Onboarding Overview. December 3, 2013

Transcription

1 Onboarding Overview December 3,

2 2 Overview ehealth Exchange Overview Onboarding and Testing Process Resources and Tools

3 ehealth Exchange Health Bank or PHR Support Organization State and Local Gov Community Health Centers Community #1 Labs Shared trust framework and rules of the road Governed by Coordinating Committee SSA VA DoD CMS Integrated Delivery System The Internet Pharmacies Community #2 Supported by Healtheway Standards, Specifications and Data Use & Reciprocal Support Agreement (DURSA) for Secure Connections PHIN Conference 25 August 2008

4 ehealth Exchange Participants Alabama One Health Record Centers for Medicare and Medicaid Services (CMS) Childrens Hospital of Dallas Community Health Information Collaborative (CHIC) Conemaugh Health System Department of Defense (DOD) Department of Veterans Affairs Dignity Health Douglas County Individual Practice Association (DCIPA) Eastern Tennessee Health Information Network (ethin) EHR Doctors Hawaii Pacific Health Geisinger Health HealthBridge HealtheConnections RHIO Central New York HEALTHeLINK (Western New York) Idaho Health Data Exchange Indiana Health Information Exchange (IHIE) Inland Northwest Health Services (INHS) Kaiser Permanente Lancaster General Health Marshfield Clinic Medical University of South Carolina (MUSC) MedVirginia Michigan Health Information Network (MiHIN) MultiCare Health System National Renal Administrators Association (NRAA) New Mexico Health Information Collaborative (NMHIC) North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) OCHIN Quality Health Network San Diego Beacon Social Security Administration (SSA) South Carolina Health Information Exchange (SCHIEx) South East Michigan Health Information Exchange (SEMHIE) Strategic Health Intelligence University of California, Davis Utah Health Information Network (UHIN) Walgreens Wright State University 4

5 ehealth Exchange Anchor Participants 5

6 Healtheway Members 6

7 ehealth Exchange Growth Participation reaching critical mass 40+ Participants 59 in testing phase Hundreds of hospitals, thousands of physician practices, millions of patients Dozens of others planning to onboard National-level coverage increasing; reaching tipping point of adoption Collaboration extending breadth and depth of connectivity Care Connectivity Consortium Kaiser Permanente, Mayo Clinic, Geisinger, Group Health Cooperative, Intermountain Healthcare Meaningful Use (Stage 2) is one factor driving adoption among vendors and providers 7

8 Benefits to Participating in the ehealth Exchange Enables exchange of data with other participants in the ehealth Exchange community without additional testing or one-off agreements Recognition as part of trusted community Confidence that the connection can be trusted since every participant is expected to meet the conditions for trust Cost-effective and efficient (national-level ROI) since all participants exchange under a common trust and interoperability framework Compliance enforced by contract and an oversight committee Functional and scalable shared services that help you find exchange partners Contributes toward measures for MU2 related to the transitions of care and referrals objective 8

9 Healtheway Support of ehealth Exchange Healtheway supports the ehealth Exchange community by: Supporting the Coordinating Committee Facilitating Task Groups which develop and maintain the rules of the road (e.g. implementation specifications, test cases, operating policies and procedures, legal agreement, etc.) Supporting product testing program that verifies product compliance with ehealth Exchange requirements Providing an efficient participant testing program to support onboarding to production ehealth Exchange community Issuing and managing digital certificates used by ehealth Exchange participants Managing the directory which enables ehealth Exchange participants to find other exchange partners 9

10 ACTIVATE TEST APPLY Onboarding Process Submit Application Package and testing agreement and fees Coordinating Committee (CC) determines eligibility Complete testing readiness checklist Complete practice tests Submit completed test results to Healtheway Test results presented for CC approval Issue digital certificate Add to service registry Countersign DURSA Go Live! 10

11 Submit Onboarding Package Onboarding Package Application for Participation Testing Services Agreement Data Use and Reciprocal Support Agreement (DURSA) ehealth Exchange Participant Agreement NOTE: The following materials may be submitted with the Application Package; however, they must be received by Healtheway in order for Applicant to complete testing Testing Readiness Checklist Testing Fees 11

12 Eligibility Criteria Be a valid business in good standing or a governmental agency, operating in the US; Meet all solvency and financial responsibility requirements imposed by statutes and regulatory authorities; Be an organization or agency that oversees and conducts, on its own behalf and/or on behalf of its Participant Users, electronic transactions or exchanges of health information among groups of persons or organizations; Have the organizational infrastructure and legal authority (through statutes, regulations, organizational agreements, contracts or binding policies) to comply with the obligations in the DURSA and to require its Participant Users to comply with applicable requirements of the DURSA; Is not aware of any information that would preclude the Applicant from fully complying with the provisions of the DURSA; Intend to Transact information with other Participants for a Permitted Purpose as defined in the DURSA; Have sufficient financial, technical and operational resources to support the testing and operation of transactions among Participants; Submit a completed Application, signed DURSA Joinder Agreement (Attachment 7 of the DURSA), and the ehealth Exchange Participation Agreement; Successfully complete testing and be accepted by the ehealth Exchange Coordinating Committee. 12

13 Determine what you want to support in production Lookup and Retrieve Documents (for Care Coordination for Treatment and/or Social Security eligibility: Send SSA clinical data electronically to allow SSA to make faster disability determinations. Required Specifications: Messaging Platform, Authorization Framework, Web Services Registry, Patient Discovery, Query for Documents, Retrieve Documents) Select which, if any, Optional Services Applicant will support for this use case Access Consent Deferred Messaging for Patient Discovery Identify the types of documents/ data you will exchange using lookup and retrieval of document functionality HL7, v Bridge C32 C-CDA Unstructured documents Other: Please specify 13

14 APPLY Submit Onboarding Package to including testing fees Document Who to Involve Summary Application & Testing Services Agreement Primary Business Contact Privacy Security Business Office Human Resources Complete Application, with careful attention to questions 8 & 9 (DURSA Flow-Down Provisions) Sign the Application and Testing Services Agreement Submit payment of testing fees to Healtheway DURSA Primary Business Contact Legal Privacy / Security Review Sections and 15.05: DURSA Flow-Down Provisions Complete the Contacts for Notice (Attachment 4) Sign the DURSA Joinder Agreement (Attachment 7) Participation Agreement Primary Business Contact Legal Sign the Participation Agreement 14

15 How to Tackle the DURSA Review DURSA and assure you have mechanisms in place to comply with all provisions Consult, as necessary, with the following Privacy Security Legal Business Office Human Resources Specifically address the DURSA flow-down provisions in Sections and See DURSA Webinar on the Healtheway Onboarding web page for details Sign the DURSA Joinder Agreement (Attachment 7 of the DURSA, with Attachment 4 Contacts for Notice) 15

16 Participation Agreement Testing Services Agreement The business agreement between Healtheway and the applicant for the provision of testing services to the applicant Required to proceed to testing Participation Agreement The business agreement between Healtheway and the Participant for the provision of services, once accepted as a Participant Managing digital certificates required for secure exchange Maintaining UDDI registry Enabling access to exchange with other participants Support of the Coordinating Committee and its processes (i.e., supporting the breach notification process, etc.). Countersigned by Healtheway only when applicant is accepted as Participant 16

17 ehealth Exchange Participation Fees Annual Revenue Annual Participation Fee < $1M $4,750 $1 - $10M $9,950 More than $10M $19,900 Fees take effect in Annual Revenue is based upon annual healthcare revenue. For governmental agencies and non-profit organizations, this should be based upon annual operating costs. 17

18 ehealth Exchange Participant Testing Fees Tests Testing Fee 2010 Smoke Tests 1 $ 11, Smoke Tests 1 $ 11, Security Tests $ 8,000 Content 2 $ 3,000 Notes: 1 Discounted testing fee if testing both 2010 and 2011 Smoke Test Cases - $4,500 for the second version tested. 2 Content testing options: 1) Basic C32; 2) Bridge C32 and 3) C-CDA. Content testing is waived if Applicant uses a product that was certified for the 2011 or 2014 edition of EHR certification for Stage 1 or Stage 2 meaningful use. Scenarios Total 2011 (no content) $ 19, (with content) $ 22, (no content) $ 23, (with content) $ 26,500 Additional Fees - Extension (beyond 60 days from Official Results Submission to Healtheway) 15% of testing fee - Retest Fee (per test result) - $2,000 18

19 Determine Eligibility Healtheway staff review applications to verify completeness and readiness for CC review. Clarifications and additional information may be requested Completed application packages presented for CC review in monthly meetings If eligible, Applicant notified and referred to begin practice testing If ineligible or if insufficient information to determine eligibility, Applicant notified, with recommended next steps 19

20 TEST Complete practice testing Notify Healtheway when results ready for official review Task Who to Involve Summary Set up in Testing Environment Primary Testing Contact Complete DIL set up checklist Register in DIL Set up with applicable tests Review & Conduct Practice Testing Technical Contact Technology Partner/Vendor Review and execute test cases Complete practice tests and address identified deficiencies Notify when practice testing completed Validate Official Test Results Technical Contact Technology Partner/Vendor Applicant notifies Healtheway Unique Execution IDs Healtheway tester validates the results and prepares testing results report 20

21 Participant Testing Process Applicant Prepare Onboarding Package Practice Testing: Ready for PRD? Participant No Healtheway Package Complete? Ready to Test? No Yes Validate Results / Prepare Report e Activate for Production: Cert / UDDI Set Up No No Coordinating Committee Eligibl e? Yes Accept as Partici pant? Yes Aegis Test Lab Environment (DIL) and NIST CDA validator tools Practice testing in DIL and with NIST Tools 21 ehealth Exchange Participant Testing

22 Coordinating Committee Determines Participation Healtheway presents Applicant s test results to the ehealth Exchange Coordinating Committee for approval on monthly basis ehealth Exchange Coordinating Committee (CC) determines whether applicant is accepted as ehealth Exchange Participant If approved, applicant progresses to Activation If not approved, Applicant notified Approved applicants must go into production and be capable of exchanging, once activated in the service registry and using the ehealth Exchange digital certificate, within 120 calendar days following the CC approval date 22

23 ACTIVATE Coordinating Committee approval Activate Go Live! Task Who to Involve Summary Activation Materials Technical/ Operational Contact Complete & sign digital certificate form and agreement Complete service registry form Process Activation Materials Technical/ Operational Contact If complete, issue production certificate and add entry to service registry. Participant activated, with system staged in production and ready to exchange If not complete, notify applicant or, if necessary, present to Coordinating Committee for resolution 23

24 Monitor New participants, or existing participants who retest, are subject to a probationary period once in production (e.g. 90 days) Participants and their partners report issues via a designated mechanism Issues are triaged to assess whether participant is meeting conformance and interoperability requirements If all issues resolved, probationary period ends Matters may be escalated, including disputes, to the Coordinating Committee for resolution 24

25 For More Information admin at healthewayinc.org Onboarding: Testing Process: DIL Test Lab: 25