1. HLN Consulting, LLC® November 8, 2006
Vermont Health Information Technology Plan Development Project Principles
HLN Consulting, LLC®
November 8, 2006
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2. Why Principles? They help establish shared understanding and language
They serve as guides for other decisions down the line
They should be resilient enough to endure the balance of the planning and implementation phases
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3. Five Groups Project Planning Data Interoperability Applications
Infrastructure
Organization
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4. Project Planning
Role of HIE: Health Information Exchange is an important component of Health Information Technology (HIT) and will drive improvements in the overall healthcare system.
Practical Now, Ideal Later: While the project needs an appropriate vision of the future, compromises will need to be made now to ensure forward progress within the frame of practical implementation.
Evolving Plan: The technology plan evolves, with as smooth transitions as are possible to new technologies to reduce severe impacts on infrastructure and investments.
Agree to Disagree: When diverse sets of stakeholders engage on complex issues, disagreements are inevitable. Civility will reign in reaching consensus agreements.
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5. Project Planning (continued)
Plan as a Living Document: We expect the plan to be a living, evolving document once it is released. This will allow adaptation to changing circumstances and evolving standards. The challenge will be not to change the rules too precipitously.
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6. Data Interoperability
Common base of data: A common base of data must be created to facilitate sharing and minimize redundancy. This data may be physically or logically consolidated (there may or may not be a central database).
Comprehensiveness: It is important to create as comprehensive a patient record as possible, and to consider the complete patient record.
Accuracy: Data must be accurate and complete (there is often a tradeoff between these two). Clinical data must be reviewed by an appropriate person to ensure accuracy.
Timeliness: Data must be available in as near real-time as possible from the point of creation.
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7. Data Interoperability (continued)
Security and confidentiality: Data must be safe from harm and accessible only to those with a "need to know." More specific rules should delineate the boundaries around data access from all perspectives (patient, provider, payer, others).
Ease of access: Data must be easy to access for all groups of authorized users regardless of their level of technical expertise. Ease of use comes first and foremost for healthcare providers who access systems.
Multiple uses: While the primary use for data is clinical support, the project must plan for multiple uses of data, including research, planning, evaluation and public health surveillance.
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8. Data Interoperability (continued)
Structural Redundancy: Data is captured in many systems and sources, and such redundancy is unavoidable.
Documentation: Detailed information about data must be created, maintained, and made available to assist in data quality assurance.
Population-based: Records should be populated prospectively, starting with birth record information, and retrospectively using historical information, to construct as complete a health record as possible. Accurate patient matching is crucial to this capability. Accommodation needs to be made for patients who are born outside of the State to ensure that their records are included.
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9. Applications
Ease of use: Applications must be easy to use for both novice and expert users, and should pose minimal adverse impact on existing business and clinical processes and activities.
Consistency: Interfaces should be similar enough to present a consistent look and feel to the user, though different interfaces might be necessary for different types of users.
Adaptability: Applications must be easily adaptable to changing functional and technical requirements.
Ensuring data quality: Applications must help ensure valid, consistent, and secure data while presenting minimal obstacles to smooth and efficient use.
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10. Infrastructure
Secure Identity and Access Rights: User identities should be immune from repudiation, and access rights should be traceable and verifiable.
Platform Neutrality: There are no predetermined platform architectures.
Reliability: Systems must operate reliably and be resilient to natural or technical disasters.
Leverage Networks: Wherever possible, existing networks should be leveraged to minimize cost and complexity.
Use of the Internet: Wherever possible, secure use of the Internet as a wide-area network should be supported and encouraged.
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11. Infrastructure (continued)
Standards: Where relevant, national, state, and local standards for healthcare information technology should guide technical decisions. Standards need not be applied uniformly – they will likely be more rigorously imposed for HIE over some other areas of HIT.
Privacy: Patient privacy should be maintained through appropriate development and implementation of policies involving consent and sharing. The physical implementation of systems should allow for audit and reporting of data access and sharing.
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12. Organization
Support of Mission: Information technology initiatives must support the specific mission and goals of the State.
Cost effectiveness: Information technology must contribute to the cost effectiveness of the processes it supports, and must be cost effective from the point of view of the system-as-a-whole.
Data Stewardship: Data stewards serve as custodians for data in their care, and are responsible (along with all providers and users of data) for ensuring the proper documentation, collection, storage, and use of data within their purview.
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13. Organization (continued)
Governance: The project should have clear and strong processes for governance, consistent with the project proposal and the highest standards of the participants.
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