New Jersey Health Information Technology

Presentation to HIT Commission

August 5, 2010

Connecting Patients to a Greater State of Health

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State HIT Program Context

2

New Jersey Health Information Technology ProgramNew Jersey Health Information Technology Program

DHS

State of NJ Department Influencers

• NJ HIT Act 2007• HIT Commission• Office for e-HIT• NJ Health Information

Network (NJHIN)• NJAMHA

• Department of Medical Assistance and Health Services State HIT Plan

• Department of Children & Families

• Patients• NHIN • HL7• HISPC • HITSP • WEDI• Professional

Associations • Providers• Other Payers• Regional

Extension Centers • Community Health

Information Exchanges

• Best Practices & Standards

Federal Influencers

• ARRA Act• HHS • ONC• CMS• MITA• HIPAA • HRSA • CHIPRA • SAMHSA • NIST• AHRQ. • FHA• X.12• NCPDP• IHE – Integrating

Healthcare Enterprise • Federal Financial

Participation (FFP)• Federal Statute• Federal Policy• Federal Guidelines

DHSS

• Department of Labor • Office of Information

Technology (OIT)• State Treasurer• State Statute, Policy &

Guidelines• Best Practices & Standards

DOBI

State Medicaid HIT Plan

MCI Project

HIE

Hospitals, Physicians

FQHCs

eHIT Office

Regulation

Governor’s Office – Policy, StandardsGovernor’s Office – Policy, Standards

Project Governance•HIT Workgroup – SMEsHIT Workgroup – SMEs•Data GovernanceData Governance•Privacy & SecurityPrivacy & Security

• Project Management Office (PMO)Project Management Office (PMO)• Change Management & CommunicationChange Management & Communication• Risk/Issue ManagementRisk/Issue Management

• HIT Steering Committee HIT Steering Committee

HCFFA • Oversight of ONC funds• Financing to grantees

Regional Extension Centers (RECs) Regional Extension Centers (RECs) • Training• Education

• Awareness

MCI –Lead & Immunization Registries

State HIT Plan & Commission

Sustainability of HIE

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Approach – Two Focus Areas – Multi-Track

Operational Issues

•Meaningful Use•Labs•ePrescribing•Summary of Care•ONC Grant•HIT Operational Plan•HIE’s Start up•REC Vendor Preference List•REC Training•State Medicaid HIT Plan•Subcommittees

Strategic Alignment

•Governance•Stakeholder Engagement•Establishing HIT Core Tenets•Vision Sessions•Program Kick off•Innovation Summit – NJIT Center•Future Grants

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AccomplishmentsFocus InitiativeGovernance HIT Coordinator Appointment

HIT Commission Executive DirectorStatewide Governance Structure EstablishedRegional Extension Centers (REC) – NJ HITEC

Established HIT Steering, Financial Sustainability, Privacy,/Security and IT Arch/Data Standard

Transformation Planning NJ State HIT Plan

State Medicaid HIT Plan

Funding Received - PlanningFunding Plan Pending – HIEsFunding Received – Regional Extension Center (REC)

Implementation & Transformation Support Sharing Medication HistoryElectronic Data Sharing Agreements DraftStakeholder Analysis

National Involvement Multi-State Collaborative – Puerto Rico/Pennsylvania/Mid Altlantic – ImmunizationMMIS 2010 National Conference

REC Conference Providence

Technology & Business Transformation Master Patient IndexEnterprise Service Bus NJ State Blueprint - A centralise model (#4)– Contadins Patient & Document Locator Plus clinicat Content

HIE’s Helath eCitiJersey ConnectSouth JerseyCamdenOther HIE’s NHIN

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Governor’s OfficeGovernor’s Office

State HIT State HIT Coordinator Coordinator

Colleen WoodsColleen WoodsProgram CoordinationProgram Coordination

Implementation Implementation OversightOversight

Privacy & Security

Consumer Advocacy & Quality Care

EconomicDevelopment

FinancialSustainability

Architecture & Data

StandardsProviders

Standing Committees

LegislativeProgram

Management

HIT Commission

HIT Program Governance(Direction & Policy)

Legal Change

Management

Financial & Grants

Management

HIT Steering Committee

Office for eHIT Development

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HIT Program Work Streams

MedicaidMedicaidSMHP, IPP, MMIS Replacement, ICD-10, 5010,

NCPDP, CASS

Health Information Exchange (HIE)Health Information Exchange (HIE)HIE Planning, HIE Implementation, MPI

Regional Extension Center (REC)Regional Extension Center (REC)REC Planning, REC Deployment

HIT PlanningHIT PlanningState HIT Strategic Plan, State HIT Operational Plan

Change ManagementChange ManagementCommunication, Education, Marketing, Branding, Web

Site

Implementation Focused EffortsImplementation Focused EffortsOperation Focused EffortsOperation Focused Efforts

LegislativeProgram

Management

Legal Change Management

Financial & Grants

Management

Pilot ProjectsPilot ProjectsMulti-State Immunization, NJ/Puerto Rico

Governor’s OfficeGovernor’s Office

State HIT State HIT Coordinator Coordinator

Colleen WoodsColleen WoodsProgram CoordinationProgram Coordination

Implementation Implementation OversightOversight

HIT CommissionHIT Steering Committee Office for eHIT

Development

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Subcommittees

HIT Steering Committee – Chairs Colleen Woods Jim Cavanugh

Establish NJ Blueprint and focus operational issues, MU

Privacy and Security – Chair Helen Oscislawski

Develop a NJHIT Legal Framework by December 2010

Financial Sustainability – Chair Hall Gregg

Develop a NJHIT Statewide Financial Sustainability Plan by December 2010

IT Architecture& Data Standards – Chair Emmanouil Skoufos

Establish data standards and protocols addressing MU first

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Other Subcommitees - TBD

Consumer Advocacy and Quality Care

Economic Development

Providers

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Regional Extension Center

Outreach & Education Programs

Needs Assessment, Practice & Workflow Design

Vendor Selection Process

Interoperability and HIE Training & Assistance

Implementation Support

Privacy & Security Information Programs

Meaningful Use Training & Achievement Documentation

Workforce Development Training

CRM Focus

5,000 Physicians – First Target

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HIT Architecture

Lab and Pharmacy Providers

Internet

EHR A

OPTIONAL DATA REPOSITORIES

Internet

Health Services Provider (HSP) – connection to HNIN Direct

NJHIN Vision - Draft

Directory of Participating Entities(HIEs, RHIOs, & EMRs of Care Providers) (*)

Directory of Individual Care Providers (statewide Provider MPI) and HIE Addresses (*)

Edge Server for Conversion of

Non-HL7 & HL7 to IHE-formatted

transactions

Generic non-IHE compatible EMRs

NHIN Connect(full connection to NHIN)

EHR B

Transaction Options being discussed by Industry Experts

1. SMTP (email)2. REST (POST/GET) (web services)3. IHE (Integrating the Healthcare Enterprise-formatted transaction)4. XMPP (e.g., JABBER, Instant Messaging)

Patient Metadata for purposes of public health and quality

purposes (e.g., Public Health objectives, Evidence-Based

Analysis) and PHR use

[Managed by NJ DHSS]

Needed for Model 1

SureScripts HubWeb-based look-up only

LabCorp LabsQuest Labs

Various Data Submissions from

willing HIEs and EMRs[XDS(b) Repository]

PHR Services (web-based) for the General Public

EHR C

EHR D

Standalone EMRs

AtlantiCareInfoShare(Wellogic)

PDQ

PIX

XDS (b)

Health-e-Cities(IGI)

PDQ

PIX

XDS (b)

Jersey Health Connect

(McKesson)

PDQ

PIX

XDS (b)

Camden HIE(Noteworthy)

PDQ

PIX

XDS (b)

Federally-Funded HIEs

State Registries (birth, death, immunization, etc.)

NJ Medicaid Rx Data

NHIN Direct

This is Model 5

NJ Medicaid(Initiate)

PDQ

PIX

XDS (b)

BP

PC

– B

asic

Pa

tien

t P

riv

acy

Co

ns

ent

PDQ – Patient Demographics Query service

PIX – Patient Identifier Cross-Reference service

XDS(b) – Cross-Enterprise Document Sharing services (Registry only)

AT

NA

– A

ud

it Tra

il & N

od

e Au

then

ticatio

n

Data Subset for PHR

purposes

Virtua Health(Wellogic)

PDQ PIX XDS (b)

South Jersey HS(Mobile MD)

PDQ PIX XDS (b)

Meridian Health(ICA)

PDQ PIX XDS (b)

Monmouth-Ocean HIE

(Vendor TBD)

PDQ PIX XDS (b)

CentraState(Vendor TBD)

PDQ PIX XDS (b)

Trenton HIE(Vendor TBD)

PDQ PIX XDS (b)

Hunterdon Health(InterSystems)

PDQ PIX XDS (b)

Clara Maas(Axolotl)

PDQ PIX XDS (b)

STATE BackBone – Supports both NHIN Connect (blue boxes) & NHIN Direct (green boxes)

State EMPI:

State Index # & Patient identifiers submitted by various HIEs/EMRs

Needed for

Models 2, 3 & 4

XDS(b) – Cross-Enterprise Document Sharing services (Repository only)

Needed for Models 2, 3 & 4

Needed for Models 2, 3 & 4

Needed for Models 3 & 4

Also needed for Model 4

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Considering Core TenetsFederal FrameworkOverall improvement of the quality, safety and efficiency of healthcareHITECH – Advance the design, development and operation of a nationwide health

information technology infrastructure that allows for the electronic use and exchange of information.

Achieve Meaningful Use through 3 stage gatesEach person in the US has a health record by 2014Align to all Federal Privacy Requirements as outlined in HITECH

Core NJ Healthcare TenetsNew Jersey will be a national leader in HITNJ will exceed all federal guidelines of meaningful useNJ wants to reduce healthcare costs through HITHIT vision achieved in 3 yearsPublic health monitoring – Leverage data to monitor health statusPopulation health protection – Leverage data to protect population Retool and develop job market based on HITProviders will experience increase in reimbursements due to state savingsFully integrate Behavioral Health and Addiction Services data with clinical dataNJ will highlight/focus on care of the elderly – long term careNJ will highlight/focus on pediatric careNJ citizens will have full access to their medical data and an electronic interaction with

their providers.