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Interoperability Leading to Information Exchange
May 2013 Vol. 2, No. 5 SUBSCRIBE | MEMBERSHIP

Interoperability Inbox

I&S Networking Breakfast and Panel Presentation
Thank you to those who attended the Interoperability & Standards (I&S) Committee networking breakfast and panel at HIMSS13. We hope you found this session useful. Time has flown by since HIMSS13, and plans are already underway for next year’s Annual Conference. The HIMSS14 Call for Proposals is now open through June 3, 2013, 5pm Central Time.

We encourage all of you to submit proposals on interoperability and standards issues to ensure that HIMSS14 is rich in educational content for those wanting to learn, understand, and discuss the big picture challenges of interoperability leading to health information exchange; and for those technical experts who deal with the nuts and bolts of these challenges on a daily basis at the standards and implementation guide level. 

We very much appreciate your involvement with this I&S Committee inaugural event. Here is the link to photos from the HIMSS Interoperability & Standards Breakfast and Panel for your review. HIMSS will happily send along digital versions of any of these pictures to you free of charge. Please e-mail Mary-Ellen Devitt the HIMSS staff liaison to the I&S Committee by clicking on the link above. We hope that you will be able to attend the I&S Networking Breakfast at HIMSS14 from February 23-27, 2014 in Orlando!

HIMSS Innovation Center Advances Interoperability
The HIMSS Innovation Center will provide ongoing services for health delivery organizations and health IT companies, along with exhibitions, educational programming, and consumer-oriented applications. In addition, the year-round interoperability showcase and exhibition space will further validate functionality for new and developing products using standards and customized testing in both a physical and virtual demonstration environment. HIMSS will be leasing 12,500 square feet of the Global Center for Health Innovation for its Innovation Center in Cleveland. HIMSS plans to double the size of the exhibition space by 2016. Click the link above to learn more.

Showcase Connection

Showcase at Government Health IT Conference and Exhibition
The HIMSS Interoperability Showcase™ will be collaborating with Integrating the Healthcare Enterprise (IHE) at the 9th Annual Government Health IT Conference & Exhibition. The Government Health IT Conference & Exhibition will be held at The Renaissance Hotel in Washington, DC. At the showcase, attendees will watch systems exchanging health information in a live standards-based interactive demonstration.

The Interoperability Showcase is a must-see exhibit for healthcare providers challenged by new meaningful use criteria. The experience will provide actionable information and the opportunity to connect with the experts who are working to establish plug and play solutions to the new requirements.

For more information about the HIMSS Interoperability Showcase at the Government Health IT Conference & Exhibition, contact Sandy Vance, Senior Director Global Interoperability Initiatives or Elizabeth Peters, Coordinator, Interoperability Showcases.

VIDEO: On the Value of the Interoperability Showcase
Video of Joyce Sensmeier, HIMSS VP Informatics, after the Interoperability & Standards Breakfast Panel in March discussing the value of the Interoperability Showcase.

Public Boost for IHE Profiles on the Global Scene
On April 29th at HIMSS13 Middle East in Riyadh, the Ministry of Health in the Kingdom of Saudi Arabia orchestrated a half-day afternoon symposium almost exclusively devoted to Integrating the Health Enterprise (IHE). According to the Co-Chair of IHE International, Elliot B. Sloane, PhD, CCE, FHIMSS,

"Dr. Ahmed Balkhair, the Saudi eHealth Director who is also Chair of IHE Saudi Arabia made it crystal clear to the entire audience that IHE was going to be the core standard against which all vendors would be judged. Furthermore, the Saudi Minter of Health formally endorsed IHE, as the primary Saudi national eHealth standard during the conference plenary session."

Vendors were able to highlight their products in a live standards based health information exchange demonstration that drew large crowds to the Interoperability Showcase™ floor in the Kingdom of Saudi Arabia. The Theme of HIMSS13 Middle East conference was "Connected Health," and HIMSS CEO Steve Lieber, emphasized HIMSS' support for IHE and the strategic role IHE plays in delivering interoperability standards.

First Annual IHE International World Summit
The first annual international world summit of IHE International was held in Istanbul, Turkey from April 16-18, 2013. The mission of IHE International is to advance the effective and safe delivery of healthcare for individuals and communities by enabling the healthcare sector and stakeholders to achieve the widespread adoption and implementation of standards-based interoperable IT systems. Systems that support IHE Integration Profiles work together better, are easier to implement, and help care providers use information more effectively to improve healthcare delivery. For more information about the IHE International World Summit in Istanbul see the Speakers List.

Interoperability for Dummies, IHE Edition—Coming Soon!
IHE USA is proud to announce the upcoming release of their new and exciting book, a Wiley publication, entitled Interoperability for Dummies, IHE Edition. This book provides an introduction into the integration and interoperability of health data, the origins of IHE, and an overview of integration profiles which are intended to be used by communities for exchanging health information. The e-Book will be available for free download this June! Keep checking IHE USA’s web site at the link above to learn how to get your copy.

Save the Date: IHE NA CAT14 is the Week of January 13, 2014
The IHE North American Connectathon (NA CAT14) will be held the week of January 13, 2014, at the Hyatt Regency in downtown Chicago. All final dates for the NA CAT14 testing, system registration and the educational webinars will be posted on IHE USA’s website in May 2013, at the link above. To receive information as it is posted please sign up to receive IHE USA's newsletters.  

Exchange Tools

New & Improved! HIMSS State HIT Dashboard
In addition to the broad range of information already available on the HIMSS State HIT Dashboard, users can now track accountable care organizations (ACOs), eHealth Exchange participants and Department of Commerce export sites. Information on these new initiatives includes:

  • A central resource of all types of ACOs across the country, including service offerings, partner and collaborator information, business model description and point of contact.
  • Office location, contacts and service offering information by state from the Department of Commerce’s International Trade Administration (ITA).
  • Location and description of participants in the eHealth Exchange, a network of nearly 40 exchange partners who securely share health information under a shared trust and interoperability framework.

See a list of specific HIT data that can be tracked using the HIMSS State HIT Dashboard.

Download the I&S Podcast Series in iTunes
The HIMSS I&S Podcast Series provides short 8-10 audio interviews and conversations on topics of interest to healthcare professionals, health IT leaders and those who want to learn more about interoperability and standards leading to health information exchange. Listen to Joyce Sensmeier, HIMSS V.P. for Informatics interview thought leaders about interoperability and standards leading to health information exchange click on the headline above.

Currently, available is Episode #1: What is interoperability in Health IT? In this episode, the Chair of the Interoperability & Standards (I&S) Committee, Dr. Keith Salzman walks us through the definition of interoperability in health IT. This definition was approved by the HIMSS Board of Directors on April 5, 2013. Keith also gives examples of healthcare operations that correlate to each of the three levels of interoperability: 1) Foundational; 2) Structural; and 3) Semantic. See Keith’s recent Blog on interoperability.

Policy Pulse

CMS/ONC on HIE and Interoperability RFI
The request for information (RFI) outlined a series of policy levers that CMS and ONC had identified for potential utilization in exploring incentives for HIE and greater interoperability—including through its current state flexibility through Medicaid, innovative payment delivery testing authority, and other levers. The RFI sought input on its proposed policy levers, in addition to seeking input on how to enhance participation among the Long-Term Care and Behavioral Health care communities. All together there were 207 responses to this RFI.

On April 18, HIMSS submitted comments to the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) on their joint Request for Information (RFI) on Advancing Interoperability and Health Information Exchange (HIE). HIMSS’ comments emphasized its commitment to the advancement of interoperable health information systems. HIMSS also suggested that CMS use innovation models to scale and evaluate, and align payments to an outcome of quality in order to incentivize participation. See all recent HIMSS public comments and position statements.

GOP Senators: Health IT policy needs 'reboot'
By Anthony Brino at Government HealthIT

Six Republican Senators are asking the healthcare community for input on "recalibrating" health information technology policy, arguing that there are several problems with the current trajectory of the meaningful use program.

In a white paper titled "Reboot: Re-examining the Strategies Needed to Successfully Adopt Health IT," the Senators argue that the federal health IT program has been hindered by a lack of progress on interoperability, billing increases sometimes associated with EHR adoption, oversight and patient privacy concerns, and financial sustainability beyond the federal incentive payments for providers buying IT systems. Click the link above to learn more.

ONC Awards HIE Interoperability Work
Sources to Ken Terry at InformationWeek

The Office of the National Coordinator of Health IT (ONC) has awarded two cooperative agreements involving cash grants to two nonprofit entities that are working toward the national goal of interoperability among health IT systems. The agreements are the first two to be struck under ONC's new Exemplar HIE Governance Program.

  • ONC is giving $285,000 to DirectTrust, a trade association that is creating a security and trust framework for directed exchanges of information.

DirectTrust's participation in the ONC cooperative will focus on the continued development of a national accreditation program for health information service providers (HISPs), certificate authorities, and registration authorities that act as trusted agents for users of directed exchange. DirectTrust has created such a program in conjunction with the Electronic Health Network Accreditation Commission (EHNAC). Since it debuted in February 2013, a dozen HISPs and certificate authorities have applied for recognition, said David Kibbe, MD, president and CEO of DirectTrust, at a press conference held to announce the ONC awards. Click the link above to learn more.

  • The office also provided $205,000 to the EHR/HIE Interoperability Work Group (IWG)*, led by the New York eHealth Collaborative (NYec), which is developing plug-and-play interoperability for both directed exchange and query-based exchange. A directed exchange setup enables secure point-to-point electronic exchanges of clinical data between care providers. Query-based exchange capability lets providers find or request data from other providers.

ONC's agreement with IWG calls for this group -- which includes 19 states, 20 EHR vendors and 22 health information exchange (HIE) vendors -- to continue its efforts to build interoperability while also addressing issues such as patient matching and querying provider directories.

See a related article in HeathIT News entitled,ONC Forges Partnership for HIE Standards.

What mHealth Devices does FDA Intend to Regulate?
The new Food and Drug Administration Safety Innovation Act (FDASIA) Workgroup of the Health IT Policy Committee held their kick-off meeting on Monday, April 29, 2013. This work group was selected by the three agencies that will be leading the work: The Office of the National Coordinator for Health Information Technology (ONC), the Food and Drug Administration (FDA), and the Federal Communications Commission (FCC). These three agencies introduced their staff liaisons and provided a brief overview of their involvement in health IT.
At this meeting, the FDASIA Workgroup reviewed its scope and draft timeline:

  • Scope:  Define mobile products, services, and technology considered as Health IT
  • Draft time line:
    • Late May (tentative):   In person FDASIA work group meeting in Washington, DC (1½ days).
    • August 7: Present draft work group recommendations to the HIT Policy Committee (virtual).
    • September 4: Present final work group recommendations to the HIT Policy Committee (in person).
    • September 2013—January 2014: Agencies prepare proposed strategies and recommendations for public comment.

The FDA has indicated that it does not intend to regulate every piece of health IT, and has given examples of software that is regulated as a device (i.e. EEG analysis, clinical lab software, radiology software). FDA only intends to regulate mobile medical apps that meet the following narrow description: 1) used as an accessory to already regulated medical device, or; 2) transform a mobile communication device into a regulated medical device.

Content for this article was made available by HIMSS VP for Government Relations, Thomas M. Leary, MA, CAE, FHIMSS. To learn more about this FDASIA Workgroup see the one page document that ONC has developed.

Register Now - June GHIT Conference & Exhibition
Hosted from June 11-12 in the Washington DC area, the 2013 Government Health IT (GHIT) Conference & Exhibition will feature two tracks of programing: Delivering Better Care at a Lower Cost and Engaging with Consumers as a Care Partner. Potential track topics include health insurance exchanges/health insurance markets (aka, HIEx or HIX), Accountable Care Organizations (ACOs), clinical and business analytics, fraud and compliance, system interoperability, mobile health, patient safety, and consumer engagement. Share your expertise through case studies, lessons learned, and best practice examples. Click the link above to register and to learn more.

National Health IT Week and Policy Summit Save the Date!
This year National Health IT Week will be Sept. 16-20, 2013. During this week, HIMSS will hold its 12th Annual Policy Summit at the Hyatt Regency Capitol Hill in Washington, DC. HIMSS member involvement in the Policy Summit includes visits to Capitol Hill where Member present HIMSS' top three Congressional Asks for the year.

To help raise awareness for various topics concerning health IT policy, the Congressional Asks Task Force makes recommendations for three top issues on which HIMSS members will advocate during National Health IT Week. Currently, HIMSS is looking for members to participate on this short-term policy work group.
If you aren’t going to the Summit, start planning your participation with the National Health IT Week Toolkit, which contains various ideas including press releases, open houses and tours of local healthcare facilities, recognition events, social media opportunities, and other events and activities which you and your organization can implement in your home town, while your colleagues participating in the Policy Summit meet with Members of Congress or their staff in Washington, D.C. to share this year’s Congressional Asks.

Best Practices in HIT

HIMSS Analytics Honors Florida Hospital with Stage 7 EMRAM Award
HIMSS Analytics announced that Adventist Florida Hospital Carrollwood, located in Tampa, Fla., has received the acute care Stage 7 award. The award represents attainment of the highest level on the Electronic Medical Records Adoption Modelâ„  (EMRAM), which is used to track the progress of electronic medical record (EMR) interoperability for an inpatient hospital/health system.

HIMSS Analytics developed the EMR Adoption Model (EMRAM) in 2005 as a methodology for evaluating the progress and impact of EMR systems for hospitals included in the HIMSS Analytics® Database. There are eight stages (0-7) that measure a hospital’s implementation and utilization of information technology applications. The final stage, Stage 7, represents an advanced patient record environment.

Florida Hospital Carrollwood is now one of an exclusive community of just over 100 U.S. facilities (approximately 2% of 5,000 hospitals) who have been awarded the sought after HIMSS Analytics Stage 7 Award. Click the link above to learn more.

Ambulatory Reach Stage 7 — Interoperability Infrastruce is Growing
In 2011, HIMSS Analytics (HA) expanded upon its EMR Adoption Modelâ„  (EMRAM) to create the Ambulatory EMR Adoption Model (A-EMRAM) focusing on out-patient records. The A-EMRAM provides a methodology for evaluating the progress and impact of electronic medical record systems for ambulatory facilities owned by hospitals or health systems.

HIMSS Analytics has recently announced Stage 7 Ambulatory EMRAM Awards for some Midwestern out-patient clinic systems. Details on NorthShore, SSM Health Care, and Essentia best practices in health IT are below and in additional links provided.

  • First Stage 7 Ambulatory EMRAM Awarded - HIMSS Analytics announced the ambulatory clinics of NorthShore University HealthSystem as the first group of ambulatory facilities to reach Stage 7 on The Ambulatory EMR Adoption ModelSM (A-EMRAM). The validation process confirms ambulatory facilities have reached Stage 7 with a site visit conducted by an executive from HIMSS Analytics and a Chief Medical Information Officer with ambulatory deployment experience to ensure an unbiased evaluation of the Stage 7 environments. 
  • Three-State Group of Ambulatory Clinics with Stage 7 Award - 54 Essentia Health ambulatory clinics, located in Minnesota, North Dakota and Wisconsin, have reached Stage 7. These facilities include physician practices, clinics, outpatient centers and specialty clinics. Tracking their progress in completing eight stages (0-7), ambulatory facilities can review the implementation and use of IT applications with the intent of reaching Stage 7, which represents an advanced electronic patient record environment. Click the link above to learn more.
  • 3 SSM hospitals, clinic reach Stage 7
    Three hospitals and a clinic, all under the St. Louis, Mo.-based SSM Health Care umbrella, have achieved Stage 7 on the HIMSS Analytics EMR Adoption Model, signifying the top of the scale for health IT implementation and use.

Volunteer Exchange

HIMSS Interoperability Maturity Model Work Group Seeks Members
The Interoperability & Standards (I&S) Committee recently established the Interoperability Maturity Model (IMM) Work Group. This work group will examine applicable maturity models and develop an Interoperability Maturity Model to accelerate our industry’s interoperability goals and promote the adoption of electronic medical records. Participation is open to all active HIMSS members and the work group will meet monthly via teleconference. If you are interested in volunteering for the Interoperability Maturity Model (IMM) Work Group, please e-mail the I&S Committee liaison, Mary-Ellen Devitt Johnson.

HIMSS14 Announces Call for Reviewers
Volunteer your time and expertise toward shaping the education content of the 2014 Annual HIMSS Conference & Exhibition, Feb. 23-27, in Orlando. The HIMSS14 call for reviewers is open through May 22. Volunteers to this process may review and recommend proposals within their areas of expertise; mentor speakers through the preparation process; act as moderator for the conference session; and join the Annual Conference Education Committee (ACEC), which makes final speaker selections. HIMSS engages more than 200 volunteer subject matter experts to review proposals. All HIMSS members are welcomed and encouraged to volunteer as a reviewer. Click the link above to learn more about become a volunteer reviewer.

HIMSS Health IT Leadership Awards Task Force Seeks Volunteers
Every year during National Health IT Week (September 16-20, 2013), HIMSS presents the HIMSS Health IT Leadership Awards in recognition of federal leaders and state legislators who have made significant contributions to the advancement of health IT to improve healthcare, meriting national recognition. Nominees for the Federal and State Health IT Leadership Awards are selected by the HIMSS "Health IT Leadership Awards Work Group." Click the link above to learn more about serving on this short-term work group.

HIMSS Accountable Care Task Force Seeks Members
The HIMSS Accountable Care Task Force is accepting members for this new Task Force. The Task Force will be focused on the adoption and use of Health Information Technology for Accountable Care organizations and will be co-chaired by Paul Oates, CPHIMS, FHIMSS, IT Architecture, Cigna and Lee Lemelson, RPh, System Vice President, Clinical Applications, Banner Health. The Task Force will work to provide valuable tools and resources to the industry, specifically, use cases and best practices for Accountable Care Organizations. The meetings are held on the first Wednesday of the month, 1 pm-2 pm (ET). To sign up for the Task Force, and to help us get to know each other’s background, skill set and interest, please take a moment to fill out this brief survey. The Task Force is open to all current HIMSS members. Contact Nancy Devlin, for further information.


Interoperability Is the Paradigm Shift in Healthcare
By Adam Bazer, HIMSS
The digitization of healthcare has always promised transformation.  The switch from paper records to EHRs is a major shift and should not be discounted.  But as the industry looks ahead, the dawning consensus focuses on the paradigm shift expansive interoperability represents, and the need for effective health information exchange to lay the groundwork for that shift to take place. For interoperability to truly be transformational, we need to embrace it in our hearts and not just in our minds.  Interoperability in our hearts, interoperability on a meta-level, alleviates the isolation inherent in our current delivery model. Click the link above to read more.

Interoperability-the Next Phase of Healthcare Transformation
HIMBSS Blog by Keith Salzman, MD, MPH, Chair, HIMSS I&S Committee

HIMSS Board of Directors recently approved a working definition of Interoperability as it is being used in Health IT. Per HIMSS Definition of Interoperability:

Interoperability means the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities. There are three levels of health information technology interoperability: 1) Foundational; 2) Structural; and 3) Semantic.

With the proliferation of EHRs and HIEs, the ability to exchange and use information between healthcare organizations for patient care is critical. Initiatives like Blue Button leverage the focal point of information exchange, the patient, who can share their records as they pass through the healthcare system, provided the record is readily available to any provider who will use it as a reference to inform their provision of care. As policy change and business models turn to support value and outcomes, interoperability between organizations will become the norm.

The CommonWell Health Alliance represents a realization of that future and should be fostered and expanded within the private sector among all who have benefitted from the ACA sponsored proliferation of EHRs. The ONC Standards and Interoperability Framework efforts to generate use cases through to implementation guides provides industry tools it can use to achieve interoperability and a process to generate any missing guides. The opportunity for collaboration and forward progress should not be missed.

Looking to the future, integration of information across healthcare organizations will reduce the complexity of information exchange and facilitate the benefits of connecting the dots to improve outcomes for patients in ways that would not be possible otherwise. But, let’s not get ahead of ourselves-moving toward a standard definition of interoperability with integration in mind should help keep us on track.

Looking to the future, integration of information across healthcare organizations will reduce the complexity of information exchange and facilitate the benefits of connecting the dots to improve outcomes for patients in ways that would not be possible otherwise. But, let’s not get ahead of ourselves-moving toward a standard definition of interoperability with integration in mind should help keep us on track.

For more information, see also Dr. Doug Fridsma’s blog as he discusses interoperability in HealthIT Buzz.

VIDEO: Politician’s Point of View — People can Benefit from HIT
Brian Patrick Kennedy, democratic state representative from Rhode Island, explains how one of the key benefits of HIE is the portability of a patient’s electronic medical record; when the patient visits a doctor or specialist, all of their medical history travels with them. The goal of expanding the use of HIEs is to ensure that patients and doctors are able to work together to receive the most thorough, cost-effective care. Click the link above to view the video.

ICD - 10 Forum June 17 - 18, 2013 Gaylord National Resort & Convention Center Washington DC Area


Expand your network by connecting to HIMSS on these social media sites:

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Big Data And Healthcare Analytics Forum. Improving Care. Reducing Costs. Uncovering Opportunity. June 4 - 5, 2013. Gaylord National Resort & Convention Center Washington DC Area.

Renew Your HIMSS Membership?

Ensure the continuation of your HIMSS member benefits, login to the Member Center to renew your membership today. If you need a paper invoice, request one via e-mail to the Member Services department. You can also renew by phone at 312-664-4467 (option 8, then 2).

Upcoming Events & Deadlines

May 22
HIMSS14 Call for Reviewers Deadline

May 27-31
Joint NFC Forum and Continua Plugfest! Event

June 3
HIMSS14 Call for Proposals Deadline

June 4-5
Big Data and Healthcare Analytics Forum Event

June 11-12
Government Health IT Conference & Exhibition Event

June 17-18
ICD-10 Leadership Forum Event

Sept. 16-20
National Health IT Week and Event


Note: The inclusion of an organization name, product or service in this publication should not be construed as a HIMSS endorsement of such organization, product or service, nor is the failure to include an organization name, product or service to be construed as disapproval.

Information Xchange features extended coverage of all aspects pertaining to interoperability and standards leading to health information exchange. Published on the first Thursday of the month, this newsletter provides the latest industry news, case studies and expert interviews. Information Xchange is a complimentary resource for HIMSS members, organizations, government agencies and anyone involved and interested in today's interoperability, standards and information exchange activities.

We hope you have enjoyed Information Xchange. If you and your colleagues would like to permanently subscribe to each and every complimentary edition, click here.

Information Xchange Team
Joyce E. Sensmeier, MS, RN, BC, CPHIMS, FHIMSS, FAAN, Vice President, Informatics,
Pam Matthews, RN, MBA, CPHIMS, LFHIMSS, Senior Director, Informatics,
Mary-Ellen Johnson, MPP, Senior Manager, Interoperability & Standards,
Julie Moffitt, Senior Coordinator, Informatics,
Matt Schlossberg, Editor, Information Xchange,, 312-915-9282
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Chicago, IL 60603-5616

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