DSRIP Meeting Agenda

PAGE 1

Date and Time 6/23/15

Meeting Title NYP PPS IT/Data Governance

Committee

Location 530 W 166th

Street, 6th

Floor,

CB12 Conference Room Facilitator Steven Kaplan, Niloo Sobhani

Go to Meeting https://global.gotomeeting.com/

join/121616565 Conference Line Dial +1 (646) 749-3122

Access Code: 121-616-565

Invitees

Andres Pereira, MD Chair: Niloo Sobhani, Steven Kaplan, MD (NYP)

Kate Nixon (VNSNY) Daniel Lowy (Argus)

Betty Cheng (CBWCHC) Greg Fortin (Isabella)

Anname Phan (NYC DOHMH PCIP/REACH) Jairo Guzman (Coalicion Mexicana)

Taeko Frost (WH CORNER Project) – Shoshana

Brown

Todd Rogow (Healthix)

Meeting Objectives Time

1. Review Action Items from Previous Meeting 2. Introduce New Committee Members 3. Review IT Processes Milestones 4. Discuss IT Current State Assessment 5. Identify Action Items for Next Meeting

5 mins 5 mins

15 mins 25 mins 5 mins

Action Items

Description Owner Start Date Due Date Status

Draft initial Current State Assessment N. Sobhani 4/28/15 6/23/15

Review local PPS Assessment I. Kastenbaum 4/28/15 6/23/15

DSRIP Meeting Minutes

PAGE 1

Date and Time 6/23/15

Meeting Title NYP PPS IT/Data Governance

Committee

Location 530 W 166th

Street, 6th

Floor,

CB12 Conference Room Facilitator Steven Kaplan, Niloo Sobhani

Go to Meeting https://global.gotomeeting.com/

join/121616565 Conference Line Dial +1 (646) 749-3122

Access Code: 121-616-565

Attendees

Betty Cheng (CBWCHC) Chair: Niloo Sobhani, Steven Kaplan, MD (NYP)

Anname Phan (NYC DOHMH PCIP/REACH) Daniel Lowy (Argus)

Shoshana Brown (WH CORNER Project) Greg Fortin (Isabella)

Peter Steel, MD (NYP) Jairo Guzman (Coalicion Mexicana)

Alvin Lin (NYC DOHMH PCIP/REACH) Todd Rogow (Healthix)

Sam Merrick, MD (NYP) Gil Kuperman, MD (NYP)

Adriana Matiz, MD (NYP) Isaac Kastenbaum (NYP)

Mediha Gega (NYC DOHMH) Maura Frank (NYP)

David Alge (NYP)

Action Items

Description Owner Start Date Due Date Status

Investigate opportunity for cross-PPS meeting I. Kastenbaum 6/23/15 7/10/15

Review funding streams (PTN and SHIP) A. Lin 6/23/15 7/10/15

Distribute NYS/KPMG Connectivity Survey I. Kastenbaum 6/23/15 7/10/15

Request committee member interest for participating in specific milestones

I. Kastenbaum 6/23/15 7/10/15

Meeting Minutes:

The Committee introduced themselves. Three new Committee members were welcomed – Shoshana Brown (WH CORNER Project), Anname Phan (PCIP), and Alvin Lin (PCIP)

S. Kaplan reviewed the NYS required milestones for the Committee. He emphasized the need for robust processes and education to do this work effectively across the network.

o A. Phan was interested in what opportunities for cross-PPS collaboration are occurring. S. Kaplan said the PPS PMO would coordinate at a high-level, but that it would be helpful for collaborators to inform that process based on their experience in other PPSs.

o T. Rogow expressed interest in participating in the creation of the Interoperability Roadmap (milestone #4).

o A. Lin described two funding opportunities to support cross-PPS IT and PCMH development – (1) Practice Transformation Networks (CMS) and (2) State Health Innovation Model. He will keep the PPS informed as these progress.

o S. Kaplan reassured the group that it would take at least 5 years to do this work well.

N. Sobhani reviewed the results of an IT capacity survey conducted during the application phase. There were areas of overlap as well as opportunities to improve the questions asked.

G. Kuperman provided an overview of the New York State DOH and KPMG DST survey plans. These were released a week prior to this meeting.

o T. Rogow mentioned that all RHIOS (qualifying entities) went through a KPMG-led survey, but he wasn’t certain how the 88% fact was developed.

DSRIP Meeting Minutes

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o T. Rogow explained that the Healthix Board approved an ambitious plan to connect with 400 providers this calendar year. There were 150 providers already in-motion. Healthix is looking for PPS to start the connection conversation ASAP.

o G. Kuperman was interested in what information was required to ‘start the Healthix connection conversation.’ T. Rogow explained that it was simple information about the vendor and IT model.

N. Sobhani reviewed the questions developed at the last meeting. o T. Rogow confirmed that the PPSs were all at the same stage. o A. Lin mentioned that PCIP/REACH was helping identify PCMH and MU statuses of downstream

providers. o A. Lin also noted that the State’s EHR incentive payment program (for all EHR models) would be

extended one year.

N. Sobhani and S. Kaplan closed the meeting with the understanding that the NYP PPS would wait to understand the surveys conducted by NYS/KPMG prior to sending out a new survey to downstream collaborators.

NYP PPS IT/Data Governance Committee Review of Required Milestones

1

Milestone Background

On June 1, NYP PPS submitted a New York State Implementation Plan

that provided a high-level summary of governance and infrastructure

work that the PPS would accomplish throughout the first three years.

This template introduced several new formal requirements to the PPS.

These milestones are in-addition to Committee’s guidance on PPS

operational concerns.

2

Milestones

Milestone DSRIP Year

Calendar

Year

Develop a data security and confidentiality plan DY1, Q4 March 2016

Perform current state assessment of IT capabilities

across network, identifying any critical gaps,

including readiness for data sharing and the

implementation of interoperable IT platform(s).

DY1, Q4 March 2016

Develop an IT Change Management Strategy. DY2, Q2 September

2016

Develop roadmap to achieving clinical data sharing

and interoperable systems across PPS network

DY2, Q2

September

2016

3

IT Systems Milestone 1: Data Security Plan

Focus: Develop a data security and confidentiality plan.

Due Date: DY1, Q4 (March 2016)

Specific Deliverables:

Data security and confidentiality plan, signed off by PPS Board, including:

– Analysis of information security risks and design of controls to mitigate

risks

– Plans for ongoing security testing and controls to be rolled out

throughout network.

Subsequent quarterly reports will require an update on progress on

implementing this plan.

4

IT Systems Milestone 2: Current State Assessment

Focus: Perform current state assessment of IT capabilities across network,

identifying any critical gaps, including readiness for data sharing and the

implementation of interoperable IT platform(s).

Due Date: DY1, Q4 (March 2016)

Specific Deliverables:

Detailed IT current state assessment. Relevant QEs (RHIOs/HIEs) should

be involved in performing this assessment.

Subsequent quarterly reports will require updates on the key issues

identified and plans for developing the PPS's IT infrastructure.

5

IT Systems Milestone 3: Change Mgmt. Strategy

Focus: Develop an IT Change Management Strategy. Due Date: DY2, Q2 (September 2016) Specific Deliverables: IT change management strategy, signed off by PPS Board. The strategy

should include:

Your approach to governance of the change process;

A communication plan to manage communication and involvement of all stakeholders, including users;

An education and training plan;

An impact / risk assessment for the entire IT change process; and

Defined workflows for authorizing and implementing IT changes

Subsequent quarterly reports will require an update on the implementation of this IT change management strategy.

6

IT Systems Milestone 4: Interoperability Roadmap

Focus: Develop roadmap to achieving clinical data sharing and interoperable systems across PPS network

Due Date: DY2, Q2 (September 2016)

Specific Deliverables:

Roadmap document, including current state assessment and work plan to achieve effective clinical data

sharing and interoperable systems where required. The roadmap should include:

– A governance framework with overarching rules of the road for interoperability and clinical data sharing;

– A training plan to support the successful implementation of new platforms and processes; and

– Technical standards and implementation guidance for sharing and using a common clinical data set

– Detailed plans for establishing data exchange agreements between all providers within the PPS,

including care management records (completed subcontractor DEAAs with all Medicaid providers within

the PPS; contracts with all relevant CBOs including a BAA documenting the level of PHI to be shared

and the purpose of this sharing).

Subsequent quarterly reports will require updates on your implementation of this roadmap and an update

on any changes to the contracts / agreements in place

7

IT Current State Assessment

8

Assessment: Agenda

Review Application-Period PPS Assessment

Review New York State-Proposed Survey

Review PPS Current Proposed Assessment

Identify Next Steps

9

IT Readiness Assessment Survey

Administered December 2014

Sent 100 organizations; 62 respondents

Questions asked

– How many employees are in your organization?

– What is your current annual IT budget?

– How many FTEs are currently budgeted for your IT department?

– If your organization has multiple facilities, is there one centralized IT department?

– Is your IT department outsourced? What vendor?

– Does your organization use an EMR? Vendor? Product? Version?

– How does your organization's use of paper charts for patient information tracking?

– Are you working towards MU? If yes, what stage?

– Does your organization use a care management and/or population management system? (Examples given)

– Does your organization participate in a RHIO?

10

Organization Name ACDP ACMH, Inc. AIDs Healthcare Foundation Allied Service Center of NYC Amsterdam Nursing Home Corp.(1992) ArchCare Argus Community, Inc. ASCNYC (AIDS Service Center of Lower Manhattan, Inc.) Association to Benefit Children Blythedale Children Hospital BOOM!Health Calvary Hospital (Including hospice, home care and wound care clinic) Center for Alternative Sentencing & Employment Services Charles B. Wang Community Health Center City Medical of Upper East Side, PLLC CityDrug & Surgical Citymeals on Wheels Community Healthcare Network Community League of the Heights, Inc. Dominican Women's Development Center Elizabeth Seton FEGS Fountain House, Inc. Ft. George Community Enrichment Center, Inc. Goddard Riverside Community Center God's Love We Deliver, Inc. Harlem United/Upper Room AIDS Ministry Inwood Diagnostic and Treatment Center Iris House Isabella Island Care Pharmacy Lenox Hill Neighborhood House Methodist Home for Nursing and Rehabilitation Metropolitan Center for Mental Health Mexican Coalition for the Empowerment of Youth and Families

Organization Name

MJHS

NAMI-NYC metro

NAMI-NYC Metro part of CBC

Natures Cure Pharmacy Inc

New York Center for Child Development

New York City Department of Health and Mental Hygiene

New York Legal Assistance Group, Legal Health Division

Northern Manhattan Improvement Corporation

Northern Manhattan Perinatal Partnership, Inc.

Northside Center for Child Development

Northside Psychiatry

Physicians Family Health Service

Project Renewal

Quick Rx Pharmacy - 27 Audubon Rx Corp

Realization Center

Schervier Nursing Care Center

St. Christopher's Inn

St. Mary's Center Inc.

St. Mary's Healthcare System for Children

The Bridge

The Hebrew Home at Riverdale

Union Settlement Association

Village Center for Care d/b/a VillageCare

VillageCare

Visiting Nurse Service of New York

Washington Heights Community Service

Washington Heights Corner Project

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Respondents

Respondents that are Healthix Members

12

1 Argus Community, Inc. Healthix 2 ASCNYC Healthix 3 Blythedale Children Hospital THINC 4 BOOM!Health Healthix 5 Charles B. Wang Community Health Center Healthix 6 City Medical of Upper East Side, PLLC Healthix 7 Community Healthcare Network Healthix 8 Harlem United/Upper Room AIDS Ministry Healthix 9 Isabella Healthix

10 MJHS Healthix 11 Physicians Family Health Service Healthix 12 Realization Center Interboro 13 Schervier Nurisng Care Center Healthix 14 The Hebrew Home at Riverdale Healthix 15 Village Center for Care d/b/a VillageCare Healthix 16 Visiting Nurse Service of New York Healthix 17 Washington Heights Community Service (blank)

Key Results (1)

31 of 62 (50%) indicated having an “EMR”

– Included MU-certified EMRs, nursing home systems, home health systems, etc.

– No predominant vendor

Foothold, McKesson, SigmaCare, ClientTrack, Accumed, Meditech, Qualifacts, GE Centricity, Aprima PM 2014, eCW, Dentrix, Practice Fusion, Evolve, Allscripts Homecare, Cerner Anasazi, MedcomSoft, PrimeRx, 10e11, PointClickCare, Delta Crescendo

– Some organizations listed more than 1 EMR

– In response to the MU stage

“None” – 18

Stage 1 – 11

Stage 2 – 2

Key Results (2)

19 of 62 (31%) indicated having care management software

– Systems mentioned

Allscripts Care Director, GSI, Roster Wrangler, iCare, Altruista,

HealthRules, “proprietary”, “multiple”

17 of 62 said they already are RHIO participants

IT budgets

– Greater than $10M – 3

– Between $1M and $10M – 7

– Between $100K and $1M – 21

– Less than $100K – 15

NYS Connectivity Assessment Plans Announced June 15, MAPP CIO Steering Committee

15

NYS Analysis of RHIO Functionality Announced June 15, MAPP CIO Steering Committee

16

Potential Survey Items Discussed at Last Meeting (4/28)

Current use of registries?

Current use of telehealth?

Current information security and consent management?

Current use of patient portals?

Current use of alert management?

Current use of reporting / analytics?

Current use of CRM?

Current use of EMPI?

Current use of Care Plans?

Identification of funded priorities vs. longterm, unfunded priorities?

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Next Steps / Action Items for Next Meeting

Current State Assessment

1. Wait for NYS Survey to be Administered (mid-July)

2. Wait for RHIO Analysis

3. Once above information has been received, consider what, if any,

additional information would be required from PPS participants to

achieve Milestone 2 (assessment)

Other Milestones / Other Concerns:

1. Identify Committee member(s) interest in Data Security Plan

contribution

2. Schedule timeline to review projects

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Appendix

19

NYP PPS Interoperability Planning Process

20

Develop

Project-

Specific

Workflows

Understand

‘touch points’

between

organizations

Harmonize

across

projects,

across

collaborators,

to develop

common

approaches

where

possible

Implement

harmonized

interoperability

Strategy

Goal of DSRIP is to make effective use of all available

services and to keep patients from sub-optimally using

the Emergency Department and Hospital.

NYP PPS Interoperability Strategy

Leverage RHIO

• Sharing of clinical data

• Support for event notification

Spread Allscripts Care Director

• Collaborative care management

• Similar to Health Home

Implement Direct Messaging

• Supports one-to-one referrals

• May be relevant when want to send data to one party but not make it available to all, e.g., mental health

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NYP PPS Interoperability Challenges

Designing the workflows that best use HIE and then implementing those workflows

Understanding how use of the RHIO, use of Direct and use of ACD all fit together to achieve the desired interactions

Understanding what the above can provide and what data exchange gaps remain that can put project goals at risk

Educating/creating a common level of understanding among PPS partners of the overall approach to interoperability and the capabilities and limitations of each component

Assuring smaller collaborators can participate in interconnected environment, e.g., help them plan for RHIO connectivity (identifying a sponsor, project management, legal, technical, clinical and consent workflows, privacy compliance, etc.), and implementation of Direct

Understanding current state and trajectory in becoming a mature technology

Staging / phasing

22