ONC HIT Policy Committee Interoperability and HIE Workgroup Panel 3: State/Federal Perspectives August 22, 2014 Jennifer Fritz, MPH Deputy Director Office of Health Information Technology Minnesota Department of Health

MN Health Information Exchange Oversight Law Minnesota Statute 62J.498 – 62J.4982 Purpose: Provides a Governance Framework to ensure that a patients electronic information follows them across the full continuum of care; To prevent fragmentation, encourage collaboration between market partners, while ensuring the use of HIE national standards so that data integrity is maintained and that information is shared in a safe, secure manner. Currently, Minnesota has 1 State-Certified HIO and 6 State-Certified HDIs 2

Minnesota HIE Oversight Requirements HIOs required to obtain full EHNAC HIE accreditation Both HIOs and HDIs – Not required (but all have agreed to participate so far): – Direct Trust member/participation/EHNAC accreditation for HISPs – MN Statewide Shared HIE Services Look up a direct address Record opt-out of record locator services Standards for query across record locator services Monitor through quarterly reports and annual re- certification requirements 3

Minnesota Statewide Shared Services Health Information Organization Health Data Intermediary Private IDN and ACO EHR Vendor Hub Peer to Peer Interstate HIE and HealtheWay Acknowledgement of Types of HIE Mechanisms in Minnesota* Robust Requirements in HIE Oversight Law Non Profit State Shared Services Architect Included in Oversight Law Direct/Push/Pull HIE protocols may be proprietary May be a HISP and/or provide HISP to HISP connectivity HIE between affiliated providers Common EHR or information system May or may not be using National HIE Standard Protocols EHR may act as HISP- push only EHR may use another HIE Service Provider for HISP services- push and pull Connects Provider A to Provider B Uses Push/Pull/Query but may not be using National HIE Standard Protocols No Standard Trust Agreement Difficult to Scale Push/Pull/Query but may not be using National HIE Standard Protocols Interstate consent needed HealtheWay- developing Nationwide connectivity Currently defined in HIE Oversight Law 4 * December 9, 2013

Example Definitions / Consensus Needed – Governance + Common definition, components, and minimum standards for a strong governance structure from different perspectives/roles (e.g., provider, consumer, intermediary) Common core sets of HIE services and standards that support health care reform Standards for interoperability across services Accreditations/certifications – minimum / recommended Framework/mechanisms for interoperability across entities providing HIE services and for providers/payers seeking to participate in HIE – Consent management/ granular consent / tracking consent / auditing – Clinical data query – Data aggregation Models – Terminology Mapping – Message Conversion – Case/Care and Population Management – Data Access Models – Provider authentication – HIE user directories – Patient matching – Record access logging 5

Questions? Jennifer Fritz – 6