 Timeline for Final Plan Due: July 1, 2007 Less than six months Consider timeline for Preliminary Plan; need more time for: –Decision making –Outreach –Review and feedback

5. 5 Next Steps Discuss organization of work: at Workgroup level; subcommittee level; or create new groups to tackle Plan tasks? Develop Final Plan development timeline. Walk through a list of issues gleaned from the Preliminary Plan. Start to build a list of tasks by topic.

6. 6 3 Ways of Looking at Plan: Stakeholders

7. 7 3 Ways of Looking at Plan: Sections 1.Executive Summary 2.Vision 3.Strategy/Objectives 4.Environment 5.Standards 6.Technology/Architecture 7.Privacy/Security/Data Ownership 8.Education 9.Funding 10.Governance/Accountability 11.Implementation 12.References

8. 8 3 Ways of Looking at Plan: Issues Some issues fit nicely into Plan Sections; other issues are cross-cutting. Either way, they represent questions that need to be answered by the Plan.

9. 9 3 Ways of Looking at Plan: Issues (cont.) Examples of issues associated with Plan sections: What is the fully-developed Vision of the Plan? How will we measure success? What is the relationship between the Plan and the current HIT environment in Vermont and nationally? What standards will the Plan establish/promote and how? What technical architecture is proposed for the HIEN? What are the requirements related to Privacy/Security in HIT/HIE and what steps should be taken to help meet those requirements?

10. 10 3 Ways of Looking at Plan: Issues (cont.) Examples of issues associated with Plan sections: How will the Plan itself promote EHI, and what is the strategy for educating stakeholders on the related issues? What funding and financing is recommended to help achieve the vision? What governance structure will be established related to Plan recommendations, and to manage the evolution of the Plan itself? What is the timeline for implementation of Plan recommendations?

11. 11 3 Ways of Looking at Plan: Issues (cont.) Examples of cross-cutting issues: How does the Certificate of Need process fit into Plan recommendations? How do HIT initiatives such as the Blueprint fit into the Plan? How does the plan propose to increase the level of provider HIT adoption? How will the plan spur and help guide institutional HIT investment? What is the Role of VITL across the Plan recommendations? What does Patient Centeredness mean in the EHI context?

12. 12 3 Ways of Looking at Plan As we move beyond the Preliminary Plan, we have work to do across all three areas: Stakeholders, Issues, Sections. Over time, cross-cutting issues and stakeholders will need to be folded into the Sections.

13. 13 Initial List of Tasks Some initial tasks follow, organized under section, stakeholder, or cross-cutting topic. This is not a complete list but a way to get us thinking about how to organize our work and solicit volunteers:

14. 14 Section: Executive Summary  Consider whether the Executive Summary will roll-up recommendations from Plan sections

15. 15 Section: Vision Develop Use Cases –Medication History –Chronic Care –ELR –EMR –Other domains? Should touch on outcomes: quality of care improvement, greater efficiency, better control of costs, reduction in redundancy of services delivered to patients Should touch on the eight stakeholders Leverage the use cases to develop a more comprehensive description of the vision across the stated domains/outcomes.

16. 16 Section: Strategy & Objectives Develop Metrics/Benchmarks –Outcomes: “all with measurable observations if possible” –Consider the idea of seeking a single metric that can help measure the success of the Plan –Develop other metrics Consider how “Strategy” relates to other sections of the Plan. Does it feed the other sections or is it derived from the other sections? Is it just a summary of recommendations from the other sections, a lead-in to those sections? Or should “strategy” be deferred to the individual sections and then detailed in “Implementation”? Develop lists of Needs of and Interdependencies between Stakeholders Document barriers (beyond just HIT adoption in practices; consider barriers to investment, stakeholder participation, etc.)

17. 17 Cross-cutting Topics: HIT Adoption/Investment  Resume working on strategy  CON considerations

18. 18 Section: Environment Monitor ongoing initiatives –Monitor national pilot projects (NHIN prototypes) –Monitor AHIC workgroup progress –Monitor HITSP –Monitor CCHIT –Monitor RTI –Monitor state initiatives Identify points in HCR 5-year plan that potentially overlap Plan issues Consider potential for interfacing with other HIENs/RHIOs

19. 19 Section: Standards HL7: Develop a strategy for dealing with HL7 in the Plan. PHIN and MITA: Strategy/overlap? What other standards should be addressed in the Plan –ONC/HITSP Standards –Vocabulary Standards –Standards to support privacy and security Proposals related to promoting/requiring standards adoption

20. 20 Section: Technology/Architecture Develop architecture: Consider HIE Component Architecture in Sec. 1.2, Blueprint Architecture Model 5b, current GE design, Technical Architecture Methodology Select NHIN prototype or AHRQ project architectures for focus and comparison Technology/Architecture to support privacy and security Authentication and Authorization (user identities) Map business needs to the architecture –OVHA –Blueprint –Other projects? –Other stakeholders? Networking/Communications infrastructure?

21. 21 Section: Privacy/Security/ Data Ownership  Read Preliminary Plan Section 4.3, 4.4.1, and Principles 1-6 (“I. … secure and private and accessed appropriately”) and RTI documents on project website. Establish scope and task list for this section.

22. 22 Section: Education  Develop Education strategy (also see “Role of VITL”)  Establish scope and task list for this section.  Connection to Privacy and Patient Centeredness Issue  White paper strategy

23. 23 Cross-cutting Issue: Role of VITL As HIEN As Educator Related to HIT adoption/investment Related to CON Related to Plan Governance

24. 24 Cross-cutting Issue: Patient Centeredness  Patient Centeredness: what does this mean in the HIT/HIE context? Consider Preliminary Plan section 4.4.1.

25. 25 Section: Governance & Accountability Plan participation and feedback –Increase Plan participation –Establish strategy

26. 26 Section: Funding/Financing  Determine scope of this section and how it relates to funding recommendations in other sections. Should this section be addressed specifically to the legislature?

27. 27 Section: Implementation & Roadmap  Too soon to tell exactly what this will look like, but don’t lose sight of this section.

28. 28 Next Steps Discuss organization of work: at Workgroup level; subcommittee level; or create new groups to tackle Plan tasks? Develop Final Plan development timeline. Walk through a list of issues gleaned from the Preliminary Plan. Start to build a list of tasks by topic.

29. 29 Don’t forget to visit the website! https://www.hln.com/clients/vitl