Hunt Blair, ONC/DHHS discusses State HIT Transformation
Rob Waters, VP development with Healthcare IT Connect sat down with Hunt Blair Principal Advisor, State HIT-enabled Care Transformation, ONC/DHHS to discuss the alignment of ONC programs and activities with the State Innovation Model under CMMI and the evolving role of health information exchange and analytics in supporting healthcare delivery transformation.
Rob Waters: Could you explain the link between the State Innovation Model and your work at ONC?
Hunt Blair: Because of the cross-cutting nature of SIM grants, the scope of which includes bringing together efforts from multiple HHS programs, grants, and initiatives in a state, ONC is part of a broad effort the CMMI team has put in place to link their HHS partners with the activities being funded under SIM. There are quarterly calls with what are called “Core Consultants” across HHS, to provide updates and check-ins, as well as more focused interactions that rise out of specific needs and issues. ONC staff serve as subject matter experts on HIT-HIE technologies and policies. ONC staff have done a series of webinars for SIM grantees to ensure that they are fully aware of ONC resources (both directly in the office and through ONC grantees such as the Regional Extension Center program), as well as to do deep dives on specific subject areas. For instance, ONC has done both webinars and direct Technical Assistance (TA) with states on the use of EHR-generated electronic clinical quality measures (eCQMs). In addition, over the past year, I have worked directly with both SIM testing and design states on an individual basis, providing on-site TA focused on their strategic approach to their overall HIT-HIE business and technical architecture designs and requirements.
RW: There is a lot of discussion about the sustainability of Health Information Exchanges (HIEs) in a post HITECH world, how do you see the role of health information exchange evolving and what federal polices are in place to support future expansion of exchange efforts?
HB: Information exchange will be a critical component to support delivery system transformation and value-based payment. It is not an exaggeration to say that 100% of CMMI’s initiatives require HIE to support patient/provider attribution and to ensure clinical information is available across the continuum of care. ONC is working closely with CMS to support the clinical data needs of its grants and payment programs. ONC is fully committed to supporting further development of constrained standards to enable exchange and interoperability. Last summer, HHS released Principles & Strategies for HIE Acceleration which articulates the policy vision for building and supporting a ubiquitous HIE ecosystem.
RW: Many States are involved with early planning to establish statewide EDW (enterprise data warehouse), integrating clinical and claims data from public sources and private initiatives, do you see a role for public-private collaboration in establishing this data analytics infrastructure?
HB:There is going to be tremendous diversity across states in the way they architect and manage data analytics infrastructure. The SIM states are, in many ways, on the cutting edge of determining what models will work best, in terms of collaborative public/private efforts, and there are definitely many reasons to approach this work collaboratively. That said, working through the implications of data governance and sharing is no small task, so it takes real leadership on both the public and private side to ensure that these efforts work. We’re in an evolutionary time, with shifting paradigms for both the relationships between provider organizations and between them and government. It obviously can make a tremendous amount of sense from a resources point of view to build shared infrastructure, but there has to be a culture of trust to support that, which can be far more complex than any technical challenges to collaboration.
RW: From the SIM (State Innovation Model) testing award recipients you’ve worked with what have been some of the innovative health IT use cases that have caught your attention to date?
HB: Maine is doing great work to bring providers from across the continuum – long term care and behavioral health – into their broader system of exchange and data sharing, Minnesota has an exciting plan to use HIT to integrate those providers as well as community based organizations and public health into what they’re calling Accountable Health Communities to support care coordination and case management. Oregon is working on the design for shared, collaborative infrastructure to support public and private data analytics needs. All of the testing states are exciting places to watch, because they’re where the proverbial rubber is really meeting the road in terms of scaling HIT-HIE to support statewide initiatives.
Hunt Blair will be presenting alongside Karen Murphy, Director of the State Innovation Model, CMMI, George Beckett, Tennessee State HIT Coordinator and Gary Christensen, GM States and Public Sector, Intersystems at the keynote panel of the Health IT, Health Information Exchange & Population Health Management Forum, Day 2 of the 2014 State HIT Connect Summit, April 1-2, Baltimore, MD