1. Beacon Community Program Build and Strengthen – Improve – Test innovation Beacon-EHR Vendor Full Affinity Group June 7, 2013

2. Full AG Roll call – Lynda Rowe Meaningful Use Stage 2 Pilot Option Review Highlighting Options with HIE Vendor Numerator/Denominator Calculation – Lynda Rowe Update on Beacon Transport Pilot Progress – Chuck Tryon/Al Donaldson/Bruce Weigend Combined User Story Document Review (Displayed on Webex) – Lynda Rowe Wrap up/Next Steps – Chuck Tryon Today’s Goals 1

3. Possible Pilot Scenarios 1 - 5 2 Pilot # Query OR Push Provider A Transport Method Certified Transport Entity Transport Method To Provider B C-CDA Generation MU 2 Metric Reporting Description Pilot 1 PushDirect (SMTP + S/MIME) EHR TechnologyTransport is directly from provider A Provider A EHR EHR Supports all aspects of DIRECT Transport Pilot 2 PushAny Edge Protocol HISP /HIE/HIODirect (SMTP + S/MIME)HISP/HIE/HIOHISP/HIO/HIEHISP/HIE/HIO must be certified to the TOC objective, i.e. support The Direct Applicability statement/produce a C-CDA Pilot 3 PushAny Edge Protocol EHR module Certified with Associated HISP/HIO (relied upon software) Direct (SMTP + S/MIME)EHR Vendor and relied upon software EHR vendor + relied upon software must meet MU2 criteria Pilot 4 PushDirect (SMTP + S/MIME)+ XDR/XDM EHRTransport is directly from provider A Provider A EHR Same as Pilot 1, except adding the optional XDR/XDM transport Pilot 5 PushAny Edge Protocol HISP /HIE/HIODirect (SMTP + S/MIME)+ XDR/XDM HISP/HIE/HIOHISP/HIO/HIEHISP/HIE/HIO must be certified to the TOC objective, i.e. support The Direct Applicability statement/produce a C-CDA

4. Possible Pilot Scenarios 6 - 10 3 Pilot # Query OR Push Provider A Transport Method Certified Transport Entity Transport Method To Provider B C-CDA Generation MU 2 Metric Reporting Description Pilot 6PushAny Edge Protocol EHR module Certified with Associated HISP/HIO (relied upon software) Direct (SMTP + S/MIME)+ XDR/XDM EHR Vendor and relied upon software EHR vendor + relied upon software must meet MU2 TOC criteria Pilot 7PushSOAP + XDR/XDM EHR – Must be certified for optional SOAP transport Transport Directly From Provider A Provider A EHR EHR Hosted SOAP + XDR/XDM Pilot 8QuerySOAP + XDR/XDM EHR – Must be certified for optional SOAP transport Any Transport via an HIE/HIO/HISP Provider A EHRHISP/HIO/HIEContent may be repackaged by HISP/HIO for provider B Pilot 9Push OR Query Any TransportHIO as an eHealth Exchange participant Query or push to provider via eHealth Exchange certified protocol Provider A EHRHIO eHealth exchange participant HIO must be a certified eHealth Exchange participant Pilot 10 QueryAny Certified Transport CEHRT natively or with relied upon software None- Query basedProvider A EHRHIO/HIE/HISPProvider A must be using CEHRT

5. Vendor Pilot Options 4 PilotSendReceive BeaconVendorBeaconVendor 1: Direct - EHR vendor complete certification Crescent City, Tulsa,SE MISuccess EHS (not yet in production) Cincinnati, Inland NW, RIQI, Tulsa, UtahNextGen UtahVitera Crescent City, SE MI, TulsaSuccess EHS 2: Direct - HIE/HIO/HISP modular certification Inland NW, ? Tulsa & KeystoneGreenwayCincinnati, Inland NW, RIQI, Tulsa, UtahNextGen Cincinnati, Inland NW, RIQI, Tulsa, UtahNExtGenUtahVitera UtahViteraCrescent City, SE MI, TulsaSuccess EHS Crescent City, SE MI, TulsaSuccess EHS Keystone, Southeast MI, WNY, Utah (Pro Only)AllScripts (Pro & Ent.) To HIO Keystone, Southeast MI, WNY, Utah (Pro Only)AllScripts (Pro & Ent.) Need HISP 3: Direct - EHR vendor + relied upon software Cincinnati, Inland NW, RIQI, Tulsa, UtahNExtGenCincinnati, Inland NW, RIQI, Tulsa, UtahNExtGen UtahVitera UtahVitera Crescent City, SE MI, TulsaSuccess EHS Keystone, Southeast MI, WNY, Utah (Pro Only)AllScripts (Pro & Ent.) Need HISP Keystone, Southeast MI, WNY, Utah (Pro Only)AllScripts (Pro & Ent.) Need HISP 4: Direct + XDR/XDM - EHR vendor complete certification Not Technologically Feasible at This Time 5: Direct + XDR/XDM - HIE/HIO/HISP modular certification Inland NW, ? Tulsa & KeystoneGreenwayCincinnati, Inland NW, RIQI, Tulsa, UtahNextGen Cincinnati, Inland NW, RIQI, Tulsa, UtahNExtGen UtahVitera Crescent City, SE MI, TulsaSuccess EHS Keystone, Southeast MI, WNY, Utah (Pro Only)AllScripts (Pro & Ent.) To HIO Keystone, Southeast MI, WNY, Utah (Pro Only)AllScripts (Pro & Ent.) Need HISP

6. Vendor Pilot Options 5 PilotSendReceive BeaconVendorBeaconVendor 6: Direct + XDR/XDM - EHR vendor + relied upon software Cincinnati, Inland NW, RIQI, Tulsa, UtahNextGenCincinnati, Inland NW, RIQI, Tulsa, UtahNExtGen Keystone, Southeast MI, WNY, Utah (Pro Only) Allscripts (Pro & Ent.) Need HISP Keystone, Southeast MI, WNY, Utah (Pro Only)Allscripts (Pro & Ent.) Need HISP 7: SOAP + XDR/XDM - Push from EHR to EHR Inland NW, ? Tulsa & KeystoneGreenway (XDS & XDR) Inland NW, ? Tulsa & KeystoneGreenway (XDS & XDR) Cincinnati, Inland NW, RIQI, Tulsa, UtahNExtGenCincinnati, Inland NW, RIQI, Tulsa, UtahNExtGen Crescent City, SE MI, TulsaSuccess EHS (XDS & XDR) Crescent City, SE MI, TulsaSuccess EHS (XDS & XDR) Keystone, Southeast MI, WNY, Utah (Pro Only) Allscripts (Pro & Ent.)Keystone, Southeast MI, WNY, Utah (Pro Only)Allscripts (Pro & Ent.) 8: SOAP + XDR/XDM - Push to HIO/HISP/HIE who forwards to Provider B Inland NW, ? Tulsa & KeystoneGreenway (XDS & XDR) Inland NW, ? Tulsa & KeystoneGreenway (XDS & XDR) Cincinnati, Inland NW, RIQI, Tulsa, UtahNextGenCincinnati, Inland NW, RIQI, Tulsa, UtahNextGen Crescent City, SE MI, TulsaSuccess EHS (XDS & XDR) Crescent City, SE MI, TulsaSuccess EHS (XDS & XDR) Keystone, Southeast MI, WNY, Utah (Pro Only) Allscripts (Pro & Ent.)Keystone, Southeast MI, WNY, Utah (Pro Only)Allscripts (Pro & Ent.) 9: EHR to an eHealth Exchange push to or query from Provider B Possible in All Environments as Long as Transport From eHealth Exchange Participant is Supported. 10: CEHRT to an HIO/HIE/HISP - Query by Provider B Possible in All Environments With Differences in the Types of Transport Supported. EHR sending vendor must support one CEHRT transport

7. Beacon Pilot Progress Tulsa – In Progress Pilot options are being reviewed and work plan developed South East Michigan – In Progress Initial meetings have taken place to discuss possible pilot options Western New York – In Progress Hosted internal discussions last week, Lynda Rowe will follow up regarding possible pilot options San Diego – In Process Initial meetings have taken place to discuss possible pilot options, and follow up meetings scheduled Utah – In Progress Already working on DIRECT pilots with clinics in the community, open to discussing other pilot options Keystone – Not Able to Run Pilots at This Time 6

8. Wrap Up/Next Steps 7 Final comments All attendees Co-Chairs: Chuck Tryon Next steps Conclusion