Meeting+Minutes+ToC+Success+Metrics+2011-07-19

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 * Meeting:** ToC Success Metrics Workgroup Meeting 4
 * Date:** July 19th, 2011

Allen Hobbs, Amy Berk, Brandy Hays, Chris Andreou, Cindy Levy, Cyndalynn Tilley, Ed Larsen, Jennifer Sisto, John Donnelly, Russell Leftwich, MD, Susan Campbell, Teresa Mota
 * Attendees**:


 * Action Items:**
 * **Action Item** || **Next Steps/ Status** || **Lead** || **Contributors** || **Due Date** ||
 * Review and Comment on the ToC Metrics Matrix || In Progress || John Donnelly, Dr. Holly Miller || Workgroup Members || **__Ongoing__** ||
 * Establish Ownership for the Remaining Items || In Progress || See Spreadsheet || Various WG members || **__07-26-11__** ||
 * Follow up with outputs of PD WG---Awaiting Feedback from Arien || In Progress || Amy Berk || Arien Malec || ASAP ||


 * __Notes from Discussion:__**
 * General Topics:**
 * Dr. Miller was absent from today’s call
 * As of last week the workgroup members were requested to review the matrix and leave comments on the wiki.
 * Members are encouraged to use the discussion tab to give your feedback on the matrix
 * Review of Agenda
 * Review of ToC Charter
 * Exchange of clinical summaries of information pertaining to transitions of care
 * Exchanged at a core level vs. at a secondary and/or tertiary level
 * Will use the charter for framing of the work to come
 * Review of Timeline
 * Complete the work by Mid-End of August; Identify the Target Metrics, their algorythyms and baselines ---outputs could be used as guidance for RI
 * Matrix Review:**
 * There is a need to assign the metrics to those on the call and then bring back to the group next week to discuss
 * Start with adoption; updates to the matrix; please see matrix
 * N-# of Care Provider EH/EPs completing exchange at year 0
 * D-# of Care Provider Entities for Stage I MU at year 0
 * Core Requirements include testing your systems ability/capability to exchange data; menu item for exchanging summary of care documents
 * Row 6 is baseline and Row 8 is the doing of ToC; same or different?
 * Row 8 is a subset of Row 6; so you would have the same denominator but a smaller numerator ---not diluting the effort that have already started; looking at those who have committed themselves and evaluating for progress
 * How many EP and EH will not be able to meet all available MU criteria? But in their partial implementations be wanting to exchange documents for ToC
 * No one will start data exchange on the same day as they begin MU
 * **We shouldn’t limit the denominator to just EP/EHthis is how it should be**---See row 8---updates made on this row
 * Having adopted the ToC [electronic] process
 * Is there an enrollment concept? # of enrollees in ToC exchange---there is a registration process that goes along with MU
 * Whether we measure a baseline or gather information from CMS as we try to report on items
 * Does it now become part of certification? If gets adopted at Stage II? Then we can leverage the EH
 * Limit by those that are certified or allow anyone? Certified b/c more in alignment with the MU platform ---may want to have a caveat that the MDNI approach may be includable
 * Denominator or Numerator
 * Open tools that are being (MDNI);different methodology for exchange of information
 * Can ToC only be done with Direct or multiple exchange architects to exchange; not limiting to Direct
 * **Are we limiting to Certified solutions (applies to EHR technology) in the denominator? Or other solutions such as Firestar or MDMI---as specified by ONC; what will ONC recommend to the Secretary; is it document, messaging or both? How will ONC approach the denominator? Not how to participate or who gets acknowledged?****Should the denominator be limited to certified EHRs or also could include MDMI/Firestone solutions or PCAST HISP-HISP. If yes, will the certification cover process adapt to these different architects?**
 * How are we defining certification? PCAST report and talks about the HISP and may not be certified?
 * PCAST HISP approach in addition to MDMI Firestar
 * Don’t want to limit creativity where it exists
 * For Row 6, we can limit to Certified solutions
 * Column E for Row 6: should be able to leverage data from CMS
 * No straight attestations that would qualify for Stage II
 * From CMS; who has attested to have done this?


 * Resolution(s):**
 * The workgroup has been assigned various metrics on the Matrix:
 * Allen/Russell will focus on Outcomes
 * Susan/Cyndalynn/Teresa will focus on Process
 * Method to establish baseline is an informational interview; additional interviews in year 1 to assess the percent increase

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