Transcript Slide 1

NC HIE Board Meeting
Implementing Statewide HIE in
North Carolina
Date: May 19, 2011
Time: 12:00 pm – 2:30 pm
NC Hospital Association
2400 Weston Pkwy, Cary, NC
Dial in: 1-866-922-3257 Participant Code: 654 032 36#
Agenda
12:00 pm –
12:15 pm
Welcome and Roll Call
Secretary Cansler
Approval of Minutes from April 21, 2011 Meeting
Unfinished Board Business
• Re-affirmation of Officers
Executive Committee Update
12:15pm –
12:45pm
CEO Update
Jeff Miller
12:45pm –
2:00pm
Work Group Updates
– Legal/Policy
– Governance
Work Group Chairs
2:00 pm – 2:15
pm
New Business
Secretary Cansler
2:15 pm – 2:30
pm
Open Public Comment & Closing Comments
Secretary Cansler
2
Unfinished Board Business
3
Board Unfinished Business
• Requirements for 501(c)(3) filing
• As required by Bylaws, the Board needs to affirm Initial Officers and
Executive Committee
• Lanier Cansler – Co-Chairperson
• Charles Sanders – Co-Chairperson
• Hadley Callaway – Vice Chairman
• Brad Wilson – Secretary
• Allen Dobson – Treasurer
• Bill Atkinson – Past Co-Chairperson
• George Saunders – Director at Large
• Conflict of Interest Documents
• Sent to all Board Members, Employees, and Key Contractors
• Other Unfinished Business
4
Board Schedule and Agenda
Date
Venue
Scheduled Topics
Key Decisions
Jun 16
Phone
•Technology Services RFP
Status and Plan
•Legal/Policy Workgroup
Review
• Approve Vendor selection for
Technology Services
• Approve Privacy Policy
Jul 21
NC IOM
• Technology Services
Contract
•2H11 Operational Plan
•Initial FY2012 Planning
Meeting
• Approve Vendor contract
• Approve 2H11 Operating Plan
Aug 18
Phone
Sept 22
TBD
Board Retreat
NC HIE staff will schedule an all day
board meeting focused on 2012
planning
5
CEO Update
6
Operations Update
•Staffing and Support Services
– CTO and VP, Finance and Operations candidates
–Over 500 applications for 2 openings
–Identified 7-10 qualified candidates per role
–Interviewed 3-4 candidates per role
–Finalists identified and offer letters forthcoming
– Legal Counsel
•Marketing Communications
– Capstrat contract signed
– Interviews with hospital stakeholders being scheduled
7
Policy Summaries
Hiring Policy
Executive Compensation
• Defines policies and procedures for
• Defines policies and procedures for
hiring new employees
• Mandates that all new positions be
approved by CEO and that the
position be either
• a new role included in the
approved budget
• the result of a transition of a
contractor/consultant role
• a replacement for an existing
role
• Prescribes that all openings will be
• documented with specific
skills and requirements
•publicly posted for minimum of
15 days
• have a minimum of three
candidates to be interview
• Defines approval and exception
processes
setting senior executive
compensation
• Mandates that all compensation
packages for senior executives will be
approved by the Executive
Committee
• Requires that CEO/HR provide
Comparative Baseline consisting of
total compensation levels of at least
2 comparable roles
• Requires that any additional
compensation (e.g. moving
expenses, allowances, etc.) be
defined and justified
• Requires that, other than CEO, all
senior executives will be hire “at will”
•Defines approval and exception
processes
Authorizations and Purchase
Limits
• Defines policies and procedures for
both approving and executing
financial commitments of the
organization
• Requires Finance to set up a
purchasing process and provide
quarterly reports to the Board
• Sets maximum approval levels of
• $75,000 – CEO
• $250,000 – Executive Committee
• $250,000+ - Board
• Sets signing authorities for
approved contracts at
• $250,000 – CEO
• $250,000 - Treasurer
• Defines delegation process
These policies will help streamline the start up operations until a complete set of
policies and procedures can be completed
•8
Operations Update
• Finance
• Status of ONC Grant Funding
• Finance strategy
– Draft Prepayment for Services Agreement shared with Executive Committee
– CMS Guidance on Medicaid support of HIE’s
• Service Development
• Vendor selection process for Technology Services has been initiated
• 32 Vendors have submitted a Letter of Intent
• RFP Response is due on Friday, May 20th
We are Here
Translate plan,
preferences, and
requirements – release
RFP
Conduct
reference
calls
Select and
prepare
evaluation
team
Review
written
responses
and down
select
Conduct
finalist
product
demos
Conduct
BAFO
workshops
Select
technology
partner
Contract
with
technology
partner
9
Work Group Updates
10
Legal and Policy
11
Legal & Policy: Timeline and Tasks
2011
Jan
Feb
Finalize Draft
Legislation
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Develop and Finalize Privacy and Security Policy and Procedures
Recent Accomplishments
• Opt Out consent legislation has been passed by the Senate, pending in House.
12
Legal & Policy: Development of Privacy & Security Policies
March 18 Meeting:
 Definitions
 Eligible Participants
 Access to Protected Health Information for Treatment, Payment and Health Care Operations
 Minimum Necessary Requirement
 Emergency Access
 Access Rights of the NC HIE Workforce
April 25 Meeting:
 Review Revisions to Above Sections
 Opt Out Consent Rights
 Restrictions on Access
 Accounting of Disclosures
 De-Identified Data
May 13 Meeting:
 Access to Data by Researchers
 Access to Data by Government Agencies
 Responding to Subpoenas and Discovery Requests
13
Legal & Policy: Next Steps
• Finalize privacy policies for submission to Board
• Develop security policies
14
Governance
15
Statewide HIE Governance: Timeline and Tasks
2011
Feb
Mar
Apr
Develop Qualified
Organization Criteria
May
Jun
Jul
Aug
Define Oversight Roles and
Enforcement Mechanisms
Sep
Oct
Nov
Dec
Develop Participation
Agreements
Recent Accomplishments
• Finalized recommendations for Qualified Organization selection criteria
• Developed preliminary recommendations for
• Oversight mechanisms
• Enforcement approach and escalation process
• Discussed considerations for NC HIE serving as a “Qualified Organization” and the implications
for oversight
16
Recommended Selection Criteria for Qualified Organizations
1. Be organized as a non-profit or for-profit corporation whose articles of
incorporation have been filed with the North Carolina Department of the
Secretary of State (or that has a certificate of good standing if
incorporated in a state other than North Carolina).
2. Agree to comply with NC HIE’s Statewide Policy Guidance (including
technical specification and privacy and security requirements) and ensure
that QO participants comply with them.
3. Agree to comply with, and ensure that its participants comply with, NC
HIE’s Fair Information Policy Principles
17
DRAFT Fair Information Policy Principles*
• Individual Access and Control: Individuals should be provided with a simple and timely means to access and
obtain their individually identifiable health information in a readable format and form. Further, there should be
openness and transparency about policies, procedures and technologies that directly affect individuals and/or
their individually identifiable health information, including their ability to opt-out or otherwise limit disclosure.
• Collection, Use and Disclosure Limitation: Individually identifiable health information should be collected, used
and/or disclosed only to the extent necessary to accomplish a specified purpose(s) and never to discriminate
inappropriately.
• Data Quality and Integrity: Persons and entities should take reasonable steps to ensure that individually
identifiable health information is complete, accurate and up-to-date to the extent necessary for the person’s or
entity’s intended purposes and has not been altered or destroyed in an unauthorized manner. Further,
individuals should be provided with a timely means to dispute the accuracy or integrity of their individually
identifiable health information, and to have erroneous information corrected or to have a dispute documented
if their request are denied.
• Safeguards: Individually identifiable health information should be protected with reasonable administrative,
technical and physical safeguards to ensure its confidentiality, integrity and availability and to prevent
unauthorized or inappropriate access, use or disclosure.
• Commitment to Reciprocity and Timeliness: Participants in the HIE should exchange individually identifiable
health information freely with other providers and organizations that have been formally approved to
participate in the HIE to coordinate patient care in accordance to the manner, timeframe, technical standards
and implementation specifications defined in North Carolina’s Statewide Policy Guidance.
• Accountability: These principles should be implemented, and adherence assured, through appropriate
monitoring and other means and methods should be in place to report and mitigate non-adherence and
breaches.
*The principles may evolve based on ongoing development and refinement of privacy and security policies
18
Recommended Selection Criteria for Qualified Organizations
5. Provide to NC HIE a list of current participants, updated on a regular basis in
compliance with a process to be established by the NC HIE Board, and a plan for
adding more participants.
6. Submit and annually update a Program Plan that describes specific activities in
which the QO will engage, including:
•
•
•
•
•
•
•
Marketing the HIE and recruiting participants
Enrolling and billing participants for QO and HIE services
Collecting and maintaining agreements with their QO participants
Maintaining a customer support process to field participant questions
Creating and maintaining a fair grievance process
Allocating resources for participation in statewide HIE collaborative process
Overseeing, auditing, and reporting QO participants’ compliance with the Statewide
Policy Guidance and any other applicable requirements
7. Demonstrate financial viability:
(a) On an annual basis:
• Submit a detailed business plan, including a three-year projection of expenses and
income and other sources of future revenues.
• Submit a rate plan outlining fee structures for HIE service for participants in the QO.
• Submit results of annual independent financial audit.
(b) Demonstrate adequate liability coverage relevant to the exchange of individually identifiable
health information (e.g., directors’ and officers’ liability, data theft, data mismanagement,
data generation errors, data breach, etc.), in accordance with such standards as may be
required by the NC HIE board of directors.
19
Governance: Next Steps
• NC HIE staff to develop:
– QO application process
– Oversight process
– Enforcement procedures
20
New Business
21
Open Public Comment and Closing Comments
22
ATTACHMENTS
Mission Statement of the NC HIE
As included in its Operational Plan, the
mission of the NC HIE is:
• To provide a secure, sustainable
technology infrastructure to support
the real time exchange of health
information to improve medical
decision-making and the coordination
of care.
Expectations of the NC HIE Work Groups
•
Participants have been nominated and invited to participate by the NC HIE governing board cochaired by Secretary Lanier Cansler and Mr. Charlie Sanders for your expertise in your field and
your commitment to improving health care quality, access, and affordability for all North
Carolinians.
•
Workgroup members are asked to draw on their expertise and perspective from across
industries sectors with an eye toward supporting the greater goal of a statewide resource for
North Carolina.
•
Workgroups are expected to be multi-stakeholder, nonpartisan and all discussions, meetings
and decision-making processes to be fully transparent.
•
Workgroups are asked to consider multiple stakeholder group perspectives when working
toward solutions.
•
Workgroups will be asked to make consensus-based recommendations to the NC HIE governing
board. In cases where consensus is not reached, the workgroup is expected to put forth a
balanced, fair consideration of the pros and cons of an issue.
•
Workgroup members are expected to respect the opinions and input of others and to engage in
fair meeting conduct to work toward consensus recommendations.
•
Workgroup members are strongly encouraged to attend meetings in person whenever possible.
•
Public stakeholder input is encouraged.
Governance Work Group
Co-Chairs
• Ben Money, NC Community Health Association
• Tom Bacon, UNC School of Medicine, AHEC
Members
• Connie Bishop, MSN RN, NC Nurses
Association
• Jacquelyn Boyden, Boyden Healthcare
Consulting
• Janis Curtis, Duke Health System
• Craigan Gray, DHHS DMA
• Mark Gregory, Kerr Drugs
• Don Horton, LabCorp
•
•
•
•
•
•
•
Steve Keene, NC Medical Society
Janice Lato, WNC Health Network
Harry Reynolds, IBM
Craig Richardville, Carolinas Healthcare System
Pam Silberman, NC Institute of Medicine
Craig Souza, NC Healthcare Facilities Association
Sam Spicer, New Hanover Regional Medical
Center
Clinical/Technical Operations Work Group
Co-Chairs
• Allen Dobson, CCNC
• J.P. Kichak, UNC Hospital
Members
• Ben Alexander, WakeMed
• Cynthia Cox, Raleigh Medical Group
• Sam Cykert, AHEC, Moses Cone
• Michael Fenton, NC CIO Office
• John Graham, UNC Institute for Public Health
• Susan Helm-Murtagh, BCBSNC
• Arlo Jennings, Mission Hospitals
• Yan Wang Kolbas, NC Nurses Association
•
•
•
•
•
•
•
Bill Leister, LabCorp
Keith McNeice, Carolinas Healthcare
System
John A. (Sandy) McNeill, NC Health Care
Facilities Association
Don Spencer, UNC Health Care
Angela Taylor, NC DHHS
James Tcheng, Duke University
John Torontow, Piedmont Health
Finance Work Group
Co-Chairs
• Maureen O’Connor, BCBSNC
• Dr. Dave Tayloe, Goldsboro Pediatrics
Members
• Mark Bell, NC Hospital Association
• Brian Harris, Rural Health Group, Inc.
• Yvonne Hughes, Coastal Connect HIE
• Mark Miller, Novant Health
• John Minnich, CSC
•
•
•
Steve Owen, NC Medicaid
Phred Pilkington, Cabarrus County
Health Dept.
Devdutta Sangvai, MD, Duke University
Medical Center
Legal/Policy Work Group – Legislation and Implementation Subcommittee
Co-Chairs
• Senator Josh Stein
• Representative Jeff Barnhart
Members
• Linda Attarian, NC DHHS (Vice-Chair)
• Judith Beach, Quintiles
• Mark Botts, UNC School of Government
• Chris Collins, NC Office of Rural Health and
Community Care
• Brian Forrest, Access Healthcare
• Chris Hoke, NC Department of Health &
Human Services
• Linwood Jones, North Carolina Hospital
Association
•
•
•
•
•
•
Trish Markus, Smith Moore Leatherwood
Barbara Morales-Burke, Blue Cross Blue
Shield of North Carolina
Melanie Phelps, North Carolina Medical
Society
Troy Trygstad, Community Care of North
Carolina
Robin Wright, NCHICA Consumer
Advisory Council
Bill Wilson, AARP