New Jersey Innovation Institute Running on FHIR

New Jersey Innovation Institute Running on FHIR

New Jersey Innovation Institute Running on FHIR 1 Who Are We? Van Ly Senior Director, Business Development John Novak Senior Director, Government Technology and Architecture

S. Arnold Zimmerman, Esq. (Van) Compliance Officer, New Jersey Innovation Institute Executive Director for the New Jersey Health Information Network 2 What is NJIIs Healthcare Delivery Systems iLab? Healthcare Focus (obviously) Reduce Cost

Improve Quality Improve Access Improve access to data which can Improve care delivery 3 What is NJIIs Healthcare Delivery Systems iLab? Market/Funding Triad

Federal State Private (Healthcare Innovation Solutions) Leverage federal & state funding to develop solutions Which can be brought to market 4 Projects

Practice Transformation Network (PTN/TCPI) Merit-based Incentive Payment System (MIPS) Delivery System Reform Incentive Payment (DSRIP) New Jersey Health Information Network (NJHIN) Onboarding of Trusted Data Sharing Organizations Substance Use Disorder Promoting Interoperability Program (SUD/PIP) Implementation Advanced Planning Document (IAPD) Programs Network of Quality Improvement and Innovation Contractors (NQIIC) 5 New Jersey Health Information Network (NJHIN)

Healthcare Division 6 New Jersey Health Information Network-The Past 7 NJHIN-Exchanging Data Since 2015 Statewide Infrastructure for Health Data Exchange Created and owned by the NJ Department of Health Managed by NJII Requirement for Charity Care Reimbursement Future Requirement for Delivery System Reform Incentive Payment (DSRIP)

Leverage Technology to Improve Health Outcomes and Lower Costs Legal Framework Data Sharing Data Use and Reciprocal Sharing Agreement (DURSA) Governance - Advisory Council - Participating Members, or Trusted Data Sharing Organizations - Committees for Compliance and Use Case Development 8 NJHIN Data Highway In Production In Development 9

New Jersey Health Information Network-The Present 10 Participating Organizations of NJHIN: Bergen New Bridge Medical Center Advocare, LLC OneHealth New Jersey (MSNJ)* Prime Health* Camden Coalition* Carepoint

RWJBarnabas Health St. Josephs Regional Medical Center St. Peters Healthcare System CentraState East Orange General Hospital Healthy Greater Newark* Trenton Health Team* HealthShare Exchange (HSX)* Jersey Health Connect* Coming Soon

Hudson Regional Medical Center NJSHINE* * Indicates Multiple Organizations are represented by a TDSO 11 NJHIN By The Numbers Hospitals Contributing ADTs Test-68 Live-48 1.9 Million ADTs/Week Master Person Index >7,092,000 unique lives

12 Live Today and In Development Live Today In Development Master Person Index (MPI) Transitions of Care (CCDA Routing)

Health Provider Directory (HPD) Immunization Registry Query Active Care Relationship Service (ACRS) or Attribution Immunization Registry Submission

PMP Query (pre-fetch) Opioid Risk Factors CCDA Query/Retrieve Patient App

Risk Assessments (FHIR) POLST Common Key Service (CKS) ADT Notifications 13 New Jersey Health

Information Network-The Future 14 Connecting to NJHIN for Charity Care "Notwithstanding the provisions of any law or regulation to the contrary, the amount hereinabove appropriated for the Charity Care Subsidy is subject to the condition that participating hospitals shall demonstrate participation in the New Jersey Department of Healths New Jersey Health Information Network (NJHIN). $252 Million in NJs Charity Care budget Nearly 1.1 Million Uninsured in NJ, of which

100,000 are under the age of 18 Connecting to NJHIN for Charity Care 68 out of 71 are actively participating in the NJHIN 48 out of 71 are actively sharing ADTs with NJHIN Available Funding for Connection DMAHS and DOH Programs to Support NJHIN Connection

For Medicaid Providers that seek to connect to NJHIN for Transitions of Care and ADT Receiver: Provider - $1,500 / provider ACTIVELY ENROLLING Hospitals - $35,000 / hospital OUT OF MILESTONES Non-Hospital Facilities (SNF, Long Term Care, Sub-Acute, Urgent Care - $5,000 ACTIVELY ENROLLING Program ENDS: September 30, 2019 DMAHS and DOH Programs to Support NJHIN Connection For Medicaid Meaningful Use Providers that seek to connect to NJHIN for Transitions of Care and ADT Receiver: Provider - $1,500 / provider ACTIVELY ENROLLING Program ENDS: September 30, 2019 (seeking

extension to support 2020 Medicaid PI Attestation) Promoting Interoperability for New Jersey Substance Use Disorder (SUD) Providers To address the NJ Opioid epidemic, the Murphy Administration has invested $6 million in the SUD Promoting Interoperability Program (SUD PIP). Close the EHR disparity amongst SUD providers Connect siloed systems of care to enhance coordination efforts and improve quality Aid in shorter-term response efforts to this crisis Increase bandwidth and capacity for treatment Promoting Interoperability for New Jersey Substance Use Disorder (SUD) Providers

Joint Initiative (power of many): Department of Health Department of Human Services (Divisions of Medical Assistance and Health Services & Mental Health and Addiction Services) New Jersey Association of Mental Health and Addiction Agencies The New Jersey Innovation Institute SUD Providers SUD Patients SUD PIP Funding Advancing Interoperability Playing with FHIR

23 What is FHIR? FHIR Fast Healthcare Interoperability Resources (hl7.org/fhir) is a next generation standards framework created by HL7. Resourced Bases Framework A common way to define and represent the resources A common set of metadata (a set of data that describes and gives information about other data.) A human readable part Open API

Whats an API? What is SMART on FHIR SMART, which stands for: Substitutable Medical Applications, Reusable Technologies Leverages the FHIR standard to normalize regardless of Electronic Health Record being used Focused on how it interact with the user and application Think about how you can use your google or Facebook Blue Button 2.0 Blue Button 2.0 from CMS is an API that contains four years

of Medicare Part A, B and D data for 53 million Medicare beneficiaries. Blue Button 2.0 uses the HL7 FHIR standard for beneficiary data and the OAuth 2.0 standard for beneficiary authorization. What is What is Argonaut? The Argonaut Project is an implementation community comprising leading technology vendors and provider organizations to accelerate the use of FHIR and OAuth in health care information exchange. What is Da Vinci Da Vinci stakeholders are industry leaders and health IT

technical experts who are working together to accelerate the adoption of HL7 Fast Healthcare Interoperability Resources (HL7 FHIR) as the standard to support and integrate value-based care (VBC) data exchange across communities. A short introduction to resources Medications are just the tip The ordering, dispensing, administration of medications and recording statements of medication use. Recording of Immunizations given (or not given), evaluation of given immunizations and recommendations for an individual patient at a point in time. The creation or querying for medications as part of drug information or drug knowledge. MedicationRequest

MedicationDispense MedicationAdministration MedicationStatement Medication MedicationKnowledge Immunization ImmunizationEvaluation ImmunizationRecommendation Consumer Mediated Exchange Consumer Driven Breaks through the

interoperability challenges by empowering the patient to upload, share, and maintain his/ her health data. This highly secure application is tailor made for the basic smart phone user. Consent Management The app provides a unique, simple, and secure document sharing process. The patient/owner of the document is able to accept or deny document requests, and does not have to set any

preliminary permission rules. Advancing Interoperablity This process also includes a unique model for a provider to forward documents to a patient or provider that is easy as printing a Document. This eliminates the need for an interface between MiQlave and the providers EMR. What is FHIR is NOT?

A silver bullet A programming language It is a framework based on Open Different systems expose different recourses Read only in many cases (we wouldnt let people change a paper record?)

Mature (Normative yes) Whats Next? FHIR Gateways to access health data Public Health Access for Submitting to public health resources State-wide Gateway for Apps to interact Secure and trusted framework

Authorization Consumer engagement enhancements Enabling New Jersey Blue Button All of Us THANK YOU

31

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