Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012

1. Developing an Ecosystem
of Connected Capabilities:
Collaboration with States
and Vendors
Presented by: Dave Whitlinger,
Executive Director, New York eHealth Collaborative
February 23, 2012
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2. NEW YORK eHEALTH COLLABORATIVE
NYeC is a not-for-profit organization, working to improve healthcare for all
New Yorkers through health information technology.
Promote the adoption and use of electronic health records
• Educate the public on the benefits of EHRs
• Assist providers transitioning from paper to electronic records
• Assist providers to qualify for Meaningful Use reimbursements
Build the SHIN-NY (State Health Information Network – New York): A secure
network for sharing electronic medical records across the state
• Allow providers to share information
• Promote collaborative care so doctors work as a team to benefit the patient
Develop statewide policies regarding HIT
• Convene stakeholders and build consensus
• Collaborate with NYS Department of Health
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3. SHIN-NY: THE NETWORK OF MAJOR HEALTHCARE
PROVIDERS WITHIN NY
• Through the HEAL grant program,
the NY State Department of Health
helped create 12 HIEs in New
York.
• Each HIE has built a local health
information exchange network and
is in the process of connecting the
healthcare providers in their
community – SHIN-NY 1.0
• SHIN-NY 2.0 will connect together
all of the individual HIEs into a
statewide network
Every state in the country is developing
a similar health information exchange network.
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4. THE OPPORTUNITY
• To improve care and decrease costs, healthcare payment systems are rapidly
shifting towards new payment mechanisms that require physicians to
collaborate on patient care
• The current market of EHR systems does not provide physicians with the tools
they need to share patient data and collaborate on patient care across the
multiple providers
• New York is leading the nation in the development of a state health information
exchange network and has established a large community of healthcare organizations
who are now connected, and facing the new collaborative care challenges
• Through partnership with other states, New York has created an industry forum
to establish a standardized “health information exchange” platform that would
create the ability to develop software applications that could be easily be installed in
many states
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5. PAYMENT REFORM REQUIRES NEW INNOVATIONS
INNOVATIONS NEEDED:
Care Integration Tools
Analytics/Data Mining
Timely Clinical
Decision Support
Consumer Engagement
Tools
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6. HEALTH INFORMATION EXCHANGE PLATFORM
Health Information • The HIE Platform is a networked
resource that has the ability to provide:
APPLICATION PROGRAMING INTERFACE
Exchange Software
• Patient Records including symptoms,
Patient Record
treatments, meds, allergies, radiology,
Locator Service
etc.
Patient
Database Identity Mgmt & • Patient identity and contact information
Authentication for administrative uses
Patient Consent • Provider identity and contact information
Provider Management for administrative uses
Database
Message • Legal records to manage and adhere to
Routing state privacy and data usage policies
• Patient care plans
Electronic Health Record Connections
• Analytics for population health and
A B C X Y Z individual physician panel management
• Communications between providers,
public health, and patients.
HOSPITAL A PRACTICE C PRACTICE Y
FQHC B HOSPITAL X HOSPITAL Z
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7. PLATFORM OF CONNECTED CAPABILITIES
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8. 4 FOCUS AREAS EMERGE
CARE PLAN • A common care plan that provides support for team based care
including tools required to support transitions of care.
MANAGEMENT
• Management of patients by risk category
ANALYTICS • Analytical tools required to support retrospective and predictive
analysis related to care coordination, panel management.
• Secure Messaging & Alerts at the point of care alerting to
PHYSICIAN ALERTS transitions of care
• Personal health management solutions that enable patient
PATIENT interaction with care team
ENGAGEMENT
• Telehealth tools that allow for better care at home
• Tools that allow patients to make better health care decisions
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9. MULTI-STATE/MULTI-VENDOR COLLABORATIVE
• NYeC has created the EHR/HIE Interoperability Workgroup to develop
technical standards for interoperability between HIE software
platforms and the applications that interface with them –
predominately electronic health record systems.
• State definition of use cases and commitment to buy common standards
creates a larger potential market and a clearer development roadmap for
vendors.
• Vendor collaboration and commitment to common APIs and certification of a
common HIE platform creates a potentially larger opportunity for all of them
by guaranteeing interoperability.
• Support from the federal government through standards setting bodies and
grant programs.
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10. MAJOR FUNCTIONAL NEEDS ADDRESSED
• Statewide Send and Receive Patient Record Exchange
• Enables user interaction with a common service to identify the address of an intended
recipient such as an individual provider or entity
• Defines a recipient's application capability to conduct exchange with compatible
protocols and provides the ability for receiving systems to process specific payloads
• Statewide Patient Data Inquiry Service
• Defines a patient inquiry and record retrieval service utilizing message record routing,
master patient index, authorization framework and identity management
• Extensible and is adaptable to the needs of other interoperability services such as a
Statewide Master Patient Index (SMPI) and Record Locator Service (RLS)
• Continuity of Care Document (CCD)
• Priority was assigned to development of a consistent implementation of the HITSP C32
CCD specification which could be implemented in a repeatable manner between EHRs
and HIEs.
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11. WIN-WIN-WIN STRATEGY FOR ALL STAKEHOLDERS
Vendors
• Differentiate product in highly fragmented market by developing a product that
offers “plug and play” to HIE across multiple states (superior interoperability)
• Build interface once, use for many different HIEs and EHRs
• Better utilize limited resources to focus on product functionality improvements and
customer adoption
State and Regional HIE
• Ability to rapidly deploy interconnection of systems by having standard interfaces
and interface approaches
• Minimize costs associated with connection fees by individual EHRs each time a
new connection is made
Providers
• Increase value proposition of individual EHRs
• Eliminate HIE connection cost as prohibitive barrier for adoption
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12. WORKGROUP MEMBERS
States EHRs HIEs • 10 States represent
~ 40% of US Population
California Allscripts ApeniMED
Colorado Cerner Axolotl • 26 Vendors are leading
Illinois DeFran Systems dbMotion EHR and HIE vendors
with significant market
Kentucky Dr. First GE
share
Maryland eClinicalWorks GSI Health
New Jersey eMDs HealthUnity
New York ePocrates ICA
Oregon First Medical Solutions InterSystems
Utah GE MedAllies
Vermont Greenway Medicity
McKesson Mirth
NextGen Misys Open Source Solutions
Sage
Siemens
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13. INTEROPERABILITY STRATEGY
Phase I: Develop Phase II: Develop Mechanisms
Implementation Guides for Compliance to Specifications
 Form workgroup with states and • Develop test specifications
vendors • Leverage REC program to drive
 Develop priority list of capabilities compliance of specifications
 Create functional & technical • Engage broader vendor
specs community for adoption of
 Collaborate with state policy specifications
advisory groups to ratify criteria • Create mechanisms to promote
 Harmonize with ONC use of standards in connecting
EHRs to HIEs
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14. Terms of Participation Agreed to by All
Stakeholders
State Responsibilities Vendor Responsibilities
 Actively participate and obtain buy-in  Vendor Responsibilities
with state policy groups
 Actively participate in workgroup
 Agree to develop compliance process
 Work collaboratively with potential
for interfaces within state
competitors
 Ensure that specifications developed
 Utilize off the shelf standards
are utilized in their state.
 Commit that upon final approval of the
 Market to the healthcare provider
specifications to develop product that
community the value of using EHRs
meets such specifications within 1-2
and HIEs that pass the “plug and play”
major product releases
compliance testing

15. SPECS COMPLETED AND RELEASED NOV 8TH
FANTASTIC RESPONSE FROM THE HIT MARKETPLACE
5,000 website visits, 500 Document Downloads, 125 Membership
requests from States, EHR Vendors, HIE Vendors, and others
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16. DRIVING INNOVATION: ENGAGING WITH THE HIT
ENTREPRENEURIAL COMMUNITY
• Develop an API layer on top of HIE infrastructure to
support coordinated care
• NYeC will be launching an API in early Spring to allow innovative
software development companies to provide apps and tools to
providers leveraging the statewide network
• Incubate Companies that offer Clinical capabilities in
support of New Payment Models
• Harness innovation by providing educational
sessions and market access to healthcare providers
to innovative companies
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17. SUMMARY
• HIE is essential to delivering coordinated, accountable
patient-centered models of care
• The key to driving adoption of HIE services is agreement on
the adoption of common principles, standards, and policies
• Collaboration between HIE Programs and Vendor Community
is an effective way to show real-world implementation of
standards and can help influence national direction
• In order to drive sustainability, State HIE programs need to go
beyond core capabilities and work with the HIT software
development organizations to develop innovation tools for
providers on top of the HIE platform

18. Questions?
Anuj Desai
Director, New York eHealth Collaborative
adesai@nyehealth.org
• For More information on the EHR/HIE Interoperability Work
Group, to download specifications, and to become a member go to:
www.interopwg.org