Health Care Vision 2020
WMHIE
Business and Finance Work Group
D R A F T Minutes of April 15, 2008
1. Minutes of March 18, 2008: Reviewed and approved as distributed.
2. Health Information Exchange (HIE) Governance Structure Input: A draft HIE governance model was distributed and reviewed. Comments included:
· The draft was a good start.
· Chief Executive Officer (CEO), Chief Financial Officer (CFO) and Chief Information Officer (CIO) level people should be represented in governance.
· Hospitals/health systems, physician organizations, payers, employers and other key stakeholders should also be represented in governance.
· J. Hazewinkel will get governance materials from a Colorado HIE and send them to D. Bagley.
· M. Schulte will send D. Bagley some contacts to get additional governance examples.
· Blue Cross Blue Shield of Michigan (BCBSM) would like to sit on some of the HIE boards.
3. Cost Model Description: D. Bagley distributed and reviewed a recommended cost model that illustrated the format and key components. The numbers in the model were based on previous HIE research and were only included for illustrative purposes.
· J. Hazewinkel will provide some ballpark volume data to D. Bagley.
· Until more specific HIE specifics are determined, cost model assumptions cannot be completed.
· Members liked the model format.
· On-going discussions with vendors and other HIEs will help refine the numbers in the cost model.
· Sample participation and revenue assumptions were also entered into the revenue side for illustrative purposes.
4. Revised Business Plan Assumptions: D. Bagley reported that the assumption changes and additions noted in the 3-18-08 meeting minutes have been included in a revised list of assumptions. Additional assumptions based on discussion with J. Ladd were also incorporated. Among the most critical assumptions are the expected levels of financial participation by the key stakeholders/HIE customers. This information cannot be included until the scope of HIE services is further defined and key stakeholders can react to it. A revised list of assumptions will be distributed via SharePoint.
· It was suggested that Cam Brown (MIHIN consultant) be invited to address the work group to talk about HIE & Regional Health Information Organization (RHIO) approaches and stakeholder engagement.
5. Updates
· Assessment tool testing, timelines: One purpose of the assessment tool is to learn more about material and labor costs associated with current methods of exchanging health information.
(a) It was suggested that getting data from sample groups (vs. all groups) may be sufficient for business plan value proposition purposes.
(b) It was also suggested that Plante Moran offer to assist groups that struggle with the assessment tool.
(c) It was noted that it will be important to know the numerator and denominator in some questions that call for a percentage-type answer. For example, 10% may mean one thing if the denominator is 10 and another thing if the denominator is 10,000. D. Bagley will revise the tool appropriately to address this concern.
· CIO subgroup formation: A subgroup of five health system CIOs has been convened to assist in identifying a HIE structure that all of them could support. The group will continue to meet until a consensus is reached.
· HIE Request For Information status:
(a) Request for Information (RFI) vs. Request For Personnel (RFP): The differences between an RFI and an RFP were discussed and it was decided that the information needed for the business plan would best be obtained through an RFI.
(b) J. Hazewinkel’s advice: “Be as comprehensive as possible as soon as possible.” Everything does not need to be done in sequential steps.
(c) One HIE vendor or multiple vendors? A single vendor is more risky. Several integrated systems may be safer and more reliable than a single system. However, certain aspects of the HIE should be done through a single vendor, e.g., clinical messaging. Vendors are getting increasingly better at integrating with other systems.
(d) How many vendors should the RFI be sent to? There are at least 19 vendors that the RFI could be sent to. Work group members recommended that the RFI be sent to no more than 4-5 vendors.
(e) Value: While the clinical messaging component is of high value to health systems, the data repository component will be of more value to payers. The state is requiring that a data repository be part of any HIE that they are helping to fund. The data repository will also be necessary to meet Aligning Forces for Quality (AF4Q) needs.
· Communications plan: Plante Moran drafted a communications plan designed to provide a clear, consistent message to key stakeholders and the community at large. The plan is very detailed, thorough and methodical. L. Zwarensteyn will identify a person to execute the plan. Successful implementation of this plan is critically important to educating key stakeholders so that they will want to participate in the HIE.
· Issue tracking matrix: D. Bagley distributed and explained the purpose of the matrix. The matrix will also be available on SharePoint site.
· Action plan progress update: D. Bagley reported that the group is ahead in some areas and behind in other areas. The group had hoped to be farther along in the areas of defining the HIE and measuring likely stakeholder participation. Measuring participation is dependent on the HIE definition and the group is trying to accelerate that task by convening the CIO subgroup and by contracting with Plante Moran to handle the RFI.
· Report to HCV 2020 Governance Board: H. Hufnagel will be preparing a short monthly business and finance work group update for the Governance Board. The first such report was included in the work group meeting packet.
6. SharePoint Demo: D. Bagley demonstrated how the SharePoint software works. In the future all meeting minutes, progress reports, work plans, tools and other work group materials will be posted on SharePoint and will be available to work group members upon demand.