Utah Digital Health Commission Meeting Minutes
Friday March 7, 2008, 10:00 a.m. -12:00 p.m.
Utah Department of Health
288 North 1460 West, Room 114
Salt Lake City, Utah
Members Present: Joseph Cramer, Scott Barlow, Rulon Barlow, Mark Munger, Chet Loftis, Brad LeBaron,
Via Video Conferencing Dennis Moser and Via Telephone Michael Jenson
Members Absent: Deb LaMarche
Staff Members: Wu Xu and Humaira Shah (UDOH, Office of Public Health Informatics)
Guests: Barry Nangle (UDOH), Don Beckwith (UDOH), Lisa Coy (MPH Student at UOU), John E. “Mickey” Braun, Jr. (Assistant Commissioner, Utah Insurance Department), Christie North (HealthInsight), Sharon Donnelly (HealthInsight), Gary Berg (HealthInsight), Francesca Lanier (UDOH), Henry W. Gardner (Vice President, Zion’s Bank), Suzette Green-Wright (Director, OCHA), Shauna Wozab (UHIN), Mollie Rebecca Poynton (Assistant Professor, UOU, College of Nursing) and Nancy Staggers (Associate Professor, Informatics, UOU, College of Nursing), Mike Martin (UDOH), Via Telephone: Mark Fotheringham (UMA Vice President of Communication)
Welcome and Update: Dr. Joseph Cramer welcomed everyone who is remotely connected or present. He debriefed the Commission that Secretary Michael Leavitt visited the Utah Partnership for Value-driven healthcare (UPV), a newly Chartered Value Exchange (CVE). UPV-CVE is part of Sec. Leavitt’s initiative about the “four pillars,” which are transparency of quality information, transparency of cost information, providing incentives for HIT adoption and connectivity, and pay for performance. He highlighted that the Commission has had a role in the HIT pillar.
Motion: Scott Barlow made a motion to accept the minutes from the last UDHSC meeting in its current forum. Brad LeBaron seconded. The motion passed unanimously.
Medicaid EMR Project Update: Sharon Donnelly reported project progress since last meeting. She discussed how they completed the recruitment for the Medicaid Provider EMR Promotion in November and December. Mark Fotheringham shared a list of specialty societies throughout the state with HealthInsight and they faxed that information to the various specialty medical associations. They got an incredible boost and got 72 clinics for the project that was funded for 35-40. Having worked with OPHI, they developed a report template (see handouts). They did over-recruit, so if they can get more funding, then they’ll continue to work past June with the clinics they have, or if not, then they’ll gently let them down and let them move on by themselves. Wu Xu asked HealthInsight to look at baseline rates of adoption. Garry Berg continues to explain the baseline assessment, saying that based on their data; EMR adoption among Medicaid providers was approximately two thirds.
Recap of the 2008 Legislative Session on e-Health Bills: Barry Nangle talked about a few of the Digital Health Services related bills. He explained the most significant ones like the recently passed House Bill 24, which is kind of a new charter for this commission. Then he talks about House Bill 47, standards for electronic exchange clinical health information. He explains how this was really a key piece of legislation for e-Health. It established the Department of Health’s authority to adopt in administrative rule, standards for the exchange of clinical health information that are developed by the community. This was controversial during the session but the passage of the bill is evidence that we are doing something which is going to have an impact on the community.
Motion: Dr. Joseph Cramer moved that we give a word of appreciation to the sponsors of these legislative actions that have relevance to e-Health areas, including House Bill 24, 47, and others.
Mark Munger seconds the motion and it unanimously passes.
Mark Munger discusses House Bill 119 and it’s related to the controlled substance database. He explains that we were the originating state, for setting up a controlled substance database in the country in the early 1990’s. He discusses that this amendment essentially does three things. It provides an educational forum for the state for both practicing physicians and pharmacies. It provides financial support to move the time frame from reporting every three days to reporting every 24 hours. It also provides funding for education and the infrastructure to build this system. Barry discusses Senate Bill 175, called death certificate procedure amendments, and it’s for physicians to do death certificates electronically.
Clinical Information Exchange Standards: Shaunna Wozab explains how one of the key assets and concepts that you can provide is setting and creating standards for the community. UHIN is a federally registered standard setting organization. They have done that successfully for years, and have now entered into the direction of the community to develop clinical standards. She explains the process of the standard development. UHIN convenes a community and reaches out to all specialties of a community. There are different ways by which a community member can submit proposals for what message they’d like to standardize. They have a process to address and prioritize the standard development as well. The community has sub-Ad Hoc committee groups that are the context experts. Each expert group comes together and hammers out those standards. The standards are then drafted, and go through the standards committee for final approval. They are then forwarded to the UHIN board. She explains that they are looking forward to working with more members of the community to create there standards. Brad LeBaron suggested to have flow charts on the processes of standard development and adoption, and also clarify what is the Commission’s role in standard adoption.
DHSC Membership: Dr. Cramer introduces two special guests, who are experts in nursing informatics. They are, Dr. Nancy Staggers who is associate professor at the University of Utah College of Nursing, and Dr. Mollie Rebecca Poynton who is assistant professor from the same college. Drs. Staggers and Poynton introduce themself as well. They talk on what nursing informatics really is, and how it manages and communicates data, information, knowledge, and supports physicians, nurses and other providers in their decision making in all roles and settings. They then discuss what are typical activities of a nursing informatics specialist: design, develop and/or implement applications for use by patients and/or providers. Then they discuss how a nursing informatics expert might assist the Digital Health Services Commission. Dr. Cramer then explains the importance of the nursing field, and how nurses are important in every field of health care. Joe talks about some vacancies on the list of commissioners. He explains how they talked about two representatives for information’s technology, including Dr. Jan Root and Marc Probst. The second position is a person not involved with Tele-health. He also explains how four members terms have expired, but statute does allow two terms and renewal. So these extensions will be honored. He thanks all those who renewed their term, including Deb LaMarche, Chet Loftis, Scot Barlow and Dennis Moser. Dr. Cramer then asks the commission and public to nominate some names for the position of the person not involved in Tele- health. He says particularly the law talks about special populations in House Bill 24. It’s suggested that someone from AARP is considered. Other names include Kevin Coonan, John. T. Nelson, Natalie Gochnour.
June 3rd Strategic Planning: Dr. Cramer talks about a retreat that we had a long time ago and now the new one will be sponsored by the University of Utah and the commission is invited along with others. It is set on June 3rd, and we hope it is accommodating for everybody. He also explains the items on the proposed agenda.
Meeting Evaluation and Next Steps: Dr. Cramer asks for thoughts from all the members.
Dennis Moser found the meeting was helpful. He would like to get a copy of the lists that needs to be put together for new commission members and the handout of the conference.
Michael Jenson appreciates everyone’s time and has no comments.
Mark Munger thinks it’s a great idea for a retreat and thinks that the strategic planning is what we really need to do. He thinks this will be a great start for next couple of years.
Chet Loftis said that anything that we can try to link what we think is important with the momentum that’s out there.
Rulon Barlow is happy to be where we are.
Scot Barlow apologizes for being late.
Brad LeBaron: I like our direction and appreciate the discussion.
Christie North: I think it’s very important for the Digital Health Commission to work very closely with the Chartered Value Exchange.
Dr. Cramer says that it is a great meeting and thanks everyone for their work. He then discusses the new website about the commission.