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Technology and Interoperability Work Group Meeting Minutes - August 8 2011 

August 8, 2011

Attendees:

In-person Attendees:

  • Charles Cox, Metro Chicago HIE
  • Wesley Valdes, UIC/OHIT

Attended by Phone:

  • James Anfield, Blue Cross and Blue Shield
  • Peter Ingram, Sinai Health System
  • Jay McCutcheon, SIU
  • Elizabeth McKnight, CHITREC
  • David Miller, Central IL HIE
  • Bill Odman, HIESI
  • Morris Rang, Blessing Hospital
  • Ira Thompson, Infinite Support Systems
  • Crystal VanDeventer, Lincoln Land HIE
  • Ron Warren, Infinite Support Systems
  • Phil Wasson, TriRivers Health Partners

Office of Health Information Technology (OHIT)

  • Mark Chudzinski
  • Diego Estrella
  • Ivan Handler
  • John Lekich
  • Mary McGinnis (by telephone)

Ivan Handler, Chief Technology Officer of the Office of Health Information Technology (OHIT), opened the meeting at 9:00 a.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: HIE Infrastructure RFP

Mr. Handler reported that eleven (11) bids had been received in response to the State of Illinois Request for Proposal (RFP) for the acquisition of the core services of the state-level health information exchange (ILHIE). The technical evaluation of those bids is proceeding currently, to be followed by presentations by those vendors who score the necessary minimum for admission to that second phase, followed by a review of the pricing of those proposals admitted to the final phase. OHIT intends to select the Vendor by the end of September 2011, followed shortly thereafter by the finalization of a vendor contract. Mr. Handler noted that the proposed schedule was very aggressive.

Progress Reports from Local HIEs

  1. Northern Illinois Health Information Exchange (NIHIE). Phil Wasson reported that NIHIE is a few weeks away from executing a contract with its selected HIE vendor.

  2. Metro Chicago Health Information Exchange (Metro Chicago HIE). Charles Cox reported that six (6) early adopters have signed MOUs, with four (4) scheduled for phase 1 activation by January, 2012; additional early adopters are being sought for phase 2. The functionality that it is anticipated in phase 1 will be: exchange of Admission-Discharge-Transfer reports; lab results; radiology reports; and dictated reports. Initial use cases will be: delivery of clinical summaries to Emergency Departments, and public health reporting (the details of which are presently being worked out).

  3. Southern Illinois Health Information Exchange (HIESI). Bill Odman reported that HIESI is currently engaged in a pilot project with NextGen, and expects to have a full update on the pilot in September.

  4. Central Illinois Health Information Exchange (CIHIE). David Miller reported that on July 12 CIHIE had its first Annual Meeting for stakeholders, at which it seated its Board of Directors for the 2011-2012 fiscal year and Board Officers were elected. A contract with a vendor (ICA) has been executed. All planning points to having the first seven (7) Charter Members live on the HIE by the end of the 4th quarter of 2011, with a "Grand Opening" in January 2012. The participation agreement for the HIE is being finalized. Information about CIHIE is now available on its Web site (www.cihie.org).

  5. Lincoln Land Health Information Exchange (LLHIE). Jay McCutcheon reported that work on the organizational legal aspects has been completed. Further work on the technical implementation is proceeding.

  6. Illinois Health Exchange Partners (IHEP). There was no report.

  7. Illinois Critical Access Hospital Network Exchange (ICAHN Exchange). There was no report.

Creation of subgroups

Mr. Handler proposed the formation of the following four subgroups: (i) Interface Standards & Operations; (ii) Audit Standards & Operations; (iii) Privacy and Security Standards & Operations; and (iv) Rural Broadband. The subgroups will continue to be a part of this workgroup, which will continue to provide guidance directly to OHIT. Mr. Handler was looking to members of the workgroup to volunteer as chairs and members of the subgroups in the next few weeks. In response to an inquiry, Mr. Handler agreed to circulate in the near future a summary description of each of the subgroups, and potential topics that he would like to see them address. The frequency of meetings and workload upon members will be determined by each subgroup.

In the ensuing discussion concern was expressed regarding:

  • the creation in Illinois of standards that are additional to, and possibly conflict with, national standards already formulated, or being formulated, under ONC supervision;
  • the practical reality of Illinois being able to devote sufficient resources to addressing an issue that the Federal Government with its resources has not yet solved;
  • the practical reality of having vendors agree to implement modifications to existing EMR systems that already comply with Federal standards in order to accommodate Illinois' modifications;
  • the practical reality of new standards being applied to legacy databases (in source systems, edge servers, provider files and payer files); and
  • the source of funding to defray the costs of any changes to the data format, content or technical specifications that emerging local/regional HIEs may be required to accommodate.

Mr. Handler acknowledged that OHIT should not be creating technical requirements that are not consistent with national standards and initiatives, but noted that OHIT in collaboration with other States is well positioned to be instrumental in the formulation of technical requirements that promote HIE interoperability; his most recent discussions at an MMIS conference with counterparts from other States confirmed his view that at progress at the Federal level in the development of national standards to facilitate HIE appears to be limited. The existing "standards" have been largely developed as frameworks for intra-enterprise exchange, or for facilitating point-to-point exchange, and lack the necessary specificity to facilitate uniform implementation and interoperability. A full resolution of the problem in our complex healthcare IT environment may well require a multi-year effort. The States cannot afford to wait; the lack of interoperability is imposing interface costs upon providers that may undermine the benefits of the EMR incentive payment program and the viability of HIEs. The Chair of the ILHIE Authority publicly flagged this issue last week to the Health IT Policy Committee (a Federal Advisory Committee reporting to ONC). Mr. Handler knows that a multi-State initiative on this matter has already been formed at NASCIO, and he believes that the necessary resources for a larger collaborative effort to succeed will be secured. The creation of true national standards for health IT will ultimately be of benefit to HIT vendors as well as healthcare providers and payers.

Other Matters

Some concern was noted regarding the distribution of meeting agendas, notices and materials. The minutes of the most recent meetings need to be redistributed.

Public Comment

There were no comments offered from the general public.

Adjournment

The meeting was adjourned at 9:55 a.m.