ToC+-+Success+Metrics+Meeting+Minutes+10-11-2011

include component="page" wikiName="siframework" page="TOC Header" **Date:** 10/11/11 **Name:** ToC Success Metrics

Agenda/Objectives:

 * **Topic** || **Owner** || **Time Allotted** ||
 * Matrix Completion || Dr. Miller / Dr. Leftwich / John Donnelly || 3:00-3:50 ||
 * F2F Announcement
 * Group will receive copy of matrix for review prior to meeting
 * Number of participants registered
 * Any metric deemed currently unmeasurable at the F2F (due to expense, IRB requirements, staffing, etc.) will be held pending identifying required components || Dr. Miller / Dr. Leftwich / John Donnelly || 3:50-3:55 ||
 * Wrap-Up / Next Steps || Dr. Miller / Dr. Leftwich / John Donnelly || 3:55-4:00 ||

Attendees:
Allen Hobbs, Holly Miller, Dr. Nezda, Dr. Leftwich, Susan Campbell, John Donnelly, Laura Heermann, Cyndalynn Tilley; Farrant Sakaguchui, Amy Berk, Smriti Singal

Action Items:

 * **Action Item** || **Next Steps / Status** || **Lead** || **Contributors** || **Due Date** ||
 * Comment on Matrix using the Discussion tab on the Wiki || In Progress || WG Members || n/a || 10/15/11 ||
 * Research previously identified definitions for small, medium, and large clinical organizations. || In Progress || Farrant Sakaguchi || Support Leads || 10/15/11 ||
 * Participate in F2F meeting on Tuesday 10/18 from 10:15am-12pm || In Progress || WG Members ||  || 10/18/11 ||

**ToC Success Metrics Discussion:**

 * Goal today is to complete as much of the matrix as possible
 * Using most recent copy of the matrix with the following changes:
 * Reformatted the Matrix overall
 * Metric Algorithm has been changed to "Hypothesis Questions"


 * Depending on the hypothesis question, we would expect the Measurement number to go up over time
 * Need to fill in hypothesis questions for Clinical Organizations
 * IN definition, need to change to reflect HISP or HIE
 * Are you using Direct in a test environment? Change to; “Do you have an interoperable solution in test? In production?”
 * If your solution is in production, how many clinicians have used the system?
 * Measuring adoption on use of HISP
 * Can’t just point out Direct; need to point out interoperability
 * Do we really need to differentiate between testing and production? Yes, we would need to clarify the questions so the metrics will reflect this differentiation
 * We are looking to see how many providers are connected and don’t necessarily care how they are connected; secure messaging implies more in regards to adoption…the "how” is very important; this is where you see enhanced workflows
 * The **how** will inform the industry in terms of technologies; as part of adoption
 * Keep it simple; exchanging a document for ToC; making certain the content in the document is used in a meaningful way; how can we keep it simple?
 * Specific value in the “how” b/c you can use free text for secure messaging; are structured data elements the future?
 * Only talking about the exchange of the ToC
 * Direct used for ToC Structured Data
 * Are we progressing towards a more tightly integrated EMR to EMR exchange overall?
 * This is going to require some staging; really trying to narrow down; get the document and using the content of the document
 * There is a utility of finding out what kinds of interoperability is being utilized; perhaps doesn’t belong in the HISP category; and put somewhere else?
 * Put under Clinical Organizations; ask them as to how they are exchanging information
 * “EHR to EHR” or “Secure Email” or “EHR to HIE”---need to separate out for small, medium, large (>/= 100 providers) organizations
 * Need to discuss the “targets” for this; what will we do with an IDN, multi-practice, etc
 * **Action: Need guidance in the industry in regards to physician size (Farrant)**
 * Single Database or shared database
 * National standard for reporting of adoption metrics; does this exist? CMS, AHRQ, AHIMA?
 * Use their reporting mechanism; this would be helpful as well as defining the sizing
 * Potential Grouping of Physicians:
 * 6-10
 * 11-20
 * Groups of 20 or more

Resolutions:

 * Updated “Hypothesis Questions” to “Metric Questions”
 * Further work will be completed on the matrix prior to the F2F; will send out for review prior to the F2F
 * A lot of this work so far has been highly theoretical; we now need to get the data; what should we do for the questions; either there are barriers for getting the questions; they would then become un-measurable? What would the funding be if there were any surveys required? As we get realistic about the different metrics measures; looking for the low hanging fruit; the ones we can get the data on; and then those that are more difficult will be held until we can define how we can get the data

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