1. New Jersey Innovation Institute Running on FHIR1

2. Who Are We? Van Ly Senior Director, Business Development John Novak
Senior Director, Government Technology and Architecture
S. Arnold Zimmerman, Esq. (“Van”)
Compliance Officer, New Jersey Innovation Institute
Executive Director for the New Jersey Health Information Network

3. What is NJII’s Healthcare Delivery Systems iLab?
Healthcare Focus (obviously)
Reduce Cost
Improve Quality
Improve Access
Improve access to data which can
Improve care delivery

4. What is NJII’s Healthcare Delivery Systems iLab?
Market/Funding Triad
Federal
State
Private (Healthcare Innovation Solutions)
Leverage federal & state funding to develop solutions
Which can be brought to market

5. Projects Practice Transformation Network (PTN/TCPI)
Merit-based Incentive Payment System (MIPS)
Delivery System Reform Incentive Payment (DSRIP)
New Jersey Health Information Network (NJHIN)
Onboarding of Trusted Data Sharing Organizations
Substance Use Disorder Promoting Interoperability Program (SUD/PIP)
Implementation Advanced Planning Document (IAPD) Programs
Network of Quality Improvement and Innovation Contractors (NQIIC)

6. New Jersey Health Information Network (NJHIN)
Healthcare Division

7. New Jersey Health Information Network-The Past

8. NJHIN-Exchanging Data Since 2015
Statewide Infrastructure for Health Data Exchange
Created and owned by the NJ Department of Health
Managed by NJII
Requirement for Charity Care Reimbursement
Future Requirement for Delivery System Reform Incentive Payment (DSRIP)
Leverage Technology to Improve Health Outcomes and Lower Costs
Legal Framework Data Sharing
Data Use and Reciprocal Sharing Agreement (DURSA)
Governance
Advisory Council
Participating Members, or Trusted Data Sharing Organizations
Committees for Compliance and Use Case Development

9. NJHIN Data Highway
In Production
In Development

10. New Jersey Health Information Network-The Present

11. Participating Organizations of NJHIN:
Bergen New Bridge Medical Center
Prime Health*
Advocare, LLC
RWJBarnabas Health
Camden Coalition*
St. Joseph’s Regional Medical Center
Carepoint
St. Peter’s Healthcare System
CentraState
Trenton Health Team*
East Orange General Hospital
Healthy Greater Newark*
Coming Soon
HealthShare Exchange (HSX)*
Hudson Regional Medical Center
Jersey Health Connect*
NJSHINE*
OneHealth New Jersey (MSNJ)*
* Indicates Multiple Organizations are represented by a TDSO

12. NJHIN By The Numbers Hospitals Contributing ADTs Test-68 Live-48
1.9 Million ADTs/Week
Master Person Index
>7,092,000 unique lives

13. Live Today and In Development
Master Person Index (MPI)
Common Key Service (CKS)
ADT Notifications
Health Provider Directory (HPD)
Active Care Relationship Service (ACRS) or Attribution
Transitions of Care (CCDA Routing)
Immunization Registry Query
Immunization Registry Submission
PMP Query (pre-fetch)
Opioid Risk Factors
CCDA Query/Retrieve
Patient App
Risk Assessments (FHIR)
POLST

14. New Jersey Health Information Network-The Future

15. Connecting to NJHIN for Charity Care
"Notwithstanding the provisions of any law or regulation to the contrary, the amount hereinabove appropriated for the Charity Care Subsidy is subject to the condition that participating hospitals shall demonstrate participation in the New Jersey Department of Health’s New Jersey Health Information Network (NJHIN).”
$252 Million in NJ’s Charity Care budget
Nearly 1.1 Million Uninsured in NJ, of which 100,000 are under the age of 18

16. Connecting to NJHIN for Charity Care
68 out of 71 are actively participating in the NJHIN
48 out of 71 are actively sharing ADTs with NJHIN

17. Available Funding for Connection

18. DMAHS and DOH Programs to Support NJHIN Connection
For Medicaid Providers that seek to connect to NJHIN for Transitions of Care and ADT Receiver:
Provider - $1,500 / provider ACTIVELY ENROLLING
Hospitals - $35,000 / hospital OUT OF MILESTONES
Non-Hospital Facilities (SNF, Long Term Care, Sub-Acute, Urgent Care - $5,000 ACTIVELY ENROLLING
Program ENDS: September 30, 2019

19. DMAHS and DOH Programs to Support NJHIN Connection
For Medicaid Meaningful Use Providers that seek to connect to NJHIN for Transitions of Care and ADT Receiver:
Provider - $1,500 / provider ACTIVELY ENROLLING
Program ENDS: September 30, 2019 (seeking extension to support 2020 Medicaid PI Attestation)

20. Promoting Interoperability for New Jersey Substance Use Disorder (SUD) Providers
To address the NJ Opioid epidemic, the Murphy Administration has invested $6 million in the SUD Promoting Interoperability Program (SUD PIP).
Close the EHR disparity amongst SUD providers
Connect “siloed” systems of care to enhance coordination efforts and improve quality
Aid in shorter-term response efforts to this crisis
Increase bandwidth and capacity for treatment

21. Promoting Interoperability for New Jersey Substance Use Disorder (SUD) Providers
Joint Initiative (power of many):
Department of Health
Department of Human Services (Divisions of Medical Assistance and Health Services & Mental Health and Addiction Services)
New Jersey Association of Mental Health and Addiction Agencies
The New Jersey Innovation Institute
SUD Providers
SUD Patients

22. SUD PIP Funding

23. Advancing Interoperability
Playing with FHIR 23

24. What is FHIR?
FHIR® – Fast Healthcare Interoperability Resources (hl7.org/fhir) – is a next generation standards framework created by HL7.
Resourced Bases Framework
A common way to define and represent the resources
A common set of metadata
(a set of data that describes and gives information about other data.)
A human readable part
Open API
What’s an API?

25. What is… SMART on FHIR Blue Button 2.0
SMART, which stands for: Substitutable Medical Applications, Reusable Technologies
Leverages the FHIR standard to normalize regardless of Electronic Health Record being used
Focused on how it interact with the user and application
Think about how you can use your google or Facebook
Blue Button 2.0
Blue Button 2.0 from CMS is an API that contains four years of Medicare Part A, B and D data for 53 million Medicare beneficiaries.
Blue Button 2.0 uses the HL7 FHIR standard for beneficiary data and the OAuth 2.0 standard for beneficiary authorization.

26. What is… What is Argonaut? What is Da Vinci
The Argonaut Project is an implementation community comprising leading technology vendors and provider organizations to accelerate the use of FHIR and OAuth in health care information exchange.
What is Da Vinci
Da Vinci stakeholders are industry leaders and health IT technical experts who are working together to accelerate the adoption of HL7 Fast Healthcare Interoperability Resources (HL7® FHIR®) as the standard to support and integrate value-based care (VBC) data exchange across communities.

27. A short introduction to resources
Medications are just the tip
The ordering, dispensing, administration of medications and recording statements of medication use.
Recording of Immunizations given (or not given), evaluation of given immunizations and recommendations for an individual patient at a point in time.
The creation or querying for medications as part of drug information or drug knowledge.
MedicationRequest
MedicationDispense
MedicationAdministration
MedicationStatement
Medication
MedicationKnowledge
Immunization
ImmunizationEvaluation
ImmunizationRecommendation

28. Consumer Mediated Exchange
Consumer Driven
Consent Management
Advancing Interoperablity
Breaks through the interoperability challenges by empowering the patient to upload, share, and maintain his/her health data. This highly secure application is tailor made for the basic smart phone user.
This process also includes a unique model for a provider to forward documents to a patient or provider that is easy as printing a Document. This eliminates the need for an interface between MiQlave and the provider’s EMR.
The app provides a unique, simple, and secure document sharing process. The patient/owner of the document is able to accept or deny document requests, and does not have to set any preliminary permission rules.

29. What is FHIR is NOT? A silver bullet A programming language Open
It is a framework based on
Open
Different systems expose different recourses
Read only in many cases (we wouldn’t let people change a paper record?)
Mature (Normative yes)

30. What’s Next? FHIR Gateways to access health data
Public Health Access for Submitting to public health resources
State-wide Gateway for Apps to interact
Secure and trusted framework
Authorization
Consumer engagement enhancements
Enabling New Jersey
Blue Button
All of Us

31. THANK YOU