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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