HIE Priorities:

The immediate priority of the State HIE program is to ensure that all eligible providers within every state have at least one option available to meet the HIE requirements of meaningful use in 2011. Accordingly, states and SDEs must outline in their State Strategic and Operational Plans a concrete and feasible plan to enable the following priority HIE capabilities:

While it is ultimately the responsibility of each Program awardee to determine the specific role and infrastructure of its HIE, the Program Information Notice (PIN) has outlined six key responsibilities for States and SDEs that must be fulfilled for continued funding through the StateHIE Program. The table below details how these responsibilities relate to the three HIE priority capabilities.

A table that details how the six key responsibilities for states and SDEs relate to the three HIE priority capabilities. The three columns, from left to right, are e-prescribing, lab results and patient care summaries. The rows correspond to each of the six responsibilities. The first row is “Initiate a Transparent Multi-Stakeholder Process.” For e-prescribing this means: convene stakeholders, including pharmacies, hospitals, payers and vendors, to determine number and types of pharmacies within state and percentage engaged in electronic exchange. For lab results this means: convene stakeholders, including labs, lab organizations, payers and vendors, to determine number and types of labs within state and percentage engaged in electronic exchange. For patient care summaries this means: convene stakeholders including providers, consumers, payers, and vendors. The second row is “Monitor and Track Meaningful Use HIE Capabilities in the State.” For e-prescribing this means: monitor data on % of pharmacies accepting electronic prescribing and refill requests. For Lab Results this means: % of clinical laboratories sending results electronically and % of health departments receiving immunizations, syndromic surveillance and notifiable lab results. The third row is “Assure Trust of Information Sharing.” For all three priorities this means: ensure the state’s privacy and security framework for HIE is consistent with and addresses the elements of the HHS HIT Privacy and Security Framework. The fourth row is “Set Strategy to Meet Gaps in HIE Capabilities for Meaningful Use.” For e-prescribing this means: use policy, purchasing and regulatory actions such as requiring e-prescribing in state or Medicaid contracts with pharmacies or issuing executive orders; target infrastructure gap areas such as shared services for small pharmacies, or to serve rural providers, which could utilize both simplified and comprehensive solutions. For lab results this means: use policy, purchasing or regulatory actions such as electronic sharing of lab results in state or Medicaid contracts with clinical labs or negotiating lower rates for a centralized interfaces; provide core services or infrastructure for labs, such as code translation services and record locator services to reduce the cost or complexity of exchange; leverage existing electronic lab reporting mechanisms when possible, such as public health labs and immunization registries; and enable statewide directories and/or merging disparate compendiums into unified common ones to help smaller labs participate in exchange. For patient care summaries this means: provide core services to reduce the cost and complexity of exchange including provider and plan directories. The fifth row is “Ensure Consistency with National Policies and Standards.” For e-prescribing this means: reconciling legal and regulatory environments to enable the flow of electronic prescriptions; and utilize technologies that are adaptable and flexible for future requirements. For lab results this means: identify state regulations and statues affecting lab interoperability; advocate for making changes to laws and regulations; and utilize technologies that are adaptable and flexible for future requirements. For patient care summaries this means: encourage stakeholders to establish state-wide standards for summaries that are aligned with national standards and utilize technologies that are adaptable and flexible for future requirements. The sixth and final row is “Align with Medicaid and Public Health Programs.” For e-prescribing this means: define strategies and timetables for making Medicaid medication history and formulary and benefit information available to providers. For lab results this means: work with Medicaid to include interfaces as part of their lab contracts and understand public health lab reporting requirements and align requirements where possible. For patient care summaries this means: work with Medicaid to incorporate and align existing documentation processes and understand public health reporting requirements and align requirements where possible.