Beacon Community and EHR Vendor Collaboration: A Catalyst for Interoperability and Exchange ONC CMS Meaningful Use Stage 2 Exchange Summit March 18, 2013

Agenda Welcome and introduction to the Beacon Vendor Affinity Group Purpose the Affinity Group Phase 1 Activities – focus on content Pilots and Lessons Learned Phase 2 Plans – focus on MU2 TOC transport Questions 1

Build and strengthen health IT infrastructure and exchange capabilities - positioning each community to pursue a new level of sustainable health care quality and efficiency over the coming years. Improve cost, quality, and population health - translating investments in health IT in the short run to measureable improvements in the 3-part aim. Test innovative approaches to performance measurement, technology integration, and care delivery - accelerating evidence generation for new approaches. The Beacon Community Program: Where HITECH Comes to Life 17 communities each funded ~$12-16M over 3 yrs to:

17 Diverse Communities 3 Hawaii County Beacon Community Hilo, HI Hawaii County Beacon Community Hilo, HI Southeast Michigan Beacon Community Detroit, MI Southeast Michigan Beacon Community Detroit, MI Crescent City Beacon Community New Orleans, LA Crescent City Beacon Community New Orleans, LA Delta BLUES Beacon Community Stoneville, MS Delta BLUES Beacon Community Stoneville, MS Keystone Beacon Community Danville, PA Keystone Beacon Community Danville, PA Utah Beacon Community Salt Lake City, UT Utah Beacon Community Salt Lake City, UT Beacon Community of Inland Northwest Spokane, WA Great Tulsa Health Access Network Beacon Community Tulsa, OK Great Tulsa Health Access Network Beacon Community Tulsa, OK Southeastern Minnesota Beacon Community Rochester, MN Southeastern Minnesota Beacon Community Rochester, MN Rhode Island Beacon Community Providence, RI Rhode Island Beacon Community Providence, RI Greater Cincinnati Beacon Community Cincinnati, OH Greater Cincinnati Beacon Community Cincinnati, OH Southern Piedmont Beacon Community Concord, NC Southern Piedmont Beacon Community Concord, NC San Diego Beacon Community San Diego, CA San Diego Beacon Community San Diego, CA Western New York Beacon Community Buffalo, NY Western New York Beacon Community Buffalo, NY Colorado Beacon Community Grand Junction, CO Colorado Beacon Community Grand Junction, CO Bangor Beacon Community Brewer, ME Central Indiana Beacon Community Indianapolis, IN Central Indiana Beacon Community Indianapolis, IN

Affinity Group Purpose Promote the adoption, use and interoperability of EHR technology to advance the care improvement goals of impacted communities Phase 1 use cases for CCD exchange (Nov 2011 – Jan 2013): – Update clinical registry or repository – Patient referral Phase 2 – Guidance on MU2 (March – August 2013) – Test required and option transports for Transitions of Care (TOC) and View online, Download, and Transmit (VDT) – Explore implementation across trust exchanges both within and between communities 4

Phase I – Affinity Group (AG) Problems and Goals The AG articulated 6 high priority problems that the group was charted to address – Information Exchange and Interoperability (4) – EHR adoption and Meaningful Use (1) – Quality Measure Reporting (1) AG members laid out specific, time-bounded goals intended to address the identified problems 5

Full Affinity Group Participants 6 Beacon CommunitiesEHR VendorsHIE Vendors Bangor Beacon Community Beacon Community of the Inland Northwest Central Indiana Beacon Community Colorado Beacon Consortium Crescent City Beacon Community Delta Blues Beacon Community Greater Cincinnati Beacon Collaboration Hawaii Beacon Community Keystone Beacon Community MyHealth Access Network (Tulsa) Rhode Island Beacon Community San Diego Beacon Community Southeast Michigan Beacon Community Southeastern Minnesota Beacon Community Southern Piedmont Beacon Community (NC) Utah Beacon Community/IC3 Western New York Beacon Community Allscripts Cerner GE Healthcare Greenway Medical NextGen Healthcare SuccessEHS Vitera Healthcare Solution Caradigm Covisint InterSystems Medicity Mirth Optum/Axolotl Orion Health

Affinity Group Governance ONC Beacon-EHR Vendor Affinity Group Co-Chairs Executive Steering Committee – 5 Beacon and 5 Vendor Representatives that guide the work of the Affinity Group – ONC Representative – Technical Support – Booz Allen Hamilton – Technical and Engagement Work Group co-chairs report out to this group 7

Phase 1 AG Accomplishments Engagement Workgroup (Co-Chair David Smith & Dan Stoke) Technical Workgroup (Co-Chairs David Groves & Tone Southerland) Chronic Illness Training TemplateBeacon Technical Discovery Guide Transitions of Care & Meaningful Use Document Beacon User Stories Version 1 & 2 Update Clinical Data Repository and Disease Registry Patient Referral User Group GuidelinesBeacon Vendor C83 Data Element Analysis Version 1 Vendor Evaluation Matrix/ROI WorkbookWork Product Descriptions/How to use guide for the C83 Data Element Analysis sheet Vendor Fair GuidelinesGlide path from HITSP C83 to CCDA –White Paper Post Live Playbook Versions 1 (Version #2 in production) Vendor Quality Measure Collection 8 *This document provides an overview of each of the Beacon-EHR Vendor Engagement & Technical Work Group work products developed between January and December 2012

C83 Pilot Project Process Goals of the C83 pilots – Sharing 66 high priority data elements Ability to keep vendor IP confidential while providing value to the participants Moving towards Stage 2 Meaningful Use – CCD Workflow 9

Phase 1 - C83 Pilot Metrics 10 GRAND TOTAL (LIVE + PLANNED)

11 Sample CCD Workflow

Phase 1 - C83 Pilot Project Results Recognized benefits of collaboration Positive impact for patients Willingness to continue towards MU2 – Direct needs to become “Real” – Vendors/communities are struggling with standards – Natural AG progression from MU Stage 1 focus 12

Mapping Data Elements to MU2 13 C-CDA Data Requirements 21 of the 36 MU2 data requirements are supported by the Beacon C83 data elements (58%) 15 of the 36 MU2 data requirements are not supported by the Beacon C83 data elements (42%) Beacon C83 Data Elements 55 of the 66 Beacon C83 data elements support MU2 data requirements (83%) 11 of the 66 Beacon C83 data elements do not support MU2 data requirements (17%)

Phase 1 - Materials/Case Studies Recent White Paper: Glide Path from HITSP C83 to C- CDA: Informed decision making for health information stakeholders: researchers-implementers/reportshttp:// researchers-implementers/reports Direct URL: hitsp_c83_to_ccda.pdf hitsp_c83_to_ccda.pdf Vendors and Communities Working Together: A Catalyst for Interoperability and Exchange: professionals/vendors-and-communities-working- together-catalyst-interoperability-and-excha professionals/vendors-and-communities-working- together-catalyst-interoperability-and-excha 14

Phase 2 – Problems & Goals Problems will focus on required and optional transports for Transitions of Care and View online, Download, & Transmit as well as exchange across trust communities Goals Educate others Build off existing work of others Leverage Beacon AG established work ID and engage community partners Support MU2 TOC and VDT member certification Pilot/test end-to-end connectivity for TOC Deliver feedback and “Lessons Learned” 15

Affinity Group Participants 16 Beacon CommunitiesEHR Vendors HIE Vendors (as invited by Beacon partners) Bangor Beacon Community Beacon Community of the Inland Northwest Colorado Beacon Consortium Crescent City Beacon Community Delta Blues Beacon Community Keystone Beacon Community MyHealth Access Network (Tulsa) Rhode Island Beacon Community San Diego Beacon Community Southeast Michigan Beacon Community Southeastern Minnesota Beacon Community Utah Beacon Community/IC3 Western New York Beacon Community Allscripts GE Healthcare (TBD) Greenway Medical NextGen Healthcare SuccessEHS Vitera Healthcare Solution Axolotl Medicity Orion Health Covisint InterSystems Mirth

Phase 2 - Affinity Group Governance Affinity Leadership Group – ONC Representative – Technical Support – Booz Allen Hamilton – 2 Co-Chairs (Beacon/Vendor) and 2 Vice-Chairs Full ONC Beacon-EHR Vendor Affinity Group – 13 Beacons and 6 Vendor Representatives that guide the work of the Affinity Group 17

Direct Model 18 Transport Options – Direct (Required) – Direct + XDR/XDM (Optional) – SOAP + XDR/XDM (Optional) TOC Alternative Query-based exchange → eHealth Exchange

Discussion For more information on the Beacon Community Program, please contact and download Beacon Community Fact Sheets at community-program community-program