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Clinical Quality and Integration Work Group Minutes - February 1 2011 

February 1, 2011

James R. Thompson Center, 100 W. Randolph, OHIT Conference Room 2-201, Chicago

Attendees (phone and in-person):

  • Farrell Davies, Heartland Community Health Clinic
  • Stephen Sproul, Advocate Health Care
  • Laura Zaremba, Office of Health Information Technology (OHIT)
  • Wes Valdes, OHIT/UIC
  • Mary McGinnis, OHIT
  • Saroni Lasker, OHIT
  • Patricia Nedved, Rush University Medical Center
  • Paige Pfenninger, Alexian Brothers Health System
  • Chris Monovich, Pfizer
  • Dave Scroll, Advocate Health Care
  • Tricia Elliott, St. Alexius Medical Center
  • Mary Driscoll, Illinois Department of Public Health
  • Janna Stansell, Health and Medicine Policy Research Group

Welcome and Introduction of Members

Wes Valdez opened the meeting with a roll call.

Laura Zaremba provided an update on OHIT's activities for the months of December 2010 and January 2011. The month of December was spent working with the Office of National Coordinator (ONC) to revise and submit the ILHIE Strategic and Operational Plan (SOP). Upon approval of the SOP on December 21, 2010, OHIT was able to begin the Implementation Phase of the Illinois Health Information Exchange. The modifications of the SOP focused on developing a strategy to assist providers in meeting the secure messaging requirement for Stage 1, Meaningful Use, and included deploying the Direct Standards. The Direct Project is a set of simple standards that allows providers to send secure data to another provider, outside their practice setting. Direct is not designed to be a full-scale health information exchange, but rather a set of standards so that data can be sent in a secure manner, through a Health Information Service Provider. Another aspect of the Direct Project is that it contributes to the development of a comprehensive provider directory. The Direct Project functionality is going to be offered to Illinois providers at no cost.

Mary McGinnis provided an update on the Environmental Scan. The e-prescribing survey results indicated a high percentage (89%) of pharmacies that are activated to receive e-prescriptions. In order to capture the remaining 11%, there is a focus on working with independent pharmacies, and Walgreens, to understand best practices, obstacles, and other factors that contribute to e-prescribing. The Lab survey, that OHIT conducted, indicated that approximately 60% of CLIA accredited, and compliant, laboratories are able to deliver lab results electronically. One of the ways that OHIT will be ensuring more electronic lab results delivery is to monitor a grant program coordinated by the Chicago Department of Health, and the Metropolitan Chicago Healthcare Council, to develop more capacity in this area. Hospitals participating in this program will be taking the right steps to achieve Stages 1, 2, and 3 of the Meaningful Use requirements.

Wes stated that the revised Strategic and Operational Plan provided more focus for the CQI Work Group, especially as it relates to Meaningful Use (MU). The Federal Register document outlined the requirements for Stage 1 of Meaningful Use, so the task is well defined, but it is also a colossal undertaking.

Mary Driscoll asked whether ambulatory providers are included in the MU standards. Wes mentioned that the Medicaid Work Group is also addressing the MU standards, so it is important to communicate with other work groups in order to avoid duplication of effort and have consistency in approach and communication.

Mary McGinnis suggested bringing the ambulatory providers question to the federal Meaningful Use Workgroup, which is asking for comments on the proposed rules for Stages 2 and 3. CMS is taking comments, suggestions, and concerns about the proposed rules, until February 25, 2011.

Mary Driscoll updated the group on the Use Cases that were developed by the Public Health Work Group (PHWG). The PHWG reviewed other states' documents regarding the use of population health data, and Meaningful Use requirements, and identified a set of metrics that can be used as Illinois' quality metrics. The PHWG also reviewed I-NEDDS and I-CARE to determine how inventory and immunization data is organized, and found these models useful for population health, and individual providers.

Mary McGinnis provided an update on the local HIEs:

  • Northern Illinois anticipates that they will have the ability to exchange data by the 2nd quarter of 2011.
  • MCHC has nearly 50 hospitals that have signed letters of intent, and is in the final stages of vendor selection.
  • ICAHN is working with several of their critical access hospital members.
  • Lincoln Land HIE plans to have the ability to exchange with a few key partners by the 3rd or 4th quarter of 2011.
  • Southern Illinois is in contract discussions with a vendor.

Janna asked if home healthcare representatives are included in the statewide discussions. Janna stressed that the inclusion of home healthcare providers in the HIE discussions is important because this care is being provided out of the office setting and the health information generated by these visits is important to the total picture of a patient's status. Wes responded the Telehealth Work Group is focusing on state-specific issues like Medicaid reimbursement policies, and are including home health providers in the discussion.

The group went on to discuss the challenges of implementing EHR systems. Stephen said that there are challenges for both primary and specialty care practices. His organizations' solution was to present a structured program to physicians and allow the physicians to decide if the program fit their needs. His organization used this approach instead of tailoring the program to each individual practice and physician. Stephen also noted that while reviewing the Meaningful Use quality measures, there seems to be a fair degree of overlapping data requirements. Stephen felt that it is important to support doctors to use EMR, and to ensure that there is a structured and consistent method to collect, submit, and report data.

Wes asked if there were other issues that the group wanted to discuss or any comments from the public. There were no comments from the public, and no further questions from the group. Wes will be working on the summary document for the Federal Register, and it will be distributed at the next meeting.

The next Clinical Quality and Integration Work Group meeting will be held Tuesday, March 1, 2011.