S TATE OF M AINE G OVERNOR’ S O FFICE OF H EALTH P OLICY AND F INANCE 15 S TATE H OUSE S TATION AUGUSTA, MAINE 04333-0078 JOHN E. BALDACCI TRISH RILEY GOVERNOR DIRECTOR June 18, 2010 David Blumenthal, MD, MPP National Coordinator for Health Information Technology Department of Health and Human Services 200 Independence Avenue, S.W. Washington, DC 20201 Dear Dr. Blumenthal, On behalf of Maine’s Office of the State Coordinator for Health Information Technology and HealthInfoNet, we are submitting the attached revised Maine Statewide Health Information Exchange Strategic and Operational Plans for your review. Our plan reflects an ongoing collaborative effort reflective of the state’s health and healthcare systems. This is the final strategic and operational plans for the state of Maine submitted to the ONC that upon approval will allow for the implementation funding of the HIE Cooperative Agreement to be released. We look forward to hearing from the ONC on the results of reviewing our plans and to begin implementation of our plans. Sincerely, James F. Leonard, Director Office of the State Coordinator for Health Information Technology Governors Office of Health Policy and Finance Shaun T. Alfreds, MBA, CPHIT Chief Operating Officer HealthInfoNet 6-18-2010 Revision Maine Statewide Health Information Exchange Strategic and Operational Plans A Strategy to Create an Infrastructure that Preserves and Improves the Health of Maine People Released to ONC and for Public Comment on 6/18/2010 2 6-18-2010 Revision Table of Contents: Acknowledgements ................................................................................................................ v Acronyms .............................................................................................................................. vi Executive Summary .............................................................................................................. vii Introduction ........................................................................................................................... 1 Background ............................................................................................................................ 4 History, Current Status, and Gaps in HIE Collaboration in Maine............................................. 7 Electronic Eligibility and Claims Transactions..............................................................................................................9 Electronic Prescribing and Refill Requests..................................................................................................................10 Electronic Clinical Laboratory Ordering and Results Delivery ...........................................................................11 Electronic Public Health Reporting.................................................................................................................................12 Quality Reporting Capabilities ..........................................................................................................................................12 Prescription Fill Status and/or Medication Fill History.........................................................................................13 Consumer Engagement in HIE...........................................................................................................................................16 Privacy and Security Policies and Procedures ...........................................................................................................17 HIE Financing and Sustainability .....................................................................................................................................18 Statewide Broadband Capacity.........................................................................................................................................23 HIT and HIE Adoption Across the State.........................................................................................................................25 State Agencies HIT and HIE Use:.......................................................................................................................................26 Provider EHR Adoption:........................................................................................................................................................27 Maine Statewide HIT and HIE Vision, Goals, and Objectives.................................................. 33 Maine HIT and HIE Strategic Goals..................................................................................................................................33 Maine HIT Strategic Objectives.........................................................................................................................................34 Legal and Policy HIE Capacity:..........................................................................................................................................36 Governance Capacity: ............................................................................................................................................................40 Business and Technical Operations Capacity:.............................................................................................................43 Technical Infrastructure Capacity:..................................................................................................................................44 Finance Capacity:.....................................................................................................................................................................45 Conclusions .......................................................................................................................... 46 MAINE’S HEALTH INFORMATION EXCHANGE OPERATIONAL PLAN........................................ 47 Coordination Activities ......................................................................................................... 48 Coordination with ARRA Programs ................................................................................................................................48 Coordination with the Maine Regional Extension Center (MEREC).................................................................49 Coordination with the Beacon Community .................................................................................................................54 Improve Management of Chronic Conditions through HIE...................................................................................54 Improve Population Health through Immunization Compliance and HIE.....................................................55 Improving Cost Effectiveness:.............................................................................................................................................56 Coordination with Community Collage and Workforce Programs....................................................................58 Coordination with MaineCare (Medicaid)....................................................................................................................61 Coordination with Other Federal Programs................................................................................................................63 Coordination with Other States ........................................................................................................................................63 Domain Requirements.......................................................................................................... 66 Governance................................................................................................................................................................................66 3 6-18-2010 Revision Finance.........................................................................................................................................................................................82 Cost Estimates and Staffing Plans ....................................................................................................................................84 Controls and Reporting.........................................................................................................................................................97 Technical Infrastructure ......................................................................................................................................................99 Standards and Certification................................................................................................................................................99 Technical Architecture ....................................................................................................................................................... 102 HIN System Overview.......................................................................................................................................................... 108 Evaluation of Technical Architecture .......................................................................................................................... 117 Lessons Learned and Modifications.............................................................................................................................. 118 Implementation Activities................................................................................................................................................