Archived Questions and Answers

Health Information Technology

Table of Contents

  1. How might potential Health Home providers access and analyze timely patient data over the next 18 months if they operate in regions without operational RHIOs?
  2. Will the State invest in off the shelf software analytic systems that can be shared openly and ramp up implementation faster?
  3. Beyond the 18 month transition period, what will the route to accessing patient data for clients not receiving care in the provider´s own system?
  4. Will it be through the database of either an HMO or BHO?
  5. Is the patient health record required to be certified as an EMR under the Federal program for reimbursing doctors for adoption of EMR´s?
  6. We have an inexpensive telemedicine application with a comprehensive electronic health record that could be adjusted to be a perfect adjunct to the Health Home program. Would you have any contact information for managed care organizations that are expressing interest in this program?
  7. On page 10, Section VI of the Health Home application (HIT): we would need to tighten up a process to meet the guidelines of 6b and it may not be available on day one of certification as a health home. Is that acceptable?
  8. Concerning IT capability, what must a Health Home provider have in place by February 15?
  9. What will be the nature of Health Home reporting, particularly regarding tracking individuals especially outreach, housing, clubs, etc.? What will be the required reporting frequency?
  10. Is it required to have a working electronic health record by the start of the Health Home program?
  11. If our agency does not yet have an electronic medical record system (EMR) and is not yet a member of a regional health information organization (RHIO) will we be disqualified from becoming a Health Home network lead agency?
  12. The requirement that the plan of care exist in a health record system that meets HITECH and meaningful use is difficult and impractical to achieve. Most care management platforms, that have extensive plans of care, will not meet meaningful use standards for some time to come and are often done centrally outside the EHR; however, most certified electronic medical records will. It will not be feasible to have the plan of care exist in a platform that meet all meaningful use provisions, especially if we are linking multiple provider organizations. Possibly one way around this is to work towards putting the plans of care into the RHIO, making the info accessible to all RHIO users but we are not sure if RHIO platform meets all HITECH.
  13. In speaking with EMR vendors and RHIOs most health information technology seems to be designed around the medical practice. Has the state reached out to EMR vendors and RHIOs to discuss developing resources to support the Health Home?
  14. Since the application requires the Health Home provider to use an electronic health record system that qualifies under meaningful use provisions of the HITECH Act, does this refer to the care management and planning record, to the systems utilized by the medical/behavioral health providers, or the information sharing portals provided by the RHIOs?
  15. When does the clock start ticking on the 18th months referred to for Phase 2?
  16. All along, Health Homes have been implying that Care Managers would have access to this medical information and that it is essential for us doing our jobs of care management. Is that not the case any longer?
  17. If the care manager is responsible for assuring everything that´s ordered gets done, why are they not required to meet the 6F requirements?

Back to current Q&As

1. How might potential Health Home providers access and analyze timely patient data over the next 18 months if they operate in regions without operational RHIOs?

RHIOs cover every county in NYS. The RHIOs/Qualified Entities will be looking to work with the health home providers and other stakeholders to increase functionality for data exchange.

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2. Will the State invest in off the shelf software analytic systems that can be shared openly and ramp up implementation faster?

The State is working with NYeC and the RHIOs/Qualified Entities to build core statewide services that will enhance connectivity and analytic systems.

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3. Beyond the 18 month transition period, what will the route to accessing patient data for clients not receiving care in the provider´s own system?

It will be up to the health home provider to connect the disparate information sources, and continue to leverage the state´s HIE infrastructure.

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4. Will it be through the database of either an HMO or BHO?

An HMO or BHO could provide access to encounter data that would help to support this requirement. In addition, clinical information would be available via the RHIOs/Qualified Entities.

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5. Is the patient health record required to be certified as an EMR under the Federal program for reimbursing doctors for adoption of EMR´s?

Where certification is available, certified EHRs must be utilized as defined under the Federal Program for adoption and for meeting Meaningful Use.

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6. We have an inexpensive telemedicine application with a comprehensive electronic health record that could be adjusted to be a perfect adjunct to the Health Home program. Would you have any contact information for managed care organizations that are expressing interest in this program?

No. It would be the responsibility of the health home to establish connections with the stakeholders involved in the care/services of the patient.

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7. On page 10, Section VI of the Health Home application (HIT): we would need to tighten up a process to meet the guidelines of 6b and it may not be available on day one of certification as a health home. Is that acceptable?

No.

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8. Concerning IT capability, what must a Health Home provider have in place by February 15?

By program implementation or the phase start date, Health Homes in that phase must be able to minimally meet the Health Home Provider Qualification Standards for HIT as described in Section 6a–d. Additionally, any health home applicant who cannot meet the final HIT requirements as described under Section 6e–i in the Provider Qualification Standards must submit a plan for how they will be met within the following 18 months.

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9. What will be the nature of Health Home reporting, particularly regarding tracking individuals especially outreach, housing, clubs, etc.? What will be the required reporting frequency?

The SPA outlines quality and tracking information which the State hopes will come primarily from claims and encounters data. Other data under discussion include patient functional status and the use of surveys to collect patient experience.

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10. Is it required to have a working electronic health record by the start of the Health Home program?

No. However, requirements 6a–d of the Provider Qualification standards must be met, if not electronically, then through other means and a plan indicating how the final HIT standards will be met within 18 months must be included in the application.

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11. If our agency does not yet have an electronic medical record system (EMR) and is not yet a member of a regional health information organization (RHIO) will we be disqualified from becoming a Health Home network lead agency?

No. An EMR system and RHIO membership is not an initial requirement for submitting an application to become a Health Home. However, the Health Home lead applicant must meet VI.6a–6d requirements as defined in the Health Home Provider Qualifications, if not electronically, then through other means and provide a plan describing how they will achieve the final standards cited in Provider Qualifications VI.6e–6i within 18 months.

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12. The requirement that the plan of care exist in a health record system that meets HITECH and meaningful use is difficult and impractical to achieve. Most care management platforms, that have extensive plans of care, will not meet meaningful use standards for some time to come and are often done centrally outside the EHR; however, most certified electronic medical records will. It will not be feasible to have the plan of care exist in a platform that meet all meaningful use provisions, especially if we are linking multiple provider organizations. Possibly one way around this is to work towards putting the plans of care into the RHIO, making the info accessible to all RHIO users but we are not sure if RHIO platform meets all HITECH.

The intent is for the care plan to be accessible to all members of the Health Home member´s care team. Working with the RHIOs to make this information available to the Health Home providers would certainly be an option. Since the RHIO is storing the data or aggregating the data, the ´platform´ does not need to meet the HITECH but will need to meet the States policies for sharing electronic health information.

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13. In speaking with EMR vendors and RHIOs most health information technology seems to be designed around the medical practice. Has the state reached out to EMR vendors and RHIOs to discuss developing resources to support the Health Home?

New York has two Regional Extension Centers (REC) to promote adoption and connectivity of electronic health systems. This support aligns with a care coordinated approach such as the Health Home. You should discuss support for these services with the REC or your RHIO.

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14. Since the application requires the Health Home provider to use an electronic health record system that qualifies under meaningful use provisions of the HITECH Act, does this refer to the care management and planning record, to the systems utilized by the medical/behavioral health providers, or the information sharing portals provided by the RHIOs?

This is for the EHR utilized by the providers. Where there is an applicable EHR available, eligible providers must use an EHR meeting the qualifications under meaningful use. ONC is determining which vendors and products can meet these qualifications. This is currently applicable for primary care, specialty care and hospital EHRs. As the capabilities and provider types expand, the Health Home providers will be expected to adopt the newer standards for HIE.

The Office of the National Coordinator is working to create interoperability standards for care plan applications. The hope is that within the next several years, these standards will be adopted by HL7 as a part of Meaningful Use. At that time, there will be an expectation that care plan applications used by Health Homes will fall under the provision of Meaningful Use.

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15. When does the clock start ticking on the 18th months referred to for Phase 2?

The 18 month timeframe for meeting HIT standards for Phase 2 started April 1, 2012 and ended September 30, 2013.

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16. All along, Health Homes have been implying that Care Managers would have access to this medical information and that it is essential for us doing our jobs of care management. Is that not the case any longer?

You are required to have an accessible plan of care (not a part of standard 6F). There are a variety of ways to access information such as a portal system or RHIO or it can be integrated into the EHR. The DOH 5055 consent form can also be used to share information within the plan of care between care management and other care plan team members.

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17. If the care manager is responsible for assuring everything that´s ordered gets done, why are they not required to meet the 6F requirements?

The care manager doesn´t have an EHR. Right now there is no certified care manager application. If there were a certified EHR that the care manager would need, they would have to meet the 6F requirements. As per question 37, ONC is working on standards for a certified for meaningful use care plan application but that solution is still several years away.

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