1. Steering Committee Presentation
IT Committee

2. Overall Approach DSRIP Project Goals
Health Information Exchange
Centralized Analytics
Electronic Medical Records
Actively Engaged Patients
The IT Committee met with each individual project workgroup to
identify each projects’ initial IT needs and requirements. The
requirements fell into a few categories.
The IT Committee analyzed each project workgroup's
requirements to determine the priority and scope of
the IT Implementation. In order to focus the IT
deployment on the most critical organizations to meet
the DSRIP Project goals, the IT Committee prioritized
Organizations based on PPS engagement.
The IT Committee recognizes the IT strategy is an iterative
approach and IT requirements will evolve as the projects deploy.

3. Prioritizing Organizations: Approach
Based on the Listing of Organization Engagement (reviewed by Steering), the IT Committee quantified organizations based on their involvement in the Projects, Committees, Cross Functional Workgroups, and many other factors. Organizations that scored a 14 or greater were chosen as the first wave of organizations. The organizations are as follows:
Visiting Nurse Service of New York
Community Care Management Partners LLC (CCMP)
Comunilife
Dennelisse Corporation
Hudson Heights IPA
Bronx Lebanon Hospital Center
Vocational Instruction Project Community Services, Inc.
Bronx Health Home
Urban Health Plan
Dominican Sisters Family Health Service Inc.
Community Healthcare Network, Inc.

4. Health Information Exchange: Phased Approach
The Health Information Exchange deployment will occur in Phases. Below are the Phases with anticipated functionality:
Phase 1:
Data will flow bidirectionally where appropriate (Alerts, Direct Messages).
All data outlined in the next slide will be viewable centrally at the HIE via VHR(Provider Portal) and/or Spectrum.
Custom reports will also be available through the Bronx RHIO
Phase 2 and 3:
For organizations that would like to consume the data into the EMR, we must determine if the organizations EMR vendor can consume data and work with the organizations HIM/data governance department.
Referral tracking and Scheduling data for no shows
As the IT Committee gathers additional requirements from the project workgroups, the scope of Phase 2 and 3 will expand

5. Health Information Exchange: Phase 1
Scope: The first phase of deployments will focus on exchanging:
Encounter Level Data(Patient Demographics, Provider, DOS, ICD9/10, CPT-4, Allergies), Consent, Laboratory, Text Reports, Medications, Messages between providers (Direct), Alerts, and Select project workgroup assessments: LACE Index score, PHQ2, PHQ9, and SBIRT
IT Committee Expectations: Bidirectional dataflow where appropriate (Alerts, Direct Messages). All other data (outlined above) will be viewable centrally at the HIE via VHR(Provider Portal) and/or Spectrum.
Timeline: The first wave of deployments will occur in TBD contingent on EMR and HIE vendor
Expected Cost: Each PPS Participating Organizations will need to connect to the RHIO. See Tiered RHIO payment model (See Appendix) for details.
Note: Each EMR vendor may have separate integration and ongoing costs to Integrate into the RHIO
Additional Notes:
The Care Coordination data is dependent on the vendor(s) and care plan standardization
For some assessments that are not fully defined, these may not be exchanged (e.x. Asthma Assessments) until they are standardized
Not all facilities will exchange all data listed above (under scope)
Organizations will have the option of a single sign-on function (context specific) if their EMR Vendor supports it.

6. Centralized Analytics and Reporting: Phase 1
Scope:
Prioritized Clinical Performance Metrics outlined in Attachment J
Both the RHIO and PPS are responsible for this item
Prioritized based on the largest gap to goal measures and feasibility
Actively Engaged Reports
Registries that include: Sticky PCP, Prescriptions filled/missed*, flags for patients of each project, patients falling off Medicaid eligibility*
Expectations: For all RHIO and PPS members, all information are viewable via provider portal, centralized analytics dashboard, and custom reports. Drill down is available with patient consent.
Timeline: The Analytics software is expected to go live in DY2 Q1 (April 1st 2016)
Expected Cost: The PPS will get charged based on the size of population, # of end users and # of reports (Expected pricing to be complete by XYZ
Additional Notes:
As projects mature, IT expects additional report requests from Project Workgroups
Nurse Family Partnership Database integration is in discussion
Custom Reports will involve working with a data analyst to create reports
* Dependencies

7. Actively Engaged Reporting
Scope: The Bronx RHIO will aggregate all Actively Engaged templates. The RHIO will receive the data in the following ways:
Organizations that are not fully integrated with the RHIO will extract data from the local EMR into a template and upload securely to the RHIO
For organizations fully integrated with the RHIO, the RHIO will collect information via existing data feeds.
Note: For certain projects that use a custom screening tool, the RHIO will need supplemental data exported out of the local organization’s EMR.
Expectations: Each organization participating in the PPS will create a data extract. Data extract template to be provided by IT Committee.
Timeline: The extraction template will be completed in the July. The RHIO will accept extracts by XYZ.
Expected Cost: Included in the previous slides price.
Additional Notes:
Some project workgroups and DOH continue to define the Actively Engaged criteria and templates
The RHIO has a strong patient matching algorithm, which enables aggregation
Organizations need to build out standardized screening assessments in the EMR

8. Unknown Variables Care Coordination Platform Integration and Decisions
Financing of IT Solutions:
EHR and PCMH: Initial procurement, technical support, developing policies and procedures, and assistance for existing users
HIE Support: Financing of the RHIO fees
Provider Directory and CRM Procurement
The number or scope of Project workgroup requests for EMR Functionality, Health Information Exchange, and Reporting
Other unidentified IT solutions needed by project workgroups

9. Appendix

10. Electronic Medical Record Functionality
Any EMR requests should go directly to the local IT department of the organization. This includes:
Template creation
Hard Stops in the EMR
Assessments
Flags to identify DSRIP Patients
Local patient registry reports
If the data must flow through the Health Information Exchange or reported centrally, these requests should go to the IT Committee.

11. What can the Project Workgroups do?
In order to exchange data on a patient, a unique identifier must be captured. In compliance with your organizations procedures, the IT Committee requests organizations collect as many of the following fields:
Data Element
Note/Values
MRN
Last Name
First Name
Middle Name
Street Address1
Street Address2
City
State
ZIP
5 or 10 digits
DOB
yyyymmdd
Data Element
Note/Values
Gender
M, F; discuss if other values created
SSN
9 digits, no dashes; send if known
Home Phone
(123)
Work Phone
Race
Ethnicity
Marital Status
Religion
Medicaid ID

12. What can the Project Workgroups do?
Documenting Point of Care Tests, Vitals, and Demographics: Staff need to document any POC in structured data fields and not in free text(a note or message). For example, this is important for example when capturing a POC A1c test. If the A1c test is only documented in the note, the PPS will not get the credit for the A1c.

13. ANNUAL RHIO PARTICIPATION FEES (2015)
Participant Type
Fee
Hospital
$130,000
Payor Organization/Health Plan
$45,000
Long-Term Care Facilities
Small
$5,000
Medium
$10,000
Large
$25,000
Home Health Organizations
Community Health Centers
Private Physician Practices/Allied Health Professionals
1 Physician or Licensed Professionals
$260
2 to 4 Physicians or Licensed Professionals
$500
5 to 10 Physicians or Licensed Professionals
$1,000
11 to 15 Physicians or Licensed Professionals
$3,000
16 to 20 Physicians or Licensed Professionals
21 or More Physicians or Licensed Professionals
Health Home Member (Not Otherwise Classified)
PPS Member (Not Otherwise Classified)
RFI Areas Addressed:
Data Capture and Access
Data Governance and Management

14. CONNECTING TO THE RHIO
We will provide you with our Implementation Manual to review. It includes information about :
Patient demographic data we need for identifying and linking patients across provider sites
Clinical and utilization data we would like to receive
File formats and file transmission information
Description of our process for working with you to create and test the data feeds
We meet with your IT staff and system vendor to discuss what data will be sent, how it will be configured and review the process to create and test the feed.
The process goes a little more quickly with a vendor we have worked with before and we have experience working with 15 EMR vendors
We are happy to start working with new vendors and will move forward with them as quickly as possible.
WE ARE FLEXIBLE IN WORKING WITH OUR MEMBERS TO BRING DATA INTO THE RHIO
We take “flat files” (Excel or CSV format) from sites that do not have EMR systems
We take HL7 feeds from sites with EMRs
We will work with you to make it as easy as possible to connect to us!
RFI Areas Addressed:
Data Capture and Access
Data Governance and Management