When Jersey Health Connect was forming in 2011, it included a small set of original hospitals and health systems referred to as “Founding Members”. Since that time, JHC membership has grown substantially, while at the same time the health system landscape in New Jersey has witnessed significant consolidation and merger activity. As a result, one of the growing challenges facing JHC was to ensure that all of its hospital and health system members would have appropriate participation in JHC’s governance – beyond that of just the Founding Members.

The JHC Board of Trustees explored various bylaw changes – engaging input from legal counsel and membership. The goal was to seek out a new structure whereby all hospital members would possess voting representation, shifting away from the old structure where only Founding Members were granted voting privileges. The new structure would also need to take into account the substantial investment that larger health systems (with multiple hospitals) make to participate in JHC.

To that end, the Jersey Health Connect Board of Trustees recently approved significant changes to the organization’s Bylaws, thereby expanding voting privileges and representation. The changes include:

• All contributing hospital members (paying membership fees) will have at least one Trustee and one vote.

• Health Systems, which have multiple hospitals paying and contributing, will have an additional Trustee and an additional vote (for every three hospitals the health system has, beyond the first hospital). This format enables a second vote with the 4^th hospital, a third vote with the 7^th hospital, and so forth.

• The new Bylaws also make provisions for a seat for a community member, and a seat for a physician member.

“We are confident the new governance structure will better represent our membership and also better position JHC for addressing the many challenges that lie ahead,” said Judy Comitto, JHC Board Chair.

Committee Structure Changes Focus on Core Needs & Issues

As part of the governance structure refinements, the JHC Board also reviewed its committee structure to ensure it was consistent with the expanding HIE agenda of its growing membership.

While the Executive, Finance, Regulatory & Governance, Communications/Outreach, and Nominating Committees continue unchanged from their initial charters, there is no longer an Evaluation Committee, which had the initial charter of assessing Meaningful Use compliance progress. In its place, a Clinical Advisory Committee was established, with the charge to evaluate appropriate clinical use of data.

Over the past year, JHC has also implemented several sub-committees as provided for in the Bylaws. Specifically, it has charged the Population Health Task Force, reporting to the Clinical Advisory Committee, with developing means to leverage the significant data that JHC has at its disposal to further population health initiatives. Likewise JHC has charged the Standards Task Force, which reports to the Technology Committee, with identifying opportunities to standardize processes or data sets among JHC’s members to better improve data quality and data availability.

Finally, the Patient Identity Task Force, also reporting to the Technology Committee, has been working towards the goal of one patient, one record, so that our clinicians have ready access to the clinical information they need, when they need it.

As always, if you want to participate on one of the JHC Committees or Sub-Committees, please do not hesitate to contact Micki Foglia at [email protected].

Health data interoperability and health information exchange are challenging prospects for the provider community.  Despite these complexities, interoperability remains the goal of the healthcare industry for some very practical reasons: enhanced data exchange brings with it the chance to improve care coordination and raise quality, while reducing costs and supporting revenue growth.

Jersey Health Connect is implementing an HIE Use Case process that will assist its members in focusing attention on identifying, developing and improving opportunities for access to community medical data.

A “Use Case” is a series of related interactions between a system user and a system that enables the user to achieve a meaningful goal. A Use Case narrative describes how the HIE will be used to accomplish a specific goal. Use Cases designed with a goal in mind are a valuable planning tool for providers, as a well-crafted Use Case communicates the functional requirements to drive the technical planning aspects. Having these details worked out first through a Use Case helps to define the scope and develop the solution – while also accelerating the technical evaluation process.

Developing Use Cases requires an understanding of the core business or clinical needs, and targeting the specific issues or opportunities to address. Defining the needs early in the process also accelerates the design effort and provides a basis to evaluate success.

By developing a process for analyzing, approving and prioritizing Use Cases that bring value to our providers and clinicians, JHC can maximize the benefits of the health information exchange for patients and communities. Several categories of Use Cases have been identified as initial priorities. These include Use Cases that support:

• Population Health Management and Accountable Care Organizations
• Improved Usability / Ease of Access to Health Information
• Real-time Alerting and Proactive Data Use Models
• Expanded Services for Payers, LTC, and Retail Participants
• Participation in State-Wide and National Exchange
• Analytics and Data Mining

As Use Cases are developed and reviewed, an ongoing process to evaluate and refine them will ensure that the positive outcomes are realized and improvements are built into the process. The following diagram demonstrates this iterative process.

We are anxious for feedback about our new HIE Use Case process and dependent on input from our clinicians to initiate this endeavor. Please join us in moving the HIE Use Case model forward and helping to identify the best ways to enhance Jersey Health Connect for our members and their patients.

If you have questions about the JHC Use Case endeavor, please contact Jim Cavanagh at [email protected].

Clinical data is a vital tool for taking care of patients for the entire clinical team – physicians, nurses, social workers, care managers and other care providers. It is also vital for those caregivers to be alerted when one of their patients utilizes the emergency department or hospital on a regular basis so that they can offer alternative treatment options and perhaps more appropriate care plans. RelayHealth is helping JHC members to identify these “frequent flyers” of the healthcare system by offering the infrastructure features to detect such events of interest and notify the relevant providers.

“We have integrated use of the RelayClinical Notify tool into our daily workflow,” says Sheilah McCoy, Director of Care Coordination for the JFK Medical Center ACO.  “The system flags our ACO beneficiaries that visit hospitals out of our network and we are able to identify ‘frequent flyers’ of emergency and hospital services as a part of our ACO care coordination model. Because fee-for-service payments still underpin the shared savings model, care coordination savings come from reductions in admissions, ED visits, and other services. Knowing the facilities our beneficiaries visit helps us to reducing leakage, thus increasing the share of services provided by our ACO, which can offset some of the revenue loss from utilization declines.  RelayClinical Notify helps us to make an early identification of such patients, and in turn offer a tangible solution to benefit both the patient and the ACO.”

The RelayClinical Notify feature allows providers and/or care team members to receive electronic notifications of their patients’ hospital and emergency department admission and discharge events. To enable these notifications, the RelayClinical service accepts inbound HL7 ADT messages (A03 – Discharge/End Visit and A04 – Register a Patient). In response to the ADT, RelayHealth delivers notification of the admit/discharge event to the provider/care team member RelayHealth inbox as a standard message type.

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The Benefits of RelayClinical Notify

• Care team members with active connections to a patient are notified upon significant care transitions
• Care team members or Practice Administrators can route notifications to specified inboxes in accordance with workflow preferences
• Care team members who prefer not to receive notifications can disable notifications or Practice Administrators can disable notifications on behalf of the care team member
• Data Administrators have visibility into Notify transaction processing with ADT transaction status and details available in the RelayHealth InterOp Portal

“Navigating through the fragmented healthcare system can be challenging even when you are healthy and is certainly compounded by illness,” says Maureen Sweeney-McDonough MSN, ANP-BC ([email protected]), manager of care coordination at Robert Wood Johnson Partners Accountable Care Organization. “Our goal is to achieve the ‘triple aim’ through care coordination, ensuring that you receive the right care, at the right time, in the right setting. We use the real-time RelayClinical Notify feature to identify patients that are being either admitted to or discharged from emergency departments or hospitals in 9 hospital systems in New Jersey. This helps our providers coordinate care as patients transition between settings enhancing their care delivery and empowering them to better manage their own health.”

RelayClinical Notify Models

RelayClinical Notify supports the notification models below – all of which leverage RelayHealth’s enhanced processing architecture.

All Providers

This model allows the service to notify all RelayHealth providers who have an existing relationship with the patient when that patient has an admission and/or discharge event from an emergency department or hospital. In this model, RelayHealth discovers the list of “connected” providers from the patient’s record rather than provider or practice information sent in the ADT message. This model provides the highest level of visibility into the patient’s care events as it allows all members of the patient’s care team to receive notification.

Primary Care Provider Only

This model continues the previously available functionality of Primary Care Provider notification upon a patient’s admission and/or discharge from the emergency department or hospital. This configuration supports facilities that have the ability to send the PCP’s Provider ID and Practice ID in the ADT A03 / A04 transactions sent inbound to RelayHealth, when those facilities do not also require notification to other care team members.

Primary Care Provider + All Providers

In this combined model, the service sends the admission and/or discharge notification to the PCP and all other RelayHealth providers with whom the patient has an existing relationship. This configuration supports facilities that have the ability to send the PCP’s Provider ID and Practice ID in the ADT A03 / A04 transactions sent inbound to RelayHealth. When the service finds a matching PCP, that provider receives the admit/discharge notification, and the service uses the patient information in the inbound ADT to discover the list of any additional associated providers who should receive the notification.

For more information about the RelayClinical Notify feature, please visit this link: (https://app.demo.relayhealth.com/resourcelibrary/downloads/FeatureGuides/FG_Health_System_Notifications.pdf)

Here are some recent updates being reported from Statewide HIEs across the country:

Vermont Information Technology – VITL

A new event notification service for Vermont providers is in the works due to the recent partnership of Vermont Information Technology Leaders(@VITLVT) VITL with PatientPing. PatientPing (@PatientPing) offers providers real time notification when their patients receive care elsewhere. Vermont patients will now receive more coordinated care through this collaboration of the public and private sectors.

VITL completed a project in December with Community Health Accountable Care, LLC (CHAC) that will provide clinical patient data for their attributed patients. The CHAC Gateway Project put in place the capability to identify and route CHAC patient data coming into the Vermont Health Information Exchange (VHIE). Once identified, the patient data will be made available to CHAC for use in managing the health of their patients from participating network providers.

CORHIO and New Mexico Health Information Collaborative (NMHIC)

Colorado and New Mexico can now share clinical patient information due to the recent connection between the health information exchanges (HIEs) of the two states. This collaboration stands to benefit patients tremendously since many commonly cross state lines for work and/or healthcare in the Four Corners Region. Prior to this connection the states had inadequate state-to-state information exchange which led to little communication among providers and poor care coordination.

Colorado Regional Health Information Organization – CORHIO

Participants in CORHIO Network now have access to data from three Wyoming hospitals. The network is now enhanced with clinical data, including laboratory, radiology and pathology results, admit/discharge/transfer information, and transcription notes from three additional hospitals in the Banner Health system, which includes Washakie Medical Center, Platte County Memorial Hospital, and Community Hospital.

HIE Texas

At both the state and federal levels, electronic health record (EHR) interoperability continues to be a focus in 2016. Carequality (@CarequalityNet), a public-private, multi-stakeholder collaborative, has joined with HIETexas (@HIETexas) to help expand connectivity in Texas.  This new partnership was led by The Sequoia Project (@Sequoiaproject) that seeks to enable seamless connectivity across all participating health exchange networks.

Pennsylvania eHealth Partnership Authority

The health information organization (HIO), Mount Nittany Exchange (MNX), which serves central Pennsylvania, has signed on to participate in the Pennsylvania eHealth Partnership Authority’s (@PAeHealth) Pennsylvania Patient & Provider Network, or P3N. So far this year, MNX is the fourth HIO to join P3N in 2016.

Washington State

The Washington State Legislature recently passed another telemedicine bill (Senate Bill 6519) for the second year in a row. The bill helps reduce the barriers to patient access to remote healthcare and also creates a telemedicine collaborative whose purpose is to “enhance the understanding and use of health services provided to telemedicine and other similar models in Washington State.”

As a stand-alone (self-funded) health information organization, JHC has outpaced HIEs all across the country. Jersey Health now boasts over 5 million transactions per month, with connectivity to over 30 hospitals and health systems and over 150 long-term care facilities.   But the work has just begun on fully realizing and uncapping the potential of Health IT for providers.

“We’ve shown physicians and providers all across New Jersey the future, and now that they see the potential…they want more,” says Lou Hermans, Executive director of JHC. “The more our physicians share and exchange data via the HIE, the more they see new applications for it. Providers have been instrumental in our strategic planning process, defining what they’d like to see us do more of and how we can adapt the architecture to help them care for patients in real-time.”

JHC is utilizing its growing network of providers (now connected to over 8,000 physicians and offices; 175 long-term care facilities; and 32 of the largest hospitals and health systems) to provide input and guidance on advancing the functional use of the network. “Our physicians, nurses, care coordinators, health IT experts and many other professional are actively engaging in our strategic planning process,” explains Lou Hermans, JHC Executive Director. “They know (first hand) what’s working and what’s needed to improve our systems. Among the areas of input and clarification, they provide much needed feedback on:

• Identifying system gaps and opportunities
• Defining provider and facility priorities and activities
• Strategic concepts for progress and a more sustainable future

As JHC completes its strategic planning process, additional provider and member meetings will be scheduled to validate HIE priorities and confirm short-term priorities. “We want to make sure our members not only play an active role in the development and advancement of our network connecting and data services – but also lead the way in building new collaborative partnerships across the New Jersey healthcare community,” says Lou Hermans.

If you are interested in participating in one of JHC’s upcoming strategic planning sessions (for physicians, long-term care providers, care coordinators and others) please contact Micki Foglia at JHC ([email protected]).

More Ransomware Attacks to Come

Healthcare led all other service industries in data breaches last year, according to Symantec’s 2016 Internet Security Threat Report.

Ransomware infections are largely opportunistic attacks that mainly prey on people who search the Web using outdated browsers or plugins. Most ransomware attacks have taken advantage of exploit kits (malicious code) that when stitched into a hacked site probes visiting browsers for the presence of vulnerabilities.

The recent attacks on Hollywood Presbyterian Medical Center in Los Angeles, Methodist Hospital in Kentucky, and now MedStar Health in Baltimore are all forms of “opportunistic attacks” that came in via spam email, in messages stating something about invoices and that recipients needed to open an attached (booby-trapped) file. A ransom request then follows to the infected organization, demanding payment in order to get its files back.

Ottawa Hospital (Ontario, Canada) recently reported that malware encrypted four computers in its network of 9,800, making information on them inaccessible. No patient information was compromised, according to the hospital. The infected machines were wiped clean and the data restored through backups. The best way to protect against ransomware attacks, experts agree, is to have a backup system, whether in a cloud network or some reserve outside of the IT network where hackers can’t get to it. Ottawa Hospital was able to recover easily thanks to having backup copies of its data.

Read more about these hospitals (and other organizations) impacted by ransomware in the articles below:

• Symantec
  Internet Security Threat Report
  https://www.symantec.com/content/dam/symantec/docs/reports/istr-21-2016-en.pdf?aid=elq_&om_sem_kw=elq_16094684&om_ext_cid=biz_email_elq_&elqTrackId=3f9e79f4cbf14b9a9d39e52f9e438f5f&elqaid=2902&elqat=2
• AHA News
  What Hospitals Need to Know About Aansomware
  http://news.aha.org/article/160222-what-hospitals-need-to-know-about-ransomware
• ARS Technica
  OK, panic—Newly Evolved Ransomware is Bad News for Everyone
  http://arstechnica.com/security/2016/04/ok-panic-newly-evolved-ransomware-is-bad-news-for-everyone/
• Healthcare IT News
  Hackers Hit Two California Hospitals with Ransomware
  http://www.healthcareitnews.com/news/hackers-hit-two-california-hospitals-ransomware
• Newsweek Tech & Science
  Ransomware Wreaking Havoc In Hospitals
  http://www.newsweek.com/ransomware-wreaking-havoc-american-and-canadian-hospitals-439714

Taking the Data Access Blindfold Off

According to the Agency for Healthcare Research and Quality (AHRQ), Care Coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in care to facilitate the appropriate delivery of healthcare services. Yet, the shared vision of “electronic assisted care coordination” that is across-settings, across patients’ lifetime, and that incorporates the broader participation of caregivers and clinicians is still evolving (National Quality Forum).
As the exchange of electronic medical data along the care continuum continues to expand, it is critical for HIEs to further enable real-time data flow across all healthcare settings, to better coordinate care and provide actionable information to the entire clinical team.
“If you look back, providers in the past were operating blind when it came to the care their patients received from other doctors and at other facilities,” says Judy Comitto, JHC Board of Trustees Chair and CIO at Trinitas Health. “But with the help of Jersey Health Connect, we are taking the blindfold off for physicians and providers at the front lines. As our HIE continues to expand and adapt to member needs, electronic access to information is being utilized in a variety of ways and in a variety of settings.”

Some of the increased uses include:

• Health Systems receiving ADTs of ACO specific patients
• Member ACOs increasingly utilizing JHC notifications and alerts
• Each month, JHC sends more than 345,000 notifications across all member hospitals
• “Frequent Flyer” reports helping to identify patients being readmitted on a regular basis
• DSRIP Patient Uploads providing acute care notifications for immediate follow-up

We have complied a few examples of JHC members using real-time information to assess patient situations, make informed care decisions, and help coordinate care – all leading to better outcomes for patients, families and caregivers.

Immediate Access to LTC Patient Medication Lists

CareOne is among the largest long-term care organizations in New Jersey, with 29 facilities throughout the Garden State – offering a full spectrum of care, including sub-acute rehabilitation and onsite pharmacies. As a part of JHC network, if a CareOne patient gets admitted (at anytime, day or night) to a JHC hospital, an updated patient medication list is available in the JHC portal when hospital staff need it. The electronic medication lists are sent via HL7 RDE interface and eliminates the outdated (and delay prone) manual/fax/paper process.

Avoiding Redundant Tests & Procedures

A patient in the Barnabas Health System recently went to see a cardiac specialist – after having an echo and a stress test done at a community hospital. Results were not forwarded to the specialist’s office. Based on those results, the visit would determine treatment plan changes – medications, additional tests, and procedures. Fortunately, the cardiac specialist was able to login to the JHC (RelayHealth) portal and pull the results – immediately. The necessary changes were made to the care plan and the patient was able to avoid delays and duplicative care. At first, the patient expressed his concern that it was going to be a “wasted” visit without those results (impacting patient satisfaction).

“RelayHealth has proven to be a valuable resource to me. This is another example of the growing instances where having the information available helps in delivering quality care while containing costs. Thank you for working on this important endeavor.” Cardiac Specialists – Barnabas Health

Access to Data in the Emergency Department

An ED physician with Meridian Health System had a patient come in – who was a patient recently seen at a regional heart center. The Meridian doctor was able to pull up the complete patient record prior to treating the patient – instantly having information at his fingertips from the JHC (RelayHealth) portal – that he wouldn’t have known otherwise. Similarly, an ED physician with Trinitas Medical Center – logged into the JHC (RelayHealth) portal and found that the patient he was treating had five MRIs in the past 6 months. As a result, the doctor changed the patient’s course of treatment…instead of ordering another MRI.

And Access, All Across the Continuum of Care

The Atlantic Health System Ambulance Company is now using the JHC (RelayHealth) portal to access HIE data from the ambulance so they can see existing diagnoses and medications on their patients to assist with treatment on the way to the hospital. The Barnabas Health Heart Transplant Unit eliminates faxing as they pull patient results directly from the JHC (RelayHealth) portal – aiding treatment in complex patient work-ups and specialty care. Summit Medical Group leverages affiliated health system data to support ACO quality contracts. The SMG staff can look into the JHC (RelayHealth) portal to see a patient record – if the patient received their HbA1c value checked outside of their own network during the ACO quality-reporting period. The prior process included SMG calling into the affiliated health system medical records department to get patient records manually – which required the medical records staff to print and send the patient records to SMG.

Do some of these stories ring a bell with you? “Yeah, we’re doing that”. If you have a story to share about your experience with JHC and utilizing the network to impact care – please send us your story and we’ll share it with our members in an upcoming newsletter.

In September 2015, Jersey Health Connect Jersey launched a Strategic Planning Process to better define the organization’s relevancy to members as HIE’s across the country begin to take a larger role in Population Health Management for providers who are transitioning to a value-based reimbursement system. JHC brought together a cross-section of members to participate in the process as it reviewed its strategic value to the evolving healthcare system and updated its core Goals & Objectives for the growing New Jersey HIE network.

As a part of that process, JHC is now working with core healthcare stakeholder groups – physicians, care coordinators, payors, long-term care providers, and pharmaceutical companies – to define the priority needs within each area of the continuum of care. These “plunges” into specific care settings, with providers who are at the frontline of healthcare change, will serve as the catalyst for the evolving use of health IT in the new value based environment.

“HIEs must recognize that sharing and aggregating health data (while meaningful and foundational to the new healthcare process) is a part of a large process of multiple building blocks to achieve a higher level of care management,” says Lou Hermans, Executive Director of JHC. “Our JHC leadership teams have identified clinical decision support (CDS) systems as a primary goal for the organization in the years ahead.”   The interactive computer programs of JHC will assist physicians and other health professionals throughout NJ with decision-making, allowing them to use HIE data to identify patient-specific care needs. They can also use the data to identify sentinel events (defined as patterns of excessive or inappropriate use of care services), missed appointments, or missing tests relative to accepted standards of care, and then promote proactive interventions to address the identified needs.

JHC is building advisory groups of core users to assist them in the identification and development of its expanded portfolio of services. Any JHC member interested in being a part of the process is welcome to join a group and bring their input and insights to the advancement of electronic health exchange. If you’d like to learn more about the Strategic Planning Process or join an advisory group, please contact Tom Casey at [email protected].

Understanding the Modifications & Changes

CMS recently released a final rule that specifies criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The final rule’s provisions encompass EHR Incentive Programs in 2015 through 2017 (Modified Stage 2) as well as Stage 3 in 2018 and beyond.

The EHR Incentive Programs in 2015 through 2017 (Modified Stage 2) reflect changes to the objectives and measures of Stages 1 and 2 to align with Stage 3, which focuses on the advanced use of EHRs. The changes also aim to reduce the complexity of the program and work toward a shift to a single set of sustainable objectives and measures in 2018. Redundant, duplicative, or topped out measures have been removed.

Starting in 2015, all providers will be required to attest to a single set of objectives and measures. Since this change may occur after providers have already started to work toward meaningful use in 2015, there are alternate exclusions and specifications within individual objectives for providers who were previously scheduled to be in Stage 1 of the EHR Incentive Programs.

To allow CMS and providers time to implement these modifications, the EHR reporting period in 2015 is any continuous 90 days period within the calendar year. All providers will have until February 29, 2016 to attest.

The bullet points below are the key modifications for the EHR Incentive programs in 2015 through 2017:

Requirements for EHR

Reporting Periods in 2015 Through 2017

Starting in 2015, the EHR reporting period for EPs, eligible hospitals, and CAHs will be based on the calendar year. This allows more time for hospitals and CAHs to implement certified EHR technology, and aligns the EHR Incentive Programs with reporting periods in other CMS quality reporting programs.

In 2015, all providers are required to use technology certified to the 2014 Edition. In 2016 and 2017, providers can choose to use technology certified to the 2014 Edition or the 2015 Edition.

In 2015 only, the EHR reporting period for EPs, eligible hospitals, and CAHs is any continuous 90-day period within the calendar year. EPs may select an EHR reporting period for any continuous 90 days from January 1, 2015 through December 31, 2015. Eligible hospitals and CAHs may select an EHR reporting period of any continuous 90-day period from October 1, 2014 to December 31, 2015. This is intended to accommodate the shift from reporting based on the federal fiscal year to the calendar year for eligible hospitals and CAHs.

Beginning with 2016, the EHR reporting period must be completed within January 1 and December 31 of the calendar year. EPs eligible hospitals, and CAHs that are new participants in the program would have an EHR reporting period of any continuous 90-day period between January 1, 2016 and December 31, 2016. However, for all returning participants, the EHR reporting period would be a full calendar year from January 1, 2016 through December 31, 2016.

In 2017, the EHR reporting period would be one full calendar year for all providers except new participants and/or providers who choose to implement Stage 3, who are allowed a 90-day reporting period.

Alternate Exclusions & Specifications

There are several alternate exclusions and specifications for certain measures that are intended to help providers previously scheduled to be in Stage 1 that may not otherwise be able to meet the criteria in 2015 and 2016 because they require the implementation of certified EHR technology beyond the functions that were required for Stage 1.

These provisions include:

1. Allowing providers who were previously scheduled to be in a Stage 1 reporting period for 2015 to use a lower threshold for certain measures. For 2016, all providers previously scheduled to be in Stage 1 may claim an alternate exclusion for the CPOE objective measure 2 (laboratory orders) and measure 3 (radiology orders). For 2016, eligible hospitals and CAHs previously scheduled to be in Stage 1 may claim an alternate exclusion for the eRx objective.
2. Allowing providers to exclude modified Stage 2 measures in 2015 for which there is no Stage 1 equivalent.

Modification to Patient Engagement Objectives

There are two objectives for EPs and one objective for eligible hospitals and CAHs with measures requiring a provider to track patient action. These measures have been modified to help providers successfully meet these objectives.

• Stage 2 Patient Electronic Access, Measure 2: For an EHR reporting period in 2015 and 2016, instead of the 5 percent threshold, this measure requires that at least 1 patient seen by the EP during the EHR reporting period, or discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH (or patient-authorized representative), views, downloads or transmits to a third party his or her information during the EHR reporting period.
• Stage 2 EP Secure Electronic Messaging: The 5 percent threshold has been changed to the capability for patients to send and receive a secure electronic message with the EP was fully enabled during the EHR reporting period.

To see the full set of revisions and changes to the Meaningful Use requirements – please click the following link: http://www.cdc.gov/ehrmeaningfuluse/docs/cms_stage_3_mu_overview_2015_2017.pdf

Over the past year, Jersey Health Connect has been working on a solution to address the issue of “parental access to minor sensitive information” within the RelayHealth portal. Fortunately, through collaborative input and insights from our members and management team, JHC has developed a solution to this sensitive issue and we are preparing to go live with a new JHC Parental Access Process on February 16, 2016.

The new process involves breaking the account relationship between parents and minors in the portal. This will only impact those minor patients age 12 or over who have an electronic PHR, and then only if their parents have assumed control of the PHR. These records are a small fraction of those that currently reside in the JHC health exchange.

As part of this solution, we have developed a form by which parents, with their minor’s consent, may preserve their access. For those that do, the process requires that form to be provided to a JHC member hospital that has treated the patient, so that form may be attached to their record in the portal. (The hospital representative who handles the release of information to patients would be the logical contact point at each JHC Member Hospital).

Ultimately (whoever is designated) to handle these requests is going to need to understand this new process. We are assuming the published line for medical records for JHC hospitals is the appropriate point of contact, but if that is not the case at any JHC member hospital – please contact Van Zimmerman, Safety Officer at JHC, [email protected]. We will be sending initial e-mail notifications to the affected accounts on January 15, 2016, after which, we would expect some volume of requests to preserve access.

Below, please find links to a formal letter discussing this, a brief PowerPoint presentation touching on the key points of this process, and the relevant form, which is located on the JHC website.

If you have any questions or concerns regarding the new JHC Parental Access Process, or there are individuals you can identify who would be involved in this process, please contact Van Zimmerman ([email protected]) and we will be happy to discuss the process and explain the technical solution that RelayHealth is providing.