Next Steps for Healthcare Information Exchange in Massachusetts

Tomorrow, I'm running a retreat of the New England Healthcare Exchange Network (NEHEN) Board of Managers and several invited stakeholders to discuss our 5 year plan for enhancing HIE functionality in the state. What are our guiding principles?

1. Create functionality that supports the workflow of our stakeholders

NEHEN's Board includes payers, providers, and patient advocates. As we think of the capabilities and functions supported by an HIE, we must meet the business needs of our stakeholders. Meaningful use is designed to foster healthcare information exchange and we want to facilitate meaningful use, but not at the expense of ignoring the needs of our stakeholders who have compliance, strategic, and customer driven needs.

2. Develop a framework of reusable functional components

In 2009, we've received 19 requests for new HIE projects. Each project is a "one off" with its own unique workflow and data exchange requirements. It is not scalable, sustainable or affordable to take on ad hoc projects that differ across each community. Ideally we'll be able to break down all our requests into a series of reusable capabilities that can be reassembled without significant IT effort to address the new project requests. Here's a list of candidate capabilities that we'll review:

Communicate Ambulatory Prescriptions

Communicate Structured Documents

Communicate Unstructured Documents

Communicate Clinical Referral Requests

Communicate Lab Results Messages

Communicate Lab Results Documents

Communicate Imaging Information

Communicate Quality Measures

Update Immunization Registry

Retrieve Immunization Registry Information

Communicate Emergency Alerts

Communicate Resource Utilization (hospital resource availability in a disaster or outbreak)

Communicate Benefits and Eligibility

Communicate Referral Authorization

Manage Consumer Preference and Consents

Access Control Service

Security Audit/Disclosure Service

Patient Identification Management Service

Knowledge and Vocabulary Service

Healthcare Document Management Service

Query for Existing Data Service

Administrative Transport to Health Plan Service

HL7 Messaging Service

Emergency Message Distribution Service

3. We need to prioritize these capabilities to guide our development efforts of over the next 5 years.

Given the business priorities of our stakeholders to achieve Medicare Part D incentives, Meaningful Use, ICD-10/5010 transition, and support Healthcare Reform, we'll develop a 5 year rollout plan for these services that will meet the greatest needs for the great number.

The outcome of this retreat will provide a foundation for the Massachusetts eHealth Institute's (our state government procurement organization for healthcare IT) ONC planning grant application.

I look forward to the retreat.