May 4, 2011
ILHIE Behavioral Health Work Group Members (by phone):
- Attendees (all by phone)
- Connie Christen, Department of Healthcare and Family Services (HFS)
- Mark Chudzinski, Office of Health Information Technology (OHIT)
- Kathye Gorosh, New Age Services Corporation
- Jim Hobbs, Department of Human Services (DHS)
- Marvin Lindsey, Community Behavioral Health Association of Illinois
- Rick Nance, Department of Human Services (DHS)
- Mike Ouska, Lutheran Social Services of Illinois
- Jay Ready, Chicago Lawyer's Committee for Civil Rights & Healthcare Consortium of Illinois
- Tom Remakel, Metropolitan Family Services
Welcome and Review of Minutes
After introductions the minutes from the April 6, 2011, meeting were reviewed and approved by the work group.
Marvin Lindsey reported that the Metropolitan Chicago Healthcare Council (MCHC) announced on April 25, 2011, that MCHC developed the MetroChicago Health Information Exchange (HIE). It is expected to be the largest metropolitan HIE in the nation, serving more than 9.4 million people. More than 66 hospitals and major outpatient care organizations have submitted letters of intent to MCHC to participate in the HIE. Marvin asked what this means for OHIT. Mark Chudzinski said there are seven initiatives throughout the state where various local HIEs are being developed. The status of the local HIEs is on the OHIT Web site. MCHC is the furthest along in terms of implementation but some of the other groups have signed contracts with vendors. OHIT welcomes the news and said the plan is to have local HIEs interoperable and exchanging data with the state level HIE which will be in operation next year.
Update on First Meeting of the State's HIE Authority Board
Mark reported that the first HIE Authority Board meeting was held on April 27, 2011. The HIE Authority Board has been delegated authority over HIE and Electronic Health Record (EHR) implementation and activities in the state. Structural details of the board were focused on at this first meeting. Dr. Cheryl Whitaker was elected as Chair of the Board and was sworn in, along with the eight board members and five ex-officio members. The board also discussed the adoption of by-laws, the board meeting schedule and the adoption of rules for public comment. It is expected that at the next Authority Board meeting they will be considering the appointment of an Advisory Committee, which is required by legislation. The board may adopt a regulation in the near future which will require all existing HIE efforts to be interoperable with the state effort.
OHIT will be releasing a Request for Proposal (RFP) in the next few weeks for the acquisition of a system by this fall. Rick Nance inquired if the RFP is for purchasing a hardware infrastructure. Mark said that OHIT will not be purchasing hardware and will be using Cloud Architecture Services instead. Initially, the state level HIE envisions offering core services to the other HIEs. Those core services include: a master patient index, a record locator service, a provider directory, a payor directory and a public health directory.
Discuss Consent Survey Recommendations
Marvin Lindsey opened the discussion saying that the draft executive summary was sent to this group and Work Group members were asked to provide recommendations that can be sent to the HIE Advisory Committee. The group discussed having a client or a parent take the survey and provide input. It was also discussed that perhaps a parent or client could be part of the Work Group. Kathye Gorosh suggested that there be a venue for ongoing suggestions from consumers. Mike Ouska suggested that the Group include this information in the report to the Advisory Committee, saying that the Group is looking into consumer input.
Mike Ouska reported that there was a clear majority of survey respondents that want opt in, versus opt out, and 80% of respondents practice a granular form in their current process. 69% feel that the HIE should be that way as well. Discussion took place on whether the group should recommend opt in, on a granular consent model, to the Authority Board. Marvin Lindsey inquired if the granular consent model technology has caught up with some of the things we're asking it to do. Mike Ouska said that he saw demonstrations of three EHRs and all of them had some capability of segmenting records, and that also allowed certain individuals access to records or part of a record. Tom Remakel commented that the granular consent model technology maintenance could be a substantial administrative burden, whentrying to keep track across multiple providers who have consent, and what they have consent for.
Jim Hobbs said that he assumed that the consent to participate in an HIE was done one time at a high level, and that in no way does it take the place of granular consent. Jim did not think that we were moving toward a global consent, and that the granular consent process would still need to be done. Mark Chudzinski pointed out that a global consent under the current wording of the Mental Health and Developmental Disabilities Confidentiality Act is open ended, and is not permissible by law. There are specific provisions regarding the consent that prevents it from being blanket and unlimited in time, which is a problem for the HIE. Mark said that the Group should be aware of Illinois Senate Bill 1234, which creates a carve-out for all of a patient's records to be disclosed without consent, for purposes of treatment and coordination of care, if the patient receives Medicaid or Medicare services. SB 1234 will be discussed further during the next Work Group conference call.
Discussion took place on what to recommend to the Advisory Committee. It was discussed, but no formal decision was made that the Group should recommend granular consent as long as it can be implemented without an excessive administrative burden. Mark Chudzinski suggested that the Work Group consider use cases to assist the Group in their recommendation. Mark will send links to current Use Case information.
The next meeting is scheduled for Thursday, June 2, 2011, from 3:30 p.m. until 4:30 p.m.