Using Health IT to Improve Consumer Health: Focus of HHS/ONC Summit of 200 Health Leaders

Informatics for Consumer Health:  Nov 5-6, 2009
Summit on Communication, Collaboration, and Quality

Developing an agenda for integrating consumer products into health information networks will be the focus of a two-day summit November 5 and 6, 2009 organized by the Office of the National Coordinator of Health IT, in conjunction with the National Cancer Institute and their sister agencies in the Department of Health and Human Services.

The Summit to be held just outside Washington, DC is an invitation-only event for up to 200 healthcare leaders, with sessions viewable to the public through Webcasts and other sessions limited to the invited audience. Webcasts will require prior registration. While a range of issues will be covered, privacy, security, and confidentiality are considered critical to the success of the Health IT initiatives. Susannah  Fox, who leads Health Research and digital strategy for Pew Internet & American Life Project, has already published a post about the privacy, security and confidentiality panel discussion to be held on Day Two.

The proposed outcomes are a “Supplement to the American Journal of Preventive Medicine,  Policy oriented white paper, and Alert service that provides updates on research and practice advances, funding opportunities and relevant meetings and conferences.”

General Information excerpted from the Summit site:
http://www.consumerhealthinformatics.org
Videocast information 
              Pre-registration requires for each day–Nov 5, 6, 2009.

Summit Agenda
See end of post for additional conference materials.

Summit Focus
“Increase the quality and utilization of evidence-based consumer products that may be integrated into health information exchange networks.” 

Background/Rationale
“Consumer behavior is an essential contributor to quality improvement in health care. Changes in basic preventive behavior—smoking cessation, better diet and exercise, and routine screenings—have already contributed substantively to decreases in death from cancer, from heart disease, and from diabetes. Predictions are that better support systems will be needed in preventive care as the U.S. population struggles with an impending epidemic of obesity and chronic disease. Within the health care system, better support for patients has been shown to improve quality of care in a system that is becoming increasingly reliant on outpatient treatment. Improvements in quality and decreases in cost have been documented through applications such as patient reminder systems, secure messaging systems between patients and providers, in-home monitoring tools, pharmaceutical error checking routines, patient education systems, and enhanced decision support tools for self-care.

“At the same time, the Department of Health and Human Services maintains a national goal to improve health care through the strategic use of health information technology. In a report released in the first quarter of 2009, the National Research Council warned that efforts to invest in Health I.T. will be fruitless unless they are aimed at providing better cognitive support for physicians, patients, and their caregivers.

“The purpose of this summit is to bring together the stakeholders involved in creating a safer, higher quality health system and from a set of structured interactions within that group to create a blueprint for improving health care quality through enhanced behavioral support for health care consumers.”

Goal:
“Increase the quality and utilization of evidence-based consumer products that may be integrated into health information exchange networks.”

Summit Objectives
“1.Increase collaborations and partnerships,
2.Develop knowledge products including a journal supplement, alert service and policy oriented white paper, and
3.Stimulate development of commercially-viable products.”

Partners:
Department of Health and Human Services

■Agency for Healthcare Research and Quality (AHRQ)
■Centers for Disease Control and Prevention (CDC)
■National Cancer Institute (NCI)
■National Library of Medicine (NLM)
■Office of the National Coordinator for Health Information Technology (ONC)

Department of Commerce
■National Institute of Standards and Technology (NIST)

Proposed Outcomes of the Meeting/Collaboration
■”Supplement to the American Journal of Preventive Medicine
■Policy oriented white paper
■Alert service that provides updates on research and practice advances, funding opportunities and relevant meetings and conferences.”

Representatives from the following sectors will be attending:
■Commercial IT
■Government
■Healthcare
■Research
■Wellness/Advocacy

Invitation-only closed sessions excerpted from Summit site.
Topic 1.
Improve quality, safety, efficiency, and reduce health disparities.

“This goal embodies the primary objectives for quality improvement articulated by the Institute of Medicine’s Crossing the Quality Chasm report. The break out group will focus on the contribution of consumer informatics to the question of continuous quality improvement as described by the IOM report.”

Topic 2.
Improve care coordination.
“One of the great promises of an interoperable electronic health record system is the capability to bridge discontinuities of care in a fragmented health care system. The goal becomes especially important as health care reform begins to evolve a more pre-emptive, personalized stance. In this break-out session, participants will identify strategies for resolving the continuity of care problem with consumer-accessible informatics solutions. Topics to be covered will likely include a renewed discussion of the medical home, continuity of care records (as a technological solution), and the role of third party continuity solutions (e.g., MS Health Vault) in bridging the gaps of an otherwise fragmented system of care.”

Topic 3.
Engage patients and families.
“There has been considerable discussion in the public health and chronic care communities over the value of encouraging patients as active participants in their health care. Doing so means creating a health information environment that is supportive of patients’ self-management goals, and is encouraging of patients’ efforts to live healthier lives. In this session, participants will discuss the role of consumer facing informatics applications in encouraging proactive involvement from patients and their families in health care.”

Topic 4.
Improve population and public health.

“In the initial proposal to create a National Health Information Infrastructure, the National Committee on Vital and Health Statistics argued that a network of interoperable, interconnected electronic health records could help dissolve the barriers between patient monitoring and efforts to improve the health of populations. This panel will consider the ways in which a national health information infrastructure could be exploited to improve population health.”

Topic 5.
Ensure adequate privacy and security protections.
“Privacy and confidentiality issues will continue to collide with national goals for health information sharing as technology specialists and advocacy groups look for new and evolving solutions to that tension. In this working group, participants will continue discussions begun earlier in the day on privacy and security issues in a more detailed discussion of recommended solutions.”

Topic 6.
Diffusing technology-based health interventions.
“Following a meeting held in Rhode Island two years ago, the National Cancer Institute has been working with a panel of specialists to develop solutions to the diffusion of technology-based health research interventions. Session attendees will share their own experience disseminating technology and discuss a potential framework and process to help others succeed.”

Topic 7.
Delivering applications to people regardless of time or location.
“Channels and strategies for delivering health information and behavioral applications are changing rapidly, from PCs to mobile telephones and other devices. In addition behavioral applications are increasingly being delivered through newer technologies such as social networking and new media. This working group will consider the challenges and opportunities of delivering behavioral applications to people at critical moments regardless of time or location.”

Topic 8.
Health 2.0.
“Shortly after the “dot.com” implosion weeded out the least successful from the most successful Web applications, industry observer Tim O’Reilly convened a panel of experts to discuss what the attributes of a second generation Web (i.e., Web 2.0) might look like. Together, the group described a collection of new approaches that emphasized (a) creating architectures for participation, (b) enabling the formation of a “collective intelligence,” and (c) utilizing data as the new “Intel Inside” for applications. This working group will consider the viability of the Web 2.0 phenomenon as it is applied to health.”

Summit Conference Materials
Program (5MB PDF)
Marketplace of Opportunities (2MB PDF)

Blumenthal looks ahead: Privacy, Security plus National Network

Blumenthal Looks Ahead to Future Topics and New Workgroups
on HIT Policy and Standards Committees: Slide Set Info
Joseph Conn reported for Modern Healthcare/HITS, October 28, 2009, on the look ahead that National Coordinator of Healthcare IT David Blumenthal presented the prior day at the HIT Policy Committee. Two items that Blumenthal declared high priorities were development of a national policy for health information privacy and security and as Conn wrote a “fresh look at continued development of the proposed National Health Information Network, or NHIN.”

Information from the slides Blumenthal used are presented below.
Here’s a link to the Slide set (ppt) posted on ONC HIT Policy Committee site.

FUTURE TOPICS
HIT Policy Committee:

  1. Privacy and Security*
  2. 2013 and 2015 MU Objectives
  3. Adoption – EHR/HIT
  4. Standards Process
  5. NHIN and State HIEs*
  6. Strategic Plan
  7. Gaps in Measurements
  8. Medicaid MU (coordinate with CMS)

HIT Standards Committee:

  1. Gaps in Standards
  2. 2013 and 2015 Certification Standards
  3. Implementation and Adoption of Standards*
  4. Process to Support NHIN
  5. Privacy and Security Standards *
  6. Retooling Clinical Measurements for EHR*Boldface: Time Sensitive Topics

PROPOSED WORKGROUPS
HIT Policy Committee Workgroups

  1. Meaningful Use*
  2. Adoption of HIT/EHR
  3. Privacy and Security [new]*
  4. NHIN and HIEs [new]*
  5. Strategic Planning [new]

HIT Standards Committee Workgroups

  1. Implementation and Adoption of Standards*
  2. Privacy and Security*
  3. Clinical Measures
  4. Clinical Operations

*Boldface: Workgroups that need to be active now

  • NOTE: Policy & Standards Committee Workgroups will share Policy Committee and Standards Committee members.

High-level Plan for Priority Topics for HIT Policy Committee (PC), Standards Committee (SC)  and their Workgroups

  • Privacy and Security (PC and SC)

               –  Create new Privacy & Security Workgroup under Policy Committee to focus on these issues; add consumer representatives
              – Ask the P&S Policy Committee Workgroup to create recommendations  based on results of the September Privacy hearing
              – Continue leveraging HIT Standards Committee Privacy and Security Workgroup to focus on Standards – security hearing is scheduled on  November 19, 2009

  • NHIN and HIEs (PC)+

               – Create new NHIN Workgroup ( may include members from the current IE Workgroup); add other necessary experts
               – Hold inaugural Workgroup in-person meeting early November; present  issues, recommendations at December Policy Committee meeting

  • Meaningful Use Specialists Measures (PC)

             – Continue to leverage MU WG
             – Hearing is scheduled for October 27 and 28 on specialties, small practices

  • Implementation/Adoption Workgroup (SC)

               – New Implementation WG has been launched under the leadership of Aneesh Chopra
               – Public hearing on October 29th to hear adoption experiences; and web-site for public input will launch at that time

  • HIT Policy Committee and HIT Standards Committee

              – Both FACA committees will receive briefing from ONC on broad strategies; ONC programs and evaluation plans Dec 2009/Jan 2010

  • Strategic Planning Workgroup (PC and SC)

              – Consider framework/guiding principles for work of PC and SC with respect to creation of Nation-wide, interoperable, private and security health information system.
               – Relate that framework to strategic plan for work of ONC.
               – Begin work on recommendations for ONC concerning a strategic plan

HIT Policy Committee Information Exchange Workgroup on Lab Info: Oct 20

HIT Policy Committee Information Exchange Workgroup
Meets on Exchange of Lab Info: October 20, 2009
The Workgroup will be hearing testimony from invited experts and stakeholders in the area of electronic exchange of laboratory information.
October 20, 2009
9:00a.m. ‐3:00 p.m. (Eastern)
Omni Shoreham Hotel
2500 Calvert Street, NW
Washington, DC 20008

AGENDA (pdf)
9:00 a.m. CALL TO ORDER
–Judy Sparrow, Office of the National Coordinator for Health Information Technology
9:05 a.m. Overview of Meeting
–Deven McGraw, Chair, Information Exchange Workgroup
–Micky Tripathi, Co‐Chair, Information Exchange Workgroup
9:15 a.m. Background
–Angela Brice-Smith, Centers for Medicare & Medicaid Services
–Kelly Cronin, Office of the National Coordinator for Health Information Technology
10:00 a.m. Part I: Business Issues related to the Electronic Exchange of Laboratory Data
–Mike Nolte, GE Health Systems
–Vasu Manjrekar, eClinicalWorks
–Phil Marshall, WebMD
–Tim Ryan, Quest Diagnostics
–Susan Neill, Texas Department of State Health Services
11:30 a.m. BREAK
11:45 a.m. Part II: Business Issues related to the Electronic Exchange of Laboratory Data
–Laura Rosas, New York City Primary Care Information Project
–Sarah Chouinard, Primary Care Systems, Inc. and Community Health Network of West Virginia
–Raymond Scott, Axolotl Corporation
–Areg Boyamyan and Jim Timmons, Foundation Laboratory
12:45 p.m. Lunch
1:30 p.m. Regulatory and Policy Issues

–Joy Pritts, Georgetown University Health Policy Institute
–Don Horton, LabCorp
–Jonah Frohlich, California Health and Human Service Agency
–Walter Sujansky, Sujansky & Associates
2:45 p.m. Public Comment
3:00 p.m. ADJOURN

HIT Policy Committee Meetings Page
You may listen in via computer or telephone.
Webconference
Audio:
 
US toll free:   1-877-705-6006
International Direct:  1-201-689-8557
Confirmation Code: HIT Committee Meeting

State HIE Coop Agreement Applications Filed: Alabama First to Publish

Oct 16, 2009 Deadline for State HIE Coop Agreement Filing;
Alabama: First State to Publish Application
Alabama became the first state to publish its Health Information Cooperative Agreement application that was due October 16, 2009, when all 50 states plus territories were to file HIE applications with the Office of the National Coordinator in DC. Congratulations Alabama.

Alabama Medicaid Transformation Grant–HIE Initiatives Web
Alabama HIE Cooperative Agreement Application
Submitted 10-16-09
Abstract (pdf)
Governor’s Letter (pdf)
Project Narrative (pdf)
Application (pdf) 
Alabama HIE Cooperative Agreement Letter of Intent (pdf) - Submitted 9-10-09

Press release (pdf) issued Oct 16, 2009 about Indiana’s filing of HIE Agreement with ONC.

Oklahoma had published a draft version of it HIE Agreement for public feedback.

Thank you to an e-Healthcare Marketing reader for pointing  out Alabama’s application to your devoted blogger!

Please help add to this list.
When you come across any State HIE LOIs that have been published on official state sites, please send me the link either by adding to comments or sending to my email address available on About Page. Thank you.

e-Healthcare Marketing carries links to 16 Letters of Intent from states for the HIE; plus Alabama above is the 17th  LOI. Please let me know if you see any additional LOIs published as well.

HHS: Public Feedback Due 9pm EST Fri, Oct 16 for Consumer Preferences Draft Requirements Document

Public Feedback Due 9pm EST Tomorrow, Friday, October 16, 2009 for the Consumer Preferences Draft Requirements Document
This is the text from an email sent out by HHS afternoon of Oct 15, 2009:

“The Office of Interoperability and Standards (OIS) and ONC would like to remind you that feedback for the Consumer Preferences Draft Requirements Document is due 9pm EST tomorrow, Friday, October 16, 2009.  The Requirements Document and instructions for providing feedback can be found at http://healthit.hhs.gov/consumerpreferences.

“The Consumer Preferences Draft Requirements Document addresses the processes, information exchanges, stakeholders, functional requirements, and issues and obstacles surrounding consumer preferences in order to help in the development of standardized data exchanges.  This requirements document is intended to address the various types of consumer preferences and be supportive of current and potential future policies, although such policy decisions are beyond the scope of the requirements document.   

“The OIS Consumer Preference Team would greatly appreciate your feedback on the requirements document.  Please review the requirements document and provide any feedback you may have, if you have already not done so, by 9pm EST tomorrow, Friday, October 16, 2009.  Please note that submissions should not contain any proprietary or private information as they may be made available for public inspection.

“All comments will be analyzed, dispositioned and utilized where appropriate, in the development of the final Consumer Preferences Requirements Document. A disposition report outlining how comments were addressed will be made publicly available after the publication of the final document.

“Thank you for your time and attention to this important matter; your feedback is greatly appreciated by the OIS Consumer Preferences Team.”

e-Healthcare Marketing post on October 7, 2009 provides overview, preferences outline, and links to documents page and document.

Oklahoma HIE Draft Application to ONC; ONC OKs OK Prelim Regional Extension Center App

Oklahoma Health Information Exchange Draft Application to ONC
Oklahoma Chosen (Preliminarily) by ONC as Early Extension Site
Oklahoma posted its draft application for the ONC’s State Health Information Exchange Cooperative Agreement to gather public comment via an online form from October 1 to 9, 2009.  The draft notes that “Oklahoma has been chosen as one of the first 20 applicants of the Extension Program. The early announcement period gives Oklahoma the maximum amount of time to lend technical support to providers and facilities migrating to HIT. The Oklahoma Primary Care Association and OFMQ are leading the efforts where the full application will be submitted on November 3, 2009.” In other words, ONC approved Oklahoma’s preliminary application, which enables it to file a full application in November 2009.
Oklahoma HIE DRAFT Application to ONC (pdf)
Oklahoma’s Letter of Intent for HIE (pdf)
OKHITECH/Oklahoma Health Information Exchange Web site

NOTE: List of Regional Extension Center preliminary approvals: The Oklahoma Center above and the University of Central Florida are the only centers that we’re aware have been published. Should you learn of any additional that have been officially published, please drop a note in the comment box, or email me at the address listed in the About section. Thank you.

Blumenthal: Standards development key to healthcare reform; Oct 14 HIT Standards Cmte

Blumenthal tells Oct 14, 2009 HIT Standards Committee:
Standards development key to healthcare reform
Diana Manos of Healthcare IT News reported on October 14, 2009, that David Blumenthal, MD, National Coordinator for Health Information Technology
told the HIT Policy Committee ‘Congress may not know it or realize it, but you all are very much at the center’ of making health reform happen, he told members of the HIT Standards Committee.”

Chopra seeks outside advice on health IT standards
Mary Mosquera of Government Health IT reported on October 14, 2009, “Aneesh Chopra,
the White House’s chief technology officer and chairman of the panel’s newly formed standards implementation group, said he wants to mine the lessons of other industries in using information handling standards successfully and then apply them broadly to healthcare.”  Chopra plans to get public feedback using a two-week online forum on standards usage, and said there would be a hearing on Oct 29, 2009 to share best practices on implementing standards.

Halamka reports on HIT Standards Committee Oct 14 meeting
In an “Adoption and Implementation” post on Life as a  Healthcare CIO blog (October 13, 2009) prior to the meeting, John Halamka wrote “To me, the work ahead is continued evolution of the work we’ve done to ensure adoption of the standards is widespread and implementation is accelerated.” Halamka describes the upcoming stages of health data exchange from 2011 to 2015, and what will be required.

In his October 14, 2009 post “The October HIT Standards Committee Meeting,” Halamka recounted David Blumenthal’s comments, who “emphasized that we need to expand the scope of our NHIN (Nationwide Healthcare Information Network)  thinking to include consumer health information platforms in addition to the provider and government organizations that have been the focus to date.” The post describes the various workgroup reports, notes that testimony from security experts would be the focus of the November 19, 2009 HIT Standards Committee meeting, and describes the need for the HIT Standards and Policy Committees to work together on privacy and security issues and the assumptions on health information exchange.

HIT Standards Committee — October 14, 2009
Key Documents

  • Agenda [DOC]
  • Clinical Operations Workgroup Update [PPT]
  • Clinical Quality Workgroup Update [PPT]
  • Privacy & Security Workgroup Update [PPT]
  • Implementation Workgroup – Charter, Membership and Framework [PPT]
  • HIT Policy Committee’s Privacy Hearing Meeting Update [PPT]
  • Missouri Statewide HIE Shows Us All

    Missouri Statewide HIE Shows Us All
    Includes View of Status of HIEs in 50 States, DC, and PR
    In presentations to Missouri stakeholders and state Senate committee on September 17 and October 1, 2009, the Missouri Statewide Health Information Exchange (HIE) showed its plans and planning process, as well as its consultant Manatt Health Solutions’ view of the status of existing HIE activities as defined by ONC.

    Missouri estimates its share of State HIE Program funding from ONC will be $12.9 million. The presentation show a clear explanation and timelines of the HITECH funding process, including Regional Extension Centers, Broadband and Telehealth in addition to HIEs. A detailed and clear process and schedule is shown for the Missouri Statewide HIE program.

    Manatt’s analysis shows seven states (out of 50 states, the District of Columbia, and Puerto Rico) as possessing a state HIE operational plan that is in alignment with ONC criteria. Those states with aligned HIE status are Delaware, Maine, New York, North Carolina, Utah, Vermont, and Wisconsin. Fourteen additional states are viewed as having a state HIE which requires alignment with ONC criteria prior to implementation. The remaining states and territories are viewed as needing significant planning efforts prior to implementation or in the initial planning stage.  Since this is in map form, it’s not clear where District of Columbia falls. Missouri may require significant planning prior to implementation based on first reading of the rest of the presentation.

    Missouri Statewide HIE Presentations To:
    Stakeholders, Sept 17, 2009 (pdf)
    Missouri Senate Healthy Missourians Committee, Oct 1, 2009 (pdf) 
    Map Analysis of State HIE Readiness for ONC: Slide 18 in either version.
    The Senate version has a few introductory slides as overview.

    Missouri Office of Health Information Technology http://dss.mo.gov/hie

    See e-Healthcare Marketing post for several State HIE Letters of Intent.

    17 State HIE Letters of Intent to Office of National Coordinator

    Updated List of 17 Published State Letters of Intent to ONC for
    Health Information Exchange Programs on Sept 11, 2009
    As the October 16, 2009 deadline closes in for the State HIE Applications, at least six more Letters of Intent have been published online. Continuing a list of state letters (17 as of Oct 16, 2009) as they come to my attention, in alpha order below:
    Alabama (pdf)
    California (pdf)
    Florida (pdf)
    Illinois (pdf)
    Michigan (pdf)    MI Governor’s Press Release (html)
    Minnesota (pdf)  MN Governor’s Designation (pdf)
    Missouri (pdf)   **Missouri HIE Overview Slides (pdf)**
    New Jersey (pdf)
    North Carolina (pdf)
    North Dakota (pdf)
    Oklahoma (pdf)    OK Governor’s Designation (pdf)
    Oregon (pdf)
    Tennessee (pdf)
    Utah (pdf)
    Vermont (pdf)
    Washington (pdf)
    Wisconsin (pdf)

    Please help add to this list. When you come across any State HIE LOIs that have been published on official state sites, please send me the link either by adding to comments or sending to my email address available on About Page. Thank you.

    Previous post with LOIs listed in order that they came to attention of e-Healthcare Marketing.

    Virginia Announces Creation of Health IT Advisory Commission

    Virginia Announces Creation of Health IT Advisory Commission
    Announcement from Commonwealth of Virginia on October 13, 2009: “Governor Timothy M. Kaine today announced the creation of the Health Information Technology Advisory Commission by Executive Order 95. The Commission, which will be chaired by Secretary of Health and Human Resources Marilyn Tavenner, is charged with ensuring broad stakeholder engagement and providing guidance to the Governor on the most effective use of American Recovery and Reinvestment Act (ARRA) funds designated for Health Information Technology.”

    Department of Health, named as lead Virginia agency for Health IT, is setting up an Office of Health IT. “The Commission will enlist a broad range of (24) stakeholders including physicians, HIE and privacy experts and hospital and insurance executives.”

    Virginia Executive Order 95 (2009): Establishing the Health Information Technology Advisory Commission