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The Ever Evolving Federal HIT/HIE Landscape
Valerie Grey
Executive Director
New York eHealth Collaborative
June 19, 2019
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A Walk Down Memory Lane
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21st Century Cures Act – Late 2016
Interoperability was a central focus
o Strengthening infrastructure
o Promoting & Protecting Privacy and Security
o Facilitating Patient Access & much more…
Established HITAC
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2018 Developments …
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2019 Developments …
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More 2019 Developments!
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A LOT of Details …. What Does it All Mean????
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Federal Proposed Rules Themes & Goals
• Freeing and sharing data should be the norm
• Leveling the playing field and ensuring choice
• Patient access and empowerment
• Innovation - FHIR based APIs as a tool
CMS Rule
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Hospital Notifications
ALERT!
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Health Plan Trusted Exchange Participation
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Patient Healthcare Claims
Super Charged …
Mixed Opinions
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ONC Rule
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• Who does it apply to and what is it?
o Applies to a health care provider, health IT developer, health information exchange, or health information network
o Any practice that, except as required by law or specified by the Secretary as a reasonable and necessary activity, is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (EHI)
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Information Blocking
• Proposed Exceptions
o Preventing harm
o Promoting the Privacy of EHI
o Promoting the Security of EHI
o Recovering costs reasonably incurred
o Responding to requests that are infeasible
o Licensing of Interoperability Elements on reasonable and non-discriminatory terms
o Maintaining and Improving Health IT performance
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Information Blocking
Major Penalties and Implications for Non-Compliance
• APIs “without special effort”o Standardized
o Transparent
o Pro-competitive
• There’s an app for that ….
• Patients must get their health data for free
• Limits on what others can be charged
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Patient Access on FHIR
EHR Certification
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Gag Clauses Screen Shots EHR Reporting Program
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USCDI – the New CCDS
Additional Requests for InformationONC & CMS
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Pricing
Left Behind Sectors
Opioids
Patient Matching
And Others …..
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Mixed Opinions
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Trusted Exchange Framework
TEF SHIN-NY
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Mirror Images?
Yes and No
• Develop, update, implement, and maintain the CA
• Identify, designate, and monitor QHINs
• Modify and update QHIN Technical Framework
• Public listening sessions
• QHIN noncompliance
• Sustainability strategies26
Recognized Coordinating Entity
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TEF Permitted Purposes
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TEF Modalities & Services
Access/Consent
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Sources: State HIE Consent Policies, 2016, US Census Bureau, Texas State Library & Archives Commission
Value Proposition
Need for More Clarity
RCE objectivity
Alignment
TimelinesConsumer awareness
Leverage Existing
NetworksConsent
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Key Issues Include
We have weighed in with detailed comments on all 3 proposals, our main points
✓We support goals✓Some changes needed✓Leverage SHIN-NY
You can find our detailed comments here:
https://www.nyehealth.org/nyec-submits-comments-to-cms-and-onc-on-21st-century-cures-implementation/
www.nyehealth.org/tefca
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New York eHealth Collaborative
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The Latest SHIN-NY Stats (April 2019)
100% of Hospitals
66% of Clinics
57% of Physician Practices
About 80% of Long Term Care*
OVER 57 MILLIONAlerts Delivered
OVER 20 MILLIONPatient Record Returns (Via EHR & Clinical Viewer)
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Executing on Roadmap
Ensuring Strong HIE Foundation
Supporting Value-Based
Care
Enabling Interoperability and Innovation
Promoting Efficiency and Affordability
Advocating Collectively SHIN-NY value studies, whitepapers, videos and other resources:
http://www.nyehealth.org/shin-ny/value-of-hie/
Formulating Post-2020 SHIN-NY Strategic Plan
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Will likely touch all of these areas ….. Your Full Day Ahead!
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Implications are sweeping
Robotic Automation
Natural Language Processing
Artificial Intelligence
Wearables
Digital Assistants
Consumer Engagement
Patient Portals & Access
Social Determinants of Health
Future of DSRIP
Value Based Care
It will be on all of us to work together and ensure the implementation keeps that quadruple aim at the center!
40 Worth Street, 5th Floor New York, New York 1001380 South Swan Street, 29th Floor Albany, New York 12210
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