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Mission
Chronology
Leadership & Staff
All Projects
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Chronology
October - December 2003: Legislation and regulations were
introduced that have further enabled the work of the MA-SHARE project
in the area of e-prescribing.
- In November 2003, the Governor of the Commonwealth of Massachusetts,
Mitt Romney, signed "An
Act Facilitating Electronic Transactions" into law,
allowing prescriptions to be submitted to pharmacies via e-mail.
- In the fall of 2003, the Massachusetts Department of Public
Health introduced "Proposed Amendments to 105 CMR 721.000:
Standards for Prescription Format and Security in Massachusetts" (Text
of Hearing Notice (pdf 53k) - October 28, 2003) to advance
standards.
July - September 2003: MA-SHARE increased its credibility
and guaranteed its sustainability when the Consortium received
significant additional funding for this project. Several other
organizations (Harvard Pilgrim Health Care, Tufts Health Plan,
Fallon Community Health Plan, and Neighborhood Health Plan) made
financial contributions. The most significant commitment was a
$500,000 cornerstone grant from BCBSMA to the MA-SHARE initiative.
A MA-SHARE governance model was proposed, documented and adopted
by the Consortium Board of Directors on September 11, 2003.
As MA-SHARE received increased attention throughout the state,
MA-SHARE received a diverse group of projects proposals. Extensive
staff review was conducted and the projects were reviewed by the
MA-SHARE Executive Sub-committee.
A series of recommendations relating to funding, project management,
networking and educational support were prepared and presented
to the first meeting of the MA-SHARE Advisory Committee on September
29, 2003.
The recommendations were endorsed by the Advisory Board and subsequently
adopted by MA-SHARE.
The CIO Forum was briefed on the significant progress of the MA-SHARE
program at its September 2003 meeting. At that meeting, the CIOs
recommended the creation of a SHARE Technology Advisory Committee
to guide MA-SHARE's evaluation and selection of "thin" technology
models that can meet the needs of clinical connectivity projects
in the state. The Consortium is in the process of organizing this
group.
The Consortium is now actively engaged in managing/monitoring
the following MA-SHARE projects:
- Bioterrorism
Syndromic Surveillance (BSS): seeking to create better
means of bringing disparate healthcare data together to permit
more immediate and accurate assessment of public health risks
and events
- Electronic Health
Records: seeking to facilitate the selection of standards
and adoption of forms of electronic health records
- Electronic
Patient-Centered Communication: seeking to encourage
and facilitate the greater use of electronic communications
between patients and their caregivers and healthcare payors
- MedsInfo-ED: seeking
to make patients' prescription history data available to hospital
emergency departments
- Pathology Database
Query: seeking to provide means of hospitals, agencies
and researchers gaining immediate, real-time access to various
institutions' pathology data
- Physician
Credentialing: seeking to bring administrative simplification
to physicians' credentialing by payor, provider, and government
organizations
- Secure E-mail: seeking
to explore means of providing secure e-mail, at this point focusing
on institution-to-institution implementations
April - June 2003: The Consortium moved forward with the
MA-SHARE initiative on several fronts:
- A seven member MA-SHARE Executive
Sub-committee was convened, chaired by Gordon Vineyard
MD (Chairman of the Consortium Board of Directors) and made
up of executive level healthcare leaders.
- A twenty-one member MA-SHARE Advisory
Committee was proposed, to consist of representatives from
hospitals, physician organizations, other healthcare providers,
health plans, state government, academia, employers, the CIO
Forum, and the Consortium. Invitations were extended to community
leaders in each of these categories.
- The Consortium Board of Directors instructed the Consortium
CEO to investigate governance models for MA-SHARE, so as to clarify
its relationship to the Consortium and to create a proper basis
for MA-SHARE's operations.
- The Consortium engaged professional staff to support the MA-SHARE
effort.
In a two-month timeframe, the Executive Sub-committee met four
times and wrestled through critical operating issues for MA-SHARE.
The MedsInfo-ED project proposal allowed the Executive Sub-committee
to focus on concrete implementation issues rather than abstractions.
A formal charter was documented which prescribed that MA-SHARE
would consider both clinical connectivity and administrative simplification
projects. The Executive Sub-committee also outlined a process for
documenting and evaluating project requests and specified criteria
for evaluating projects.
January - March 2003: In early January, the Massachusetts
Health Data Consortium prepared the first draft of a white paper
entitled: How
Massachusetts Can Play a Leadership Role In Community Clinical
Connectivity (PDF). The document summarized what had been learned
from the efforts to-date and outlined some organizational approaches
on how to proceed (contemplating a broad-based steering committee
supported by a senior level executive committee). In the recommended
plan, the Consortium would serve as convener and project coordinator.
Finally, the need for seed funding was highlighted.
Over the next three months, the white paper was presented to the
CIO Forum, the Consortium Board of Directors, and several healthcare
organizations in the state (state government officials, Massachusetts
Medical Society, Massachusetts Hospital Association, BCBSMA, and
the Massachusetts Coalition for the Prevention of Medical Errors).
Subsequently the white paper draft was revised as these organizations
added their inputs.
In March, 2003 the Consortium also issued a short "prospectus" proposing
a budget and a short-term plan for initiating a community clinical
connectivity initiative. Two healthcare organization in the state,
Partners Healthcare System and BCBSMA, agreed to make a lead grant
of $35,000 each to the Consortium to this important new project.
The project was re-named MA-SHARE, an acronym for Massachusetts
- Simplifying Healthcare Among Regional Entities.
The e-prescription project was also transformed and gained momentum.
Meanwhile, AHCI, the health plan medical directors' group, contacted
the Consortium to propose that the healthcare organizations in
the state cooperate to pilot a technological approach that would
allow providers to have access to patients' medication histories
in hospital emergency departments. This project came to be called "MedsInfo-ED".
June - December 2002: The Massachusetts Health Data Consortium
continued its leadership in educating the CIOs about inter-organizational
clinical data issues and other "community clinical connectivity" matters.
A great deal of material was gathered and presented concerning
community clinical connectivity initiatives around the country.
Two initiatives in particular had achieved some level of maturity:
-
Santa
Barbara County Care Data Exchange: With the help of a
major grant from the California Healthcare Foundation, the providers
of Santa Barbara County worked with CareScience, Inc. to develop
and implement a clinical data exchange network.
-
Indianapolis
Network for Patient Care: With major funding from grants
and state government, the Regenstrief Institute and healthcare
providers in Indianapolis developed and implemented a community
clinical information system.
The CIO Forum members began to develop some conclusions based
on what they had learned:
- First, they preferred the technology model of the Santa Barbara
initiative, which did not rely on a single centralized clinical
database like the Indianapolis Network for Patient Care model.
The CIOs were instead drawn to an approach that would query,
assemble, and present clinical data from multiple sources in
real-time - which the CIOs described as a "thin model".
- Second, the CIOs felt that the technology should not drive
cooperative clinical data efforts. Rather, they concluded that
community clinical connectivity initiatives should begin by focusing
on projects that have real value to healthcare organizations
in the state - that initiatives should respond to an articulated
need, rather than be devoted to building a technology solution
and only afterward exploring how such the solution might be propogated
and sustained.
- Third, the CIOs agreed that Massachusetts should not immediately
pursue outside grant funding to build a community clinical network.
They felt any effort initially should have significant support
from healthcare organizations in the state if it was to be sustainable
over the long term.
- Finally, the CIOs recognized that any clinical connectivity
effort would have to overcome major challenges with regard to
organizational ownership of data and patient authorization to
access data.
The CIOs also began to learn more about what was going on around
the U.S. with regard to "e- prescriptions". Medco Health Solutions,
a Prescription Benefit Manager (PBM) and an IT Partner in the CIO
Forum, described RxHub,
a joint venture of the country's three largest PBMs organized to
address e-prescriptions. Also, the Consortium investigated a major
project of the Rhode
Island Quality Institute that included Surescripts,
a joint venture of the region's major pharmacy chains. To stimulate
discussion among the CIOs, Blue Cross Blue Shield of Massachusetts
(BCBSMA) prepared a high level planning document encouraging a
collaborative e-prescription initiative in the state.
To determine where to go with these discussions and lessons learned,
a "Community Clinical Connectivity Planning Group" (consisting
of CIOs and clinical leaders in Massachusetts) was convened in
late November 2002. The group felt the Consortium was the appropriate "neutral
third party" to pursue a community clinical connectivity effort
and encouraged the Consortium to document a proposal on how to
proceed. The group also agreed that e-prescriptions could be an
initial priority in any initiative.
May 2002: At the 2002 CIO Forum Retreat, the CIOs discussed
these emerging initiatives. John Glaser, CIO of Partners Healthcare,
suggested that the CIO Forum get more engaged in addressing inter-organizational
clinical data issues. The CIOs agreed and set a priority for the
next year to research the status of current practice in the following
areas:
- the experiences of community clinical efforts in other communities
- the value proposition for a community clinical network
- technical architecture models
- governance and management models
- the typical risks and barriers that must be addressed (e.g.,
ownership of data, master patient / provider indices, etc.)
In addition, Dr. James Fanale, the Chief Medical Officer at BCBSMA,
briefed the CIOs on the work of The Alliance for Health Care Improvement
(
AHCI) -- a collaboration of medical directors from five Massachusetts
not-for-profit health plans. The AHCI was created to promote collaboration
in cost-effective, population-wide strategies designed to improve
the health status of health plan members and the community at large.
Lively discussion led to an agreement that the CIO Forum and AHCI
work collaboratively on electronic prescribing of medications,
based on the significant opportunities for financial and clinical
benefits and resolution of important technological issues.
1998-2002: The Consortium engaged in a series of projects
and initiatives related to the privacy and security of healthcare
data. The Massachusetts Health Care Task Force recommended that
the Consortium play the role of convener and coordinator for issues
related to HIPAA and administrative simplification in the state.
In 2001 and 2002, a series of national initiatives and reports
recognized that information technology issues were affecting healthcare
quality in the U.S.:
- The Institute
of Medicine (IOM) published "Leadership
by Example: Coordinating Government Roles in Improving Healthcare
Quality", identifying technology as a critical element
in a national strategy for improving healthcare process and
outcomes
- Another IOM report, "Fostering
Rapid Advances in Healthcare: Learning from System Demonstrations",
called on the Federal government to take a leadership role
in promoting innovative technology initiatives in the healthcare
industry
- The circumstances following 9/11 have highlighted the country's
vulnerability to bio-terrorism and the need to improve the timely
exchange and analysis of healthcare data that can be used to
identify and address incidents and attacks. CDC,
public health agencies, providers, and vendors have worked together
to launch the National
Electronic Disease Surveillance System (NEDSS).
- HIPAA appointed the National
Committee on Vital and Health Statistics (NCVHS) to "study
the issues related to the adoption of uniform data standards
for patient medical record information and the electronic
exchange of such information" and report to the Secretary
of Health and Human Services (HHS).
- An office was created in the Federal government, tasked with
coordinating activities related to a National
Health Information Infrastructure (NHII) and HHS secretary
Tommy Thompson stated his commitment to developing paperless
medical records.
- The Healthcare
Information and Management Systems Society (HIMSS) identified
NHII as its top policy, focusing on education both for the
healthcare industry and those on Capitol Hill.
- The recommendations of the Leapfrog
Group, a consortium of employers focused on providing high
quality care for their employees, included technology-based
solutions, such as computerized provider order entry (CPOE).
- The eHealth
Initiative (eHI), a national consortium of IT vendors
and consultants, was formed to promote the adoption of clinical
data standards.
- At the request of The
Commonwealth Fund, the Consortium prepared a background
paper entitled
"Mobilizing Health Information Technology to Improve the Quality of Health
Care".
- The Markle
Foundation organized
Connecting For Health, a collaborative of 90 public and private
organizations working to accelerate adoption of standards for
electronic medical information systems.
- Robert
Wood Johnson Foundation published "The
eHealth Landscape", a white paper which summarizes
the major players, issues, and emerging trends and technologies
in the eHealth arena
- The Public
Health Data Standards Consortium (PHDSC) is a voluntary
confederation of 39 organizations developing a new non-profit
corporation to support the development and promulgation of
clinical standards to address national and regional public
health needs
1994-1997: The Consortium evolved from an organization
focused on data analysis to a 140+ membership organization, focused
on collaborative health data initiatives in the state. The CIO
Forum, which today has 35+ Chief Information Officers from
healthcare organizations in Massachusetts, was created in 1995.
The major industry technology innovation at that time was the
Community Healthcare Information Network (CHIN). The CIO Forum
took a counter perspective to the centralized CHIN vision, instead
seeking to develop a "virtual electronic network".
Several clinical and administrative data workgroups were formed
and produced valuable products, such as security and medication
enhancement recommendations to the CDC's Data
Elements for Emergency Department Systems (DEEDS).
In 1997, the CIO Forum spawned the New
England Healthcare EDI Network (NEHEN), an innovative cooperative
solution to exchanging administrative transactions via electronic
data interchange (EDI). The NEHEN architecture reflected the
CIOs' support for a decentralized, community data sharing model.
This page last updated April 27, 2006
For further information regarding the MA-SHARE initiative and
its projects, please contact Gail Fournier, Partner, CSC Consulting, via
e-mail. We welcome your further questions & look
forward to your participation in our work and our events!
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