1. State Alliance for e-Health Conference Meeting January 26, 2007

2. Vision and Goals The State Alliance for e-Health is a consensus based, executive-level body of state elected and appointed officials formed to address the unique role states can play to facilitate the adoption of interoperable electronic, health information exchange (HIE). 1

3. Vision and Goals The work of the Alliance will be guided by the following principles: The underlying goal for achieving a nationwide health information network (NHIN) is to enhance the efficiency and effectiveness of the delivery of health care. Interoperable, electronic exchange will occur in a manner that protects consumers’ health information. HIE networks will provide for the portability of and ready access to health information by consumers and providers. HIE networks will allow for timely exchange of health information to improve population health. 2

4. Vision and Goals The State Alliance shall: Operate in an environment of shared learning, where all members represent an appreciated and important point of view. Identify opportunities and advance recommendations to states for supporting and facilitating the development of a NHIN. 3

5. Vision and Goals Key areas may be emphasized in the initial efforts by the State Alliance and one or all of its taskforces: Privacy and security Licensure of clinicians in HIE Liability in HIE Integration of Public Programs in HIE State Roles in HIE 4

6. Setting Priorities, Health Information Protection Taskforce Examine and recommend actionable solutions to privacy and confidentiality issues in interstate interoperable, electronic HIE. Patient consent processes for provider access to sensitive health information such as HIV/AIDS, minors, and mental health data. Secondary use of data for purposes such as population health management and pay-for-performance programs. Consider state roles in establishing or endorsing best practice standards/guidelines for state practitioners (e.g., clinicians, public health) regarding security of HIE. Patient identity management. Provider identity management. Authentication and Authorization for data sharing. Identify and share state best practices in critical areas of health information protection, such as protecting consumers from medical identity theft. 5

7. Setting Priorities, Health Care Practice Taskforce Develop a background document exploring the legal and professional practice standards that are inconsistent with interoperable, electronic HIE, such as liability and licensure standards, issues. Provider liability associated with the inappropriate release and use of electronic health information. Licensure issues related to providing health care services and medical advice electronically across state lines. Develop best practices and potential harmonization mechanisms for regulatory, legal, and professional standards for the practice of medicine that benefit interoperable, electronic HIE. Patient identity management. Provider identity management. Authentication and Authorization for data sharing. Consider the development of model compacts or policies for allowing the delivery of health services across state lines dical identity theft. Examine existing standards and state laws pertaining to ePrescribing. National standards. State Boards of Pharmacy rules. 6

8. Setting Priorities, Health Information Communication and Data Exchange Taskforce Examine state issues (regulatory challenges, standardization opportunities public program interfaces, and other issues) that emerged from recent HIE demonstrations. Examine financial models for the development and sustainability of HIEs. Identify and Examine potential roles for Medicaid and other public health programs in interoperable, electronic HIEs. 7

9. Setting Priorities, State Alliance for e- Health Develop a background document that includes lessons learned in existing demonstrations and initiatives and state- relevant recommendations made by the American Health Information Community (AHIC). Review recent state legislation and proposals relevant to health information technology (health IT) and interoperable, electronic HIE. Vote on and publicize policy statements, resolutions, and recommendations, including those accepted from the supporting taskforces. 8

10. Taskforce Charges, Health Information Protection Taskforce Support the State Alliance on issues regarding the protection of consumer health information that ensures appropriate interoperable, electronic health HIE within states and across states. Develop and advance actionable policy statements, resolutions, and recommendations for referral to the State Alliance to inform their decision-making process in addressing state-level issues related to preserving the privacy of consumer health information while ensuring appropriate and secure electronic exchange of consumer health data within states and across states. 9

11. Taskforce Charges, Health Care Practice Taskforce Support the State Alliance on issues regarding the regulatory, legal, and professional standards that have an impact on the practice of medicine and create barriers to interoperable, electronic HIE. Develop and advance actionable policy statements, resolutions, and recommendations for referral to the State Alliance to inform their decision-making process in addressing state-level issues related to best practices and the harmonization of regulatory, legal, technical, and professional standards that have an impact on the practice of medicine in interoperable, electronic HIE. 10

12. Taskforce Charges, Health Information Communication and Data Exchange Taskforce Support the State Alliance on issues regarding the appropriate roles for states participation in interoperable, electronic HIE. Develop and advance actionable policy statements, resolutions, and recommendations for referral to the State Alliance to inform their decision-making process in addressing state efforts for interoperable, electronic HIE and the ways in which states can enhance publicly funded programs, through cooperative HIE activities with the private sector. 11