April 21, 2011
Attendees (phone and in-person):
- Chair: Mary Driscoll, Illinois Department of Public Health (IDPH)
- Matt Charles, IDPH
- Mark Chudzinski, Office of Health Information Technology (OHIT)
- Craig Conover, IDPH
- Doug Corbett, Ford-Iroquoi Public Health Department
- Todd Davis, IDPH
- Ivan Handler, OHIT
- Doreen Haaksma, Independent Consultant
- Krysta Heaney, OHIT
- Robin Holding, IDPH
- Bala Hota, Cook County Health and Hospital System
- Dorian Jones, IDPH
- Josh Jones, Chicago Department of Public Health
- Mike Jones, Healthcare and Family Services (HFS)
- Judy Kauerauf, IDPH
- Vince Keenan, Illinois Academy of Family Physicians
- Patrick Lenihan, University of Illinois at Chicago
- Miriam Link-Mullison, Jackson County Health Department
- Teri Nicholson, IDPH
- Mary McGinnis, OHIT
- Mohammed Shahidullah, IDPH
- Julie Sharp, Kane County Health Department
- Jeff Swim, DuPage County Health Department
Mary Driscoll, Chair of the Public Health Work Group, opened the meeting at 2 p.m.; the meeting was hosted via telephone conference. Roll was taken.
Review of Minutes:
With no changes noted, the minutes from February 23, 2011, were approved.
Mary McGinnis provided a status update on the Illinois Health Information Exchange (ILHIE).
- The inaugural meeting of the ILHIE Authority Board of Directors is scheduled for next Wednesday, April 27, 2011, in Chicago. A meeting agenda will be posted to the ILHIE Web site 72 hours in advance of the meeting in accordance with the Open Meetings Act.
- Ivan Handler has joined the OHIT team as its new Chief Technology Officer. Ivan previously served as the Chief Information Officer for the Illinois Department of Healthcare and Family Services.
- OHIT is the process of developing a request for proposals (RFP) for the ILHIE technical architecture. Once finalized, the RFP will be posted to the State Procurement Bulletin.
- Each of the planned local HIEs within Illinois expect to have functionality available in Q4 2011.
- For eligible providers seeking to participate in the Electronic Health Record (EHR) Incentive Program in 2011, who also do not have mechanism for exchange available to them, OHIT will act as a broker to facilitate exchange via Direct. Currently, the Office of the National Coordinator has identified approximately 40 different providers of Direct services. OHIT will provide an assessment of the various Direct service offerings and make that information available on its Web site.
Public Health Node Update:
Bala Hota provided a status update on the Public Health Node (the "Node") concept. The Node is contemplated as a service managed by public health and will enable the electronic application of business rules for the identification of data elements of public health interest.
Communicable disease surveillance rules would be a primary application of the Node and would address the mandatory reporting of communicable disease to public health. Bala noted that although the EHR Incentive Program for Meaningful Use is accelerating electronic laboratory reporting (ELR), the EHR certification process only addresses rules for ELR message structure, it does not address the surveillance rules for identifying conditions of interest to be sent to public health.
Public health could develop the electronic case definitions and surveillance rules for identifying conditions of interest. The Node would apply the surveillance rules to information and pass appropriately identified information to public health. The development of the Node would: 1) assist Eligible Hospitals in meeting the ELR Meaningful Use objective by serving as a vehicle/mechanism for data submissions to public health; 2) assist providers with mandated reporting; 3) assist public health in the collection of standardized information through the development of rules that are uniformly applied to data; and 4) reduce the costs associated with EHR adoption as it would eliminate the need for providers to purchase and implement costly interfaces for various types of reporting.
Through the Center for Disease Control (CDC) Epidemiology and Laboratory Capacity Program public health will explore developing the Node. The current knowledge bases developed at Cook County Health and Hospital System and the Chicago Prevention EpiCenter can be leveraged, expanded, and will serve as a model for automating data submission to public health.
Mary Driscoll further explained how once the Node has been tested, public health can develop additional rule sets for other data elements of interest, for example, chronic disease registries and multi-drug resistant organism disease registries.
Ivan Handler provided some background information on the state's intention to develop a cloud-based solution for ILHIE services to reduce the infrastructure and maintenance cost associated with hardware. Bala Hota agreed that a cloud-based solution was a positive strategy to pursue. Ivan Handler proposed that the ILHIE could provide hosting services for the Node, and suggested a planning meeting to align public health and the HIE timelines.
Teri Nicholson provided an update on the immunization registry, I-CARE. IDPH (the "Department) is currently testing with 19 providers (six physician practices, eight vendors, and three hospitals) and the first provider is transitioning to production of consented data. Teri Nicholson also provided an update on the status of the Department's CDC immunizations grant work which focuses on moving providers from a batch data submission environment to real time interfaces. The interface is written and the department has tested it internally, but has not yet tested with providers and vendors. Jeff Swim asked if the new I-CARE functionality would include real-time bi-directional communication between the provider and I-CARE for query and immunization updates. Teri Nicholson explained that it would and that the Department was also exploring additional immunization inventory enhancements, such as incorporating v-tracks information. The I-CARE team has a call arranged with Michigan, as the only state to implemented v-tracks into their immunization registry, to further discuss this functionality.
Todd Davis explained that the Standard and Certification Criteria for EHRs identified HL7 2.5.1, versus HL7 2.3.1, as the required messaging standard for ELR. As a result, I-NEDSS is currently modifying its systems to accept HL7 2.5.1 as well as HL7 2.3.1. Todd Davis explained that the Department has received some data from the PHIN-MS quality framework to start the data conversion process and is using the data to validate trees and begin the mapping process. As an interim solution, the department will explore mapping between the two HL7 versions. I-NEDSS will maintain interfaces for both messaging formats as all of the reference labs in Illinois are transmitting in HL7 2.3.1.
Jessica Ledesma provided an update on HB 1338, the Immunization Data Registry Act. Jessica Ledesma informed the group that HB 1338 passed the House with only a few nay votes. Mary Driscoll explained that the Department has had a long history of advocating for an opt-out immunization registry. Mark Chudzinski offered OHIT's support and assistance to IDPH in creating a consent management systems, explaining that the ILHIE will also develop a consent management system for the HIE and that OHIT and IDPH should explore ways to share lessons learned, and may eventually use the ILHIE platform to support I-CARE registry management.
Other State HIEs:
Jessica Ledesma provided an update on how other states' public health departments are interfacing with their state HIEs. Jessica Ledesma explained that the relationship between public health and statewide and local HIEs varies, with some states having very strong and interrelated planning and implementation relationships while others are more loosely coupled. One factor that appears to be particularly relevant to the type and nature of the public health HIE relationship is whether the Office of the National Coordinator (ONC) funded HIE grant program is administered by the public health agency or whether a non-profit or other outside state government agency is administering the program.
CDC Meaningful Use and Public Health Information Network (PHIN):
Mary Driscoll provided an update on the Public Health Information Network call hosted by the CDC. CDC, federal CMS, and ONC are working together collaboratively and CDC has asked public health departments to comply with the Meaningful Use requirements.
Mary Driscoll reviewed the department's readiness to receive data to meet the public health Meaningful Use objectives. IDPH can accept the submission of ELR data and immunization data. At this time, IPDH cannot receive data for syndromic surveillance.
The CDC is scheduled to begin a comment period for the receipt of electronic syndromic surveillance reporting standards. The Department will continue to monitor standards development.
Face to Face Meeting
The Work Group recommended topics for discussion at the face-to-face meeting tentatively scheduled for June 16, 2011, in Pontiac, Illinois. The following were suggested as agenda items:
- State Health Improvement Plan
- State update on Meaningful Use
- Approaches to negotiating with vendors
- Supporting local health departments in local HIE implementation
- Public Health Node
Vince Keenan shared, with the Work Group, an article prepared by Dr. Stasia Kahn and vetted by OHIT and IDPH, describing the public health reporting requirements applicable to Medicare Eligible Professionals. The department will develop additional resources for providers that will be made available on OHIT, IDPH, and HFS Web sites.
The meeting was adjourned at 4 p.m.