1. HITPC - Information Exchange Work Group Meaningful Use Stage 3 Subgroup 2: Care Coordination and Patient and Family Engagement Co-Chairs: Jeff Donnell and Larry Garber Members: Peter DeVault, Jonah Frohlich, Arien Malec

2. IE Workgroup Timeline DateTopic Wednesday, August 22 nd 1:00-2:00 pm Goals and Objectives for stage 3 Wednesday, August 29 th 10:00- 11:00am ET Goals and Objectives for stage 3 Tuesday, September 4 th, 2:00-3:00pm ET Goals and Objectives for stage 3 IE WG Call - Wednesday, September 5 th, 3:00-4:00pm ET Review SubWG recommendations IE WG Call - Week of September 10 th Finalize recommendations September 18 th MU WG meeting 2

3. Recommendation Options The Subgroup is tasked with reviewing and developing prioritized recommendation in four key areas. The Subgroup has a number of options for addressing these areas including: – Stage 3 – Certification only – Explore in RFC – Push to Stage 4 – No recommendation 3

4. Subgroup 2 Assigned Topics Query for patient record Exchange of Electrocardiography Notification of utilization events (i.e. ED visit/admission) Specifying transition content needed for specific transitions Data portability Query Entity-Level Provider Directory (if time permits) HITPC: MU Workgroup Stage 3 Recommendations 4

5. Proposed Approach DateTopic Wednesday, August 22 nd 1:00-2:00 pm Goals and Objectives for stage 3 Query for patient record Notification of utilization event Wednesday, August 29 th 10:00- 11:00am ET Goals and Objectives for stage 3 Specifying transition content Exchange of electrocardiography Tuesday, September 4 th, 2:00-3:00pm ET Goals and Objectives for stage 3 Data portability Query Provider Directory (if time permits) Finalize recommendations in all areas 5

6. Query for patient record Review existing recommendation language and comments received How does the subgroup want to move forward with this recommendation? Stage 3 Certification only Explore in RFC Push to Stage 4 No recommendation 6

7. Request for Information (New, Menu) Proposed Phase 3 IE WG EP/EH OBJECTIVE: The EP/EH that receives a patient that is typically cared for by another provider of care but has not received a relevant care transition dataset from that provider should perform an electronic query* for patient information from that provider with the patient's consent. EP/EH MEASURE: The EP, eligible hospital, or CAH that receives a patient that is typically cared for by another provider of care but has not received a relevant care transition dataset from that provider, performs an electronic query for patient information from that provider with the patient's consent using certified EHR technology or documents the patient's refusal to authorize the query more than 10 % of the time. *Performing directed queries to specific organizations with standard authorization definitions is critical during unplanned visits. One workflow that must be supported by the certified EHR is to first, electronically request authorization template from releasing organization, and then electronically submit the completed authorization form if no authorization already exists. The advantages to this approach are that it: 1) supports interstate requests where release of information laws differ but need to follow the state that is releasing the data, 2) ensures that the releasing organization has the capability to satisfy the request in terms of data segmentation, and 3) could be done with both DIRECT as well as IHE. 7

8. Notification of Utilization Event A number of HIE across the country are developing notification event. For example when a patient presents at the ED an notification would be sent to the patients PCP. Should this be the triage note? This functionality can help support PCMHs and other new health care delivery models. Other possible Event Notifications: Hospital Discharge Instructions Death What should our recommendation be for each? Stage 3 Certification only Explore in RFC Push to Stage 4 No recommendation 8

9. Next Steps Any resources that should be provided to the subgroup for future calls? DateTopic Wednesday, August 22 nd 1:00-2:00 pm Goals and Objectives for stage 3 Query for patient record Notification of utilization event Wednesday, August 29 th 10:00- 11:00am ET Goals and Objectives for stage 3 Specifying transition content Exchange of electrocardiography Tuesday, September 4 th, 2:00-3:00pm ET Goals and Objectives for stage 3 Data portability Query Provider Directory (if time permits) Finalize recommendations in all areas 9