Questions and Answers

Q & A Topics

General | Billing and Payment | Chronic Illness Demonstration Project (CIDP) | Health Home Design | Health Home Development Funds | Health Home Letter of Intent/Applications/Provider Enrollment/Application Form | Health Home Network | Health Information Technology | Managed Care | Member Forms | Population Assignment/ Eligibility (Patient Tracking System) | Quality Metrics and Evaluation (CMART) | Spend Down | Targeted Case Management (TCM) |

Health Information Technology

  1. Where can I find more information about the HEAL Projects and the Statewide Policy Guidance (SPG)?
  2. Which domains of HIT will be monitored?
  3. What Health Home Funding opportunities are available to help supplement the cost of developing a robust Electronic Health Record? Do these funds cover other Health Home costs as well?
  4. What computerized system will be used to enhance communication amongst our providers and PCP offices and how will that be paid for?
  5. How will the State support more comprehensive integration of the RHIOs into this effort?
  6. What kind of technical support/assistance will be offered in implementing HIT at all levels?
  7. Is it expected that health home providers will link to MCOs?
  8. What is NYeC and what is their website?
  9. Please clarify what "as feasible" means in Section VI, 6a-6d of the Health Home application.
  10. The Initial Standards for HIT call for: a health record system which allows the patient health information and plan of care to be accessible to the interdisciplinary team of providers, "as feasible". Providing that a TCM has established, timely, case conferencing, electronically shares the patient's plan of care with a unique identifier and has a system in place to keep each member of the interdisciplinary team up to date - along with a plan to meet the final standards and a letter of support from our local RHIO, will we meet this initial HIT requirement for Health Home?
  11. Can HIT Standard 6c be interpreted to mean that using faxing or providing copies as an interim measure before full implementation of 6e-6i is allowable to make the plan of care accessible?
  12. Do Health Homes need a full EHR or utilize a Care Management platform that could interface with the RHIO's HIE. Can you speak to this?
  13. The draft NYS Health Home SPA... (on page 5 of 23) recognizes that many of the potential health home providers may not yet utilize HIT. It states that these providers will be encouraged to utilize RHIOS or other qualified entities to access patient data. It is expected that health home providers must achieve final HIT standards within 18 months?
  14. Where can I find more information about Health Information Technology (HIT)?
  15. The Health Home SPA states that a single case record will be agreed to and shared by all team professionals. How will this work?
  16. If another organization/entity within our network already has EMR and RHIO access will this be sufficient?
  17. Do all individual members of a Health Home network need to purchase a separate membership in a local RHIO?
  18. Can individual members exchange information through the RHIO simply by being a member of the Health Home?
  19. Regarding the Network, 6F of the Medicaid Health Home Provider Application asks "Health Home provider uses an electronic health record system that qualifies under Meaningful Use provisions of the HITECH Act, which allows the patient´s health information and plan of care to be accessible to the interdisciplinary team of providers. If the provider does not currently have such a system, they will provide a plan for when and how they will implement it." Do EHRs meet the meaningful use standards?
  20. Are non–direct care providers required to meet the full New York HIT standards as outlined in the Health Home application? If so, how can they achieve this?
  21. In the August 2011 NYS Medicaid Update, the Medicaid Electronic Health Records Incentive Program is showcased on the cover. It appears that the eligibility requirements exclude organizations that are providing Health Home care management services but not direct medical services performed by doctors. Is this true? Has the state considered opening this application process to Health Home care management providers?
  22. What does a Health Home need to do to comply with 6d. if there are multiple RHIO's in the area that the Health Home is serving?
  23. Do you have a specific list of the outcome measures (quality, utilization) that the Lead Health Home will need to report? (more specific than shown in the SPA)
   Archived Questions
1. Where can I find more information about the HEAL Projects and the Statewide Policy Guidance (SPG)?

The HEAL project ended in November of 2013 but any information can be found at the NY DOH Division of Health Information Technology (DHITT) website: Health Information Technology Information on the Statewide Policy Guidance can be found at the New York e–Health Collaborative (NYeC).

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2. Which domains of HIT will be monitored?

Applicants will need to attest to participation in a RHIO/Qualified Entity, exchange of interoperable clinical information, certified EHRs, clinical decision support, and following statewide policy guidance for interoperable Health Information Exchange (HIE).

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3. What Health Home Funding opportunities are available to help supplement the cost of developing a robust Electronic Health Record? Do these funds cover other Health Home costs as well?

Health Home Development Funds (HHDF) were distributed to Health Homes to support in 4 approved spending categories including: Member Engagement and Health Home Promotion, Workforce Training and Retraining, Clinical Connectivity and Health Information Technology (HIT) Implementation, and Joint Governance Technical Assistance. More information regarding Health Home Development Funds can be found on the HH website by clicking here.

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4. What computerized system will be used to enhance communication amongst our providers and PCP offices and how will that be paid for?

There is no ´common´ computerized system in NY. There is the SHIN–NY (Statewide Health Information Network for New York) which is an open source network for sharing information across disparate systems. As of April, 2014, the SHIN–NY has been designated a "Public Utility" and there are no application costs associated with accessing Health Information. Projects will still be required to fund connectivity and interoperability with their local RHIO.

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5. How will the State support more comprehensive integration of the RHIOs into this effort?

The RHIOs are integral to efficient and timely sharing of health information. The DOH has discussed the health home initiative with the RHIOs and the HEAL Projects. We have encouraged the RHIOs and the Regional Extension Centers (REC) to reach out to and work collaboratively with potential providers in meeting Health Home HIT requirements.

New York State is also working closely with the Office of the National Coordinator for HIT (ONC) to prepare for the adoption of interoperability standards for care plan applications when those standards are finalized.

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6. What kind of technical support/assistance will be offered in implementing HIT at all levels?

Health home providers should contact one of the two New York Regional Extension Centers for evaluations and support in implementing HIT. The website for the New York City Regional Extension Center is here. For support outside the NYC boroughs, the website for the NYeC Regional Extension Center is here.

In addition, for non–technical Health Home HIE support, you can email Health Homes. Select "Health Information Technology" from the subject menu and a member of the Health Homes team will be able to respond to your question.

Where can I find a list a list of Regional Health Information Organizations Information on the NYS RHIOs can be found here.

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7. Is it expected that health home providers will link to MCOs?

Yes, and it is expected that health home providers will leverage HIE and abide by state wide policy guidance in sharing information.

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8. What is NYeC and what is their website?

NYeC (pronounced "nice") was founded by health care leaders throughout New York State with support from the New York State Department of Health, as a public–private partnership serving as a focal point for key healthcare stakeholders to build consensus on health information technology (HIT) policy priorities and collaborate on national, state and regional HIT adoption, implementation and optimization initiatives. For more information, click here.

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9. Please clarify what "as feasible" means in Section VI, 6a–6d of the Health Home application.

When initially beginning the projects, we understand that the projects may be predominately paper based, or rely on software systems that do not meet interoperability requirements. Rather than slow down the initiatives, we suggest utilizing and leveraging the HIT/HIE infrastructure in New York where ´feasible´, knowing that the projects are committing to meeting the final standards 18 months after project inception.

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10. The Initial Standards for HIT call for: a health record system which allows the patient health information and plan of care to be accessible to the interdisciplinary team of providers, "as feasible". Providing that a TCM has established, timely, case conferencing, electronically shares the patient´s plan of care with a unique identifier and has a system in place to keep each member of the interdisciplinary team up to date – along with a plan to meet the final standards and a letter of support from our local RHIO, will we meet this initial HIT requirement for Health Home?

Yes.

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11. Can HIT Standard 6c be interpreted to mean that using faxing or providing copies as an interim measure before full implementation of 6e–6i is allowable to make the plan of care accessible?

Yes.

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12. Do Health Homes need a full EHR or utilize a Care Management platform that could interface with the RHIO´s HIE. Can you speak to this?

Those providers giving clinical services will need to maintain a certified EHR that is capable of interfacing with the RHIOs. Other providers where a certified EHR is not available will need to have interfaces to the RHIOs for sharing and obtaining the information.

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13. The draft NYS Health Home SPA... (on page 5 of 23) recognizes that many of the potential health home providers may not yet utilize HIT. It states that these providers will be encouraged to utilize RHIOS or other qualified entities to access patient data. It is expected that health home providers must achieve final HIT standards within 18 months?

Yes.

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14. Where can I find more information about Health Information Technology (HIT)?

Visit the Department´s Health Home website by clicking here or visit the NYeC

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15. The Health Home SPA states that a single case record will be agreed to and shared by all team professionals. How will this work?

Health Homes must be able to share patient specific information with all members of the health home team for each patient enrolled in the Health Home. Health Homes are responsible for developing their own solutions to functionally meet this requirement so that the entire team can share and discuss information about the patient including changes in patient status and treatment.

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16. If another organization/entity within our network already has EMR and RHIO access will this be sufficient?

No. The purpose of the health information technology requirements is to assure the Health Home has a means of sharing patient information with its network. The Health Home Lead applicant assures this takes place by meeting Section VI of the Health Home Provider Qualification standards.

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17. Do all individual members of a Health Home network need to purchase a separate membership in a local RHIO?

The only requirement is for the designated Health Home to have a RHIO membership. RHIO membership is encouraged for all other downstream providers but it is not a requirement. RHIOs have different memberships by provider type and or stakeholder. If a hospital is a member of the RHIO, the hospital caregivers can access information under that membership. Individual practitioners, group practices, care organizations or MCOs would need separate membership. As the SHIN–NY is now a public utility, there are no longer any membership fees to join a local RHIO.

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18. Can individual members exchange information through the RHIO simply by being a member of the Health Home?

Yes and No.

Personal Health Information can be sent to a RHIO providing that that organization has a participation agreement with that RHIO and the electronic health record system has an interface with the RHIO. Personal Health Information can only be pulled from the RHIO for those patients who have signed a RHIO consent form which contains the name of the organization in question.

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19. Regarding the Network, 6F of the Medicaid Health Home Provider Application asks "Health Home provider uses an electronic health record system that qualifies under Meaningful Use provisions of the HITECH Act, which allows the patient´s health information and plan of care to be accessible to the interdisciplinary team of providers. If the provider does not currently have such a system, they will provide a plan for when and how they will implement it." Do EHRs meet the meaningful use standards?

Our EHR standard is that providers will use MU certified EHRs. It does not mean that they will have attested to Medicare and Medicaid and be receiving HITECH incentives. RHIOs don´t have an MU requirement.

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20. Are non–direct care providers required to meet the full New York HIT standards as outlined in the Health Home application? If so, how can they achieve this?

Non–direct care providers can join RHIOs to access and share data but will have their direct providers abide by the SPG and the HIE requirements. While they can utilize a version of their care management system to develop partnerships to maximize the use of HIT across providers, we look for a system that is interoperable among providers and is not a standalone system. This is especially important as Health Home providers cross over different Health Homes.

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21. In the August 2011 NYS Medicaid Update, the Medicaid Electronic Health Records Incentive Program is showcased on the cover. It appears that the eligibility requirements exclude organizations that are providing Health Home care management services but not direct medical services performed by doctors. Is this true? Has the state considered opening this application process to Health Home care management providers?

Eligibility for the Quality Payment Program (formally known as the Medicaid Electronic Health Record Incentive Program) is defined at the national level. There is currently no additional funding to expand this list. The website for this program is here.

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22. What does a Health Home need to do to comply with 6d. if there are multiple RHIO´s in the area that the Health Home is serving?

Where more than one RHIO is an option, you can work with any of the RHIOs or one which will best meet your needs.

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23. Do you have a specific list of the outcome measures (quality, utilization) that the Lead Health Home will need to report? (more specific than shown in the SPA)

Please visit the Health Home website by clicking here.

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