Tuesday, September 14, 2010

The Characteristics of HIE Governance

Today, the Massachusetts eHealth Institute Ad Hoc Health Information Exchange Workgroup discussed the desirable characteristics of HIE governance. Here's what we outlined:

Guiding Principle - To provide oversight and governance for an effective rollout of HIE across Massachusetts that accelerates and enables a network-of-network approach by tying existing assets to procured services in a unified, transparent and standards driven manner while embracing and enhancing the principle of public private partnership.

Specific Principles for Governance
* Principle #1 - Enhance trust and credibility by establishing a Multi-Stakeholder, open and transparent body
* Note - Need to draw distinction between this governing body and the existing ones and perhaps consolidate to a fewer number.

* Principle #2 - Reflect Public/Private partnership in a way that balances the priorities of regulation, transparency and common good with the imperatives of value generation, sustainability and market economics.

* Principle #3 - Enhance credibility and trust by adopting best practices that eliminate any conflicts of interest.
* Manage procurement by groups not having an interest in bidding for services
* Govern operational delivery utilizing groups and individuals separate from the community that provides these services.

* Principle #4 - Provide a comprehensive platform that merges the tactical task of oversight of HIE rollout with the strategic need for innovation driven vision setting. Provide the following functions
* Priority setting for HIE procurement
* Provide oversight of an HIE project/program management office
* Holding service providers accountable for meeting goals
* Provide oversight for resource allocation
* Provide a forum for fostering innovation, and
* Be an enabler and accelerator for the adoption of HIE by anticipating and removing roadblocks

A great discussion and a very sound set of governance characteristics. Our next step is to present these ideas to the Massachusetts HIT Council for their feedback and then think about various structures to operationalize HIE governance - i.e. state department, new 501c(3), private sector etc.

1 comment:

Mark Segal said...

John, this is a very promising approach. I especially like the focus on public/private partnerships and the recognition that networks of networks will be an important element of many state HIE strategies to provide effective intereroperability and robust, bi-directional exchange. The focus on process and transparency should provide appropriate opportunities for input by vendors, technology experts, and other interested parties, who must be part of a true public/private partnership. I'd also like to applaud the recognition in your prior post http://geekdoctor.blogspot.com/2010/09/health-information-exchange-gap.html of the importance of thinking ahead to Stages 2 and 3 of meaningful use in designing infrastructure and governance, as well as general opportunities to build on current capabilities in standards and technology that may exceed Stage 1 requirements. I'd also like to call out the importance of the plans for Image Exchanges, an area of HIE that holds substantial promise for quality, patient safety, and cost.