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Technology and Interoperability Work Group Meeting Minutes - May 17 2011 

May 17, 2011

Attendees:

  • Julie Bonello, Access Community Health Network
  • Denis DeMasie, Rush Copley Medical Center
  • Tom Dombrosky, Lincoln Land HIE
  • Peter Ingram, Sinai Health System
  • Steve Lawrence, IHIP
  • Jay McCutcheon, SIU
  • Mary Ring, Illinois Critical Access Hospital Network
  • Ira Thompson, Infinite Support Systems
  • Crystal VanDeventer, Lincoln Land HIE
  • Phil Wasson, TriRivers Health Partners

Office of Health Information Technology (OHIT)

  • Mark Chudzinski
  • Diego Estrella
  • David Fagus
  • Ivan Handler
  • John Lekich

Ivan Handler, Chief Technology Officer of the Office of Health Information Technology (OHIT), opened the meeting at 3:00 p.m. hosted by OHIT at the State of Illinois J.R. Thompson Center in Downtown Chicago, with a telephone conference call-in number. It was noted that notice of the meeting and the agenda were posted on the OHIT Web site and at the Chicago meeting location no later than 48 hours prior to the meeting. Roll was taken, and the ability of those attending by telephone to hear and participate was confirmed.

OHIT Update

Mr. Handler reported that on May 11 and 12 representatives from the ONC had conducted a site visit at OHIT; OHIT received a favorable assessment. OHIT is on schedule for starting the ILHIE implementation by September.

Progress Reports from Local HIEs

  1. Illinois Health Exchange Partners (IHEP). Steve Lawrence reported that IHEP was meeting today with its selected vendor, Medicity. Tomorrow, the Board would be reviewing four proposals for the engagement of a law firm to work on the HIE's operating agreements. IHEP hopes to be operational by the fourth quarter.

  2. Lincoln Land Health Information Exchange (LLHIE). Jay McCutcheon reported that work was still proceeding and that Lincoln Land had no updates at present.

  3. Metro Chicago Health Information Exchange (Metro Chicago HIE). Peter Ingram reported that spoke for Metro Chicago HIE has 10 early adaptors identified, and hopes to have their start up in the Fall.

  4. Northern Illinois Health Information Exchange (NIHIE). Phil Wasson reported that Tiani Spirit has been selected as the HIE vendor, to be finalized by late August. They are working with four participants, with rollout at each requiring 2-4 weeks. They are also currently in discussions with EPIC regarding the exchange of CCDs.

  5. Illinois Critical Access Hospital Network Exchange (ICAHN Exchange). Mary Ring reported that ICAHN Exchange is in discussions with NextGen, which intends to have a new version of system available in the first week of June. Several of their member hospitals look forward to attesting to Meaningful Use this 3rd quarter.

  6. Southern Illinois Health Information Exchange (HIESI). There was no report.

  7. Central Illinois Health Information Exchange (CIHIE). There was no report.

Milestone Report

Mr. Handler suggested that the collection of information regarding the status of local/regional HIEs be facilitated with a simple report template on which progress toward key milestones would be reported. In the ensuing group discussion, the following milestones were proposed: vendor selection, vendor contract execution, initiation of services ("go-live") by use case/workflow, and configuration of privacy and security policy. Mr. Handler suggested that sample/model use cases be e-mailed to him; OHIT is not looking to dictate clinical workflow practices, but needs to appreciate the data elements that are needed for clinical workflow in order to inform its technical engineering of the HIE, as well as appreciate the roles of different HIE participants and data sources.

Use of Direct and Commercial HISPs

Mr. Handler reported on the decision of OHIT to not replicate at the state-level HIE certain HISP services that were going to be available in the marketplace through commercial entities; commercial providers mentioned in the ensuing discussion as offering HISP functionality in various States included: Cerner, Medicity and Microsoft. OHIT proposes to provide to such commercial providers in the Illinois market a public portal through which providers can enroll for HISP services from registered commercial HISPs. The group did not confirm whether there was any actual demand in the Illinois marketplace for Direct functionality.

Meaningful Use Discussion

Mr. Handler noted that the State needs to ensure that all providers in the State are able to attest to Meaningful Use and receive the Federal incentive payment for EMR adoption. For areas of the State where no local/regional HIE service is available to providers ("white spaces"), the State will need to enable connectivity to the State-level HIE. To the extent that connectivity to the State-level HIE may be provided to any provider in the State, the prospect will exist of some providers having a choice whether to connect to the State-level HIE directly, or through a local/regional HIE. The resolution of any policy issues that may be arising from any potential competition of the State-level and local HIEs is beyond the scope of this technical workgroup.

Mr. Handler noted that for the exchange of structured lab data, different methodologies and "standards" exist. It was suggested that a local/regional HIE's choice of particular standards for their HIE be reported through the Milestone Report.

The group went on to discuss the exchange of "care summaries", and noted that the term "care summaries" is difficult to define. The selection of the CCD format is preferred by some vendors, while certain local HIEs prefer to follow IHE or HL7 standards initiatives in this area. The cost of the interfaces, necessary in lieu of standards that assure interoperability of all EMR systems, is proving to be exorbitant, and it is difficult for small providers to exert leverage on the vendors to have them absorb the cost. OHIT volunteered to gather information on interface costs and compile the data. The alternative would be for the Federal government to provide resources toward the purchase of interfaces.

Privacy and Security

With regard to privacy and security, Mr. Handler underscored the need for establishing public trust in the HIEs. Attention needs to be focused on operating in compliance with best practices and standards regarding encryption, and with annual penetration testing.

Other Matters

The next meeting was scheduled for 9:00 am on June 13th.

Public Comment

There were no comments offered from the general public.

Adjournment

The meeting was adjourned at 4:00 p.m.