Health IT Policy Committee and Health IT Standards Committee Work Product Collaboration of the Health IT Policy and Standards Committees Policy and Standards Federal Advisory Committees on Health Information Technology to the National Coordinator Interoperability Experience Task Force Jitin Asnaani, co-chair Anjum Khurshid, co-chair May 11, 2016

Health IT Policy Committee and Health IT Standards Committee Work Product Membership 2 MemberOrganizationRole Jitin AsnaaniCommonWell Health AllianceCo-Chair Anjum KhurshidLouisiana Public Health InstituteCo-Chair Shaun GrannisRegenstrief InstituteMember Ty FaulknerLawrence Technological UniversityMember Janet CampbellEpicMember Larry WolfStrategic Health NetworkMember Phil PosnerPatient AdvocateMember A. John Blair, IIIMedAllies, Inc.Member Jane PerlmutterGemini GroupMember Lawrence GarberReliant Medical GroupMember Christopher RossMayo ClinicMember Kelly AldrichCenter for Medical InteroperabilityMember George ColeAllscriptsMember Jorge FerrerVeterans Health AdministrationFederal Ex Officio Anastasia PerchemONCONC Lead

Health IT Policy Committee and Health IT Standards Committee Work Product Agenda I.Opening Remarks II.Review Hearing Outcomes III.Review Panel Recommendations IV.Recap & Next Steps V.Adjourn 3

Health IT Policy Committee and Health IT Standards Committee Work Product Virtual Hearing Commonly Noted Challenges & Recommended Solutions Panel #1 (1 of 2) Challenges: »Data availability/accessibility Many times patients are unable to transmit data; and sometimes it’s just because organizations are turning it off. Christina C., Get Real Health »Data Blocking »Data Transmission/Data Reconciliation »Unstructured Data Unable to bring unstructured data into EHR in a usable format. Steven L., Sutter Health 4

Health IT Policy Committee and Health IT Standards Committee Work Product Virtual Hearing Commonly Noted Challenges & Recommended Solutions Panel #1 (2 of 2) Recommended Solutions: »Accept Direct communication from patients EMR Technologies should accept Direct communications from patients. Christina C., Get Real Health »Utilize Open APIs Need trusted connections between systems to allow for Direct and Open APIs. Christina, Get Real Health »Standardize Data Elements »Incorporate automated reconciliation of data to remove provider burden Automate reconciliation process to reduce burden on provider and allow for real-time usability. Steven L., Sutter Health 5

Health IT Policy Committee and Health IT Standards Committee Work Product Virtual Hearing Commonly Noted Challenges & Recommended Solutions Panel #2 (1 of 2) Challenges: »Financial incentives »Legacy systems and variability of EHRs limit conformance of acceptable standards Legacy IT infrastructure and clinical workflows to not assume interoperability. Lara S., PatientPing »Regulatory fear/Compliance driven innovation Clarify HIPAA allows for data exchange for the purpose of treatment and identify which states have patient consent laws that supercede HIPAA. John V., Athenahealth »Provider/Practice workflows »Access to real time information (e.g., med reconciliation) is limited »Too much data Future exchange will be challenging because there will be to much data in too many documents from too many structures without standardization. Scott Stuewe, Cerner 6

Health IT Policy Committee and Health IT Standards Committee Work Product Virtual Hearing Commonly Noted Challenges & Recommended Solutions Panel #2 (2 of 2) Recommended Solutions: »Advance and engage providers with interoperability efforts »Limit governance over standardization so as not to stifle creativity and innovation –Improve CCDA specifications beyond MU2 validators Standards have played a real strong role in interoperability….however, don’t allow them to stifle creativity in the industry. Scott C., Cerner »Look at incentives to drive behavior changes, improve usability (e.g., MU) –Promote policy solutions that use consistent outcome-based metrics in order to align incentives »Foster collectives and collaborations to enhance infrastructure 7

Health IT Policy Committee and Health IT Standards Committee Work Product Virtual Hearing Commonly Noted Challenges & Recommended Solutions Panel #3 (1 of 2) Challenges: »Data standardization –Normalize semantic data –Improve data structure/standardization to allow multiple sources (lab, eRX) effective and accurate transmission to EHRs. Daniella M., Keck School of Medicine –Create standardized data warehouse »Policy obstacles –Data blocking and data sharing between organizations There have to be incentives to share your data. Research alone is not a business incentive. Daniella M., Keck School of Medicine »Data reconciliation has become a burden for providers 8

Health IT Policy Committee and Health IT Standards Committee Work Product Virtual Hearing Commonly Noted Challenges & Recommended Solutions Panel #3 (2 of 2) Recommended Solutions: »Develop/Improve policy to reduce interoperability obstacles (focus on privacy and security) Bob Calco, Apex Data Solutions »Engage physicians with a focus on workflow and technology will follow. John K., Indiana Health Information Exchange »Automate reconciliation –Incorporate predictive risk modeling to give providers easy to utilize data to make actionable decisions 9

Health IT Policy Committee and Health IT Standards Committee Work Product Next Steps »Workgroups to review Virtual Hearing feedback »Incorporate feedback to Use Cases »Determine the “top 3-5” high-priority challenged- areas still being impacted »Begin draft recommendations 10

Health IT Policy Committee and Health IT Standards Committee Work Product Workplan 11 Meeting DatesTask Tue, Mar 8, :00pm ET Task Force Kickoff Needs identified by Task Force Wed, Mar 23, :00pm ET Finalize the Use Case Framework Topics for the virtual hearing (time permitting) Wed, Apr 6, :00pm ET Review Use Case Homework Planning for Virtual Hearing #1 Wed, Apr 20, :00pm ET Administrative planning call for hearing (not public) Tue, Apr 26, 2016 – 1:00pm ET Refine the use case framework Fri, May 6, :30am ET Virtual Hearing Wed, May 11, :30am ETSummarize hearing outcomes Begin to draft recommendations Wed, Jun 1, :00pm ETRefine recommendations June 8, Joint HITPC/HITSC MeetingDraft Recommendations presented to HITPC/HITSC Tue, June 21, 2016 – 1:00pm ETRevise and edit recommendations June 23, Joint HITSC/HITPC MeetingRecommendations presented to HITSC/HITPC Tue, July 5, 2016 – 1:00pm ETRevise and edit recommendations