Oregon Health Authority

Provider Directory Advisory Committee

Provider Directory Subject Matter Expert Workgroup

Draft Charter, March 2017

Approved by the Health Information Technology Oversight Council (HITOC) on <date>

I. Overview, purpose, and authority

The Provider Directory Advisory Committee (PDAC) and the Provider Directory Subject Matter Expert Workgroup (PD-SME) are established by the Oregon Health Authority as an external subject matter expert and stakeholder body for the Statewide Provider Directory (“Provider Directory”). The purpose for each group is distinct:

·  PDAC: to provide guidance to the Oregon Health Authority (OHA) related to Provider Directory services with a focus on strategy and approaches that ensure a successful Provider Directory implementation and ongoing use.

·  PD-SME: to ensure the Provider Directory meets the needs for users by working through technical details and issues

The PDAC and PD-SME are not decision-making bodies but provide critical recommendations and advice to OHA for the implementation of the Provider Directory. Outputs from the PD-SME are reported to PDAC. PDAC reports periodically to HITOC. This charter defines the objectives, responsibilities, and scope of activities of the PDAC and will be reviewed periodically to ensure that the work of the PDAC and PD-SME is aligned with HITOC’s direction.

II. Role, Duties, Membership

PDAC
Role / Duties
1. Advisory body to the OHA / Identify and make specific recommendations to the OHA related to:
1.  Provider Directory policy, program, and technical areas to achieve the goals for the Provider Directory. Areas include but are not limited to:
·  Data Governance
·  Governing bodies
·  Provider Directory landscape and standards
·  Use cases
·  Communications and Outreach
·  Fees
·  Vendor design, development, and implementation
·  Program and Operations planning and implementation
2.  Provider Directory risks to the project/program and risk mitigation strategies
3.  Provider Directory gaps and barriers
4.  Identify laws, policies, other events/influences that impact the Provider Directory
2. Share information / Connect advisory group information to their organization to share broadly and also connect to their organization’s members in other related health IT committees.
PD-SME
Role / Duties
1. Advisory body to the OHA and PDAC / 1.  Participate in work sessions and discussions that address
·  specific use cases
·  data standards
·  data models
·  transport standards
·  work flows
2.  Work through implementation, policy, and programmatic issues and participate in user acceptance testing
2. Share information / Connect advisory group information to their organization to share broadly and also connect to their organization’s members in other related health IT committees.

Decisions

PDAC and PD-SME will make technical, policy, and operational recommendations to OHA for the statewide Provider Directory services. Decisions by the group will be made by consensus. OHA will coordinate decision making with stakeholder members as necessary and coordinate communication with HITOC regarding recommendations from the PDAC and PD-SME.

Chair

OHA will select the Chair from among the Members. The Chair will serve throughout 2017-2018.

Duration and Membership

Members shall initially serve throughout 2017-2018. Reappointment is at the discretion of the member, the PDAC chair, and the OHA.

PDAC and PD-SME membership should include a broad mix of health care perspectives from the healthcare enterprise including:

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ü  Hospitals

ü  Health Information Exchanges

ü  Health Plans

ü  CCOs

ü  Long term care

ü  Clinics and providers

ü  Behavioral Health

ü  Dental

ü  Independent Physician Association

ü  Healthcare Research

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PDAC Membership / PDAC membership should include those who serve in leadership and/or decision-making roles within their organization and are responsible for provider data in some way. PDAC members may serve in roles in credentialing; data, business, systems, and research analysis; care coordination and information exchange; information technology; provider contracting/information; claims processing; program integrity; and quality.
PD-SME Membership / PD-SME membership should include those who closely manage and work with provider data and serve in roles in credentialing; data, business, systems, and research analysis; care coordination and information exchange; information technology; provider contracting/information; claims processing; program integrity; and quality.

HITOC role and coordination with other Committees

HITOC will monitor progress and effectiveness of the Provider Directory, and provide guidance on cross program issues that impact multiple programs particularly where there is opportunity for alignment or risk of misalignment, such as data sharing barriers or fee models. OHA staff will share regular reports about progress on the provider directory with HITOC, the OHA Health Information Technology Advisory Group (HITAG) and other groups as relevant.

IV. Staff Resources

The Council is staffed by the Office of HIT, as led by the Director of HIT, for the Oregon Health Authority. Support will be provided by other OHA leaders, staff, and consultants as requested or needed.

·  Karen Hale, Provider Directory Program Manager, Office of Health Information Technology, OHA, , 503-602-3252

·  Stacey Weight, Policy Analyst, Office of Health Information Technology, OHA, , 503-602-3259

·  Jason Miranda, Lead Implementation Analyst, Office of Health Information Technology, OHA, , (503) 383-6261

·  Rachel Ostroy, Implementation Director, Office of Health Information Technology, OHA,

·  Susan Otter, Project Sponsor, Director of Health Information Technology, OHA,

V. Expectations for Meetings

The following expectations apply to all meetings:

·  The PDAC and PD-SME will meet every other month in offsetting months beginning in March 2017;

·  Location of meetings will be in the Portland/Willamette Valley area (with special exceptions);

·  A standard meeting time will be established (with special exceptions);

·  Meeting materials and notes will be posted to the OHA’s Provider Directory website;

·  OHA may also call for member participation outside the regularly scheduled meetings if needed;

·  Due to the nature of the discussions, in-person attendance at the meetings is preferred;

·  Ad hoc meetings can be called;

·  All meetings will be public and documented on the Provider Directory website and meet requirements for public meetings: http://www.oregon.gov/oha/OHIT/Pages/Provider-Directory-Advisory.aspx

·  Members are expected to review materials ahead of the meeting and come prepared to discuss and participate.

VI. Amendments and Approval

This charter may be amended. An amended charter requires approval by HITOC before it takes effect

VII. Provider Directory Background

The Oregon Health Authority (OHA) is developing a Provider Directory that will be operational in 2018. Healthcare entities will use the Provider Directory to find authoritative healthcare practitioner and practice setting information. The Provider Directory is part of our Health IT (HIT) portfolio which includes other HIT services such as the Oregon Common Credentialing Program and the Clinical Quality Metrics Registry. Harris Corporation is the system integrator and is responsible for procuring and overseeing the implementations.

The Provider Directory will leverage data from existing, trusted data sources, starting with the upcoming Oregon Common Credentialing Program which places a 120-day requirement for providers to update their information in a central database. Other authoritative data sources will also be included. It will also leverage national or federally recognized standards (such as the IHE-HPD standard) which supports the management of provider directories and opens the door for an interoperable solution.

The project includes design, development, implementation, and maintenance of the technical solution, data validation and management, as well as operations, ongoing management, and oversight of the program. An incremental implementation approach, driven by stakeholder endorsed use cases will be applied to ensure success out of the gate.

Provider Directory Objectives and Benefits

Improve operational efficiencies – Having one trusted, single, complete source of provider and practice information, will eliminate the need to gather and find data from multiple sources. Healthcare entities’ need to meet requirements for updated/accurate provider directories will be satisfied by using the Provider Directory. Providers will not be burdened by multiple requests for the same information. Staff time spent on finding accurate provider information will be reduced.

Improve ability to coordinate care and exchange health information – Providers will find other providers along with their Direct secure messaging (DSM) addresses and other provider contact information allowing electronic clinical data to be sent to the correct recipient for referrals and care coordination. Providers will be able to meet Health Information Exchange meaningful use requirements.

Improve data needed for health care analysis – There will be one source of data on where and when providers practice to support analysis of claims, generation of metrics and data analysis for quality improvement and related payment efforts.

VIII. Resources

·  Provider Directory Advisory Group Summary –2015-2016

·  Provider Directory Subject Matter Expert Workgroup Summary – 2014

·  Common Credentialing - The Provider Directory is a complimentary effort with the work of the Common Credentialing Advisory Group; which will advise the Authority on the implementation of a legislative requirement for OHA to establish a program and database for the purpose of providing credentialing organizations access to information necessary to credential all health care practitioners in the State. OHA staff are working closely together on both efforts.

·  Business Plan Framework - The Provider Directory is one of several elements of new state level HIT services that supports new models of care under Oregon’s health system transformation efforts.

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