Cracking the Code on Nationwide Interoperability DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Healtheway is the trusted, independent convener of industry and government Works to address the challenges of secure, interoperable nationwide health information exchange (HIE). 2 Healtheway’s Role NATIONWIDEINTEROPERABLESECURE

Current Healtheway Initiatives The eHealth Exchange is the largest health information exchange network in the US Carequality is a public-private collaborative creating a standardized, national-level interoperability framework to link all data sharing networks Copyright © 2015 Care Connectivity Consortium

Largest HIE Network in the U.S. 4 Tech Vendors Federal Govt States PharmaciesPayers HIEs Care Facilities Shared Governance and Trust AgreementCommon Standards, Specifications & Policies

10 Years of Progress 2006 ONC sponsors prototype architectures, followed by trial implementations Focus shifted to supporting production pilots 2009 First production exchange between Social Security Administration and MedVirginia, followed by Veterans Health Administration and Kaiser Permanente 2012 Exchange transitions to Healtheway. Private sector participation increases 2015 Nationwide implementation across 50 states

eHealth Exchange: Benefits 10,000 medical groups 900+ dialysis centers 8200 pharmacies Supporting more than 100 million patients All 50 states Four federal agencies (DoD, VA, HHS including CMS, and SSA) 30% of U.S. hospitals BenefitHow eHealth Exchange Achieves Benefit Reducing Costs Using common standards, legal agreements and governance enables participants to reduce legal fees and avoid building custom interfaces with trading partners. Improving Clinical and Business Decisions Access to a nationwide data sharing network provides secure access to the comprehensive health data that healthcare providers, pharmacies and payers require to improve clinical decision making, patient safety, process improvement and fair payment. Exchanging Data with Government Agencies Federal participation in the eHealth Exchange supports data sharing among all participants and with agencies such as Centers for Medicare & Medicaid Services, the Department of Defense, the Social Security Administration and the Department of Veterans Affairs. Planning for the Future Because the eHealth Exchange is governed by a representative set of participants, its multi-purpose interoperability platform has the ability to evolve and incorporate new use cases, standards, etc.

Improves Care Coordination and can reduce medical errors Expedites Social Security Benefits for the disabled Ensures that individuals with End Stage Renal Disease receive the highest quality of care Allows access to critical information such as test results, medication history and allergy information is available to providers when the patient is transferred to another service. Enables exchange with government providers with national level ROI Can earn credit for MU2 Transitions of Care Measures Supports active duty military, retirees, their families, and veterans throughout their care by making it possible for medical records to follow the patient PATIENTS PROVIDERS ACTIVE DUTY MILITARY, RETIREES, AND VETERANS How does the eHealth Exchange impact us?

Innovation Strategy AUGMENT Increase connectivity to other care settings Improve content & patient matching Identify high value transactions MODERNIZE Review legal framework, specifications, policies Federated HPD Expand supported transport protocols (e.g. Direct and FHIR) ACCELERATE Rapid Onboarding Strategy Enhance Testing Program INNOVATE 150+ Participants Increased adoption, transactions, connected providers

Carequality Accelerating seamless, interoperable health information exchange

What if you had a cell phone plan that only allowed you to call other customers of your carrier? That’s the situation for most healthcare providers today, when they join a data sharing network. The Challenge

The Solution Carequality creates a standardized, national-level interoperability framework to link all data sharing networks Carequality is creating a web of interconnected networks

A Trusted Approach Collaborative Multi- Stakeholder Open Real- World Carequality is Managed by Healtheway is a nonprofit acting for the public good. It convenes industry and government to address common interoperability challenges. Carequality’s strength lies in its diverse stakeholder base. We approach the interoperability challenge from all sides.

The Carequality Community Physicians Consumers Government Agencies Data Sharing Networks Payers Behavioral Health Acute Care Long Term/ Post-Acute Care Hospice and Home Care Research Public Health Vendors Standards Development Orgs. Pharmacies EMS Services

Carequality Members

Common rules of the road: In order for the varied participants to trust each other with health information, everyone needs to have a legal obligation to abide by the same rules. Well-defined technical specs: Shared rules are not enough; clear standards must be laid out in an implementation guide that all implementers can follow. A participant directory: To connect using the common standards, systems must know the addresses and roles of each participant. Essential Elements

February 2014 Carequality Launch May 2014 Operating Principles & Governance Model June 2014 Steering Committee Formed Aug/Sept 2014 Advisory Council & Work Groups Chartered January 2015 Principles of Trust Adopted April 2015 Initial Rollout Kickoff A Brief History

Carequality Initial Rollout Begins: APRIL 2015! Initial Use Case Implementation Guide: Implement the technical, business, and policy requirements outlined in the Query Use Case Implementation Guide, and provide feedback to inform the version of the Guide adopted for general public use. Legal Framework for Exchange: Provide feedback on Carequality’s legal framework, and implement the standardized terms once they are adopted. It’s not too late to participate in the initial rollout! For information, contact

Demos: - Interoperability Showcase & - Main Conference Exhibit Floor Booth #8448