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Section 1: Agency Information

Number of positions filled with this proposal

1

Agency Name

New York State Department of Health

Agency Code

12000

Agency Website

http://www.health.state.ny.us

Career Track

Public Policy

Unit

Health Information Technology Transformation

Unit Description

The Department of Health has launched a comprehensive health information technology (health IT) program as part of the Governor's health agenda to advance patient centered care and enable improvements in health care quality, affordability and outcomes for each person, family and business in New York. Under the direction of Deputy Commissioner Lori M. Evans, the Department of Health's new Office of Health Information Technology Transformation (OHITT) is charged with coordinating health IT programs and policies across the public and private health-care sectors. These programs and policies will establish the interoperable health IT infrastructure and capacity so that health information is electronically available at the time and place of care and interoperable across health care settings to:

- Inform medical decisions and advance the delivery of appropriate evidence based medical care.

- Improve health care quality and prevent an epidemic of medical errors.

- Rein in health care costs resulting from inefficiency, medical errors, inappropriate care and incomplete information.

- Improve care coordination among physician offices and other ambulatory care providers, laboratories, pharmacies, hospitals, community health centers and long term care and home health facilities.

- Support new quality based health care reimbursement models for Medicaid and commercial insurers.

- Support new disease management capabilities.

- Enable bidirectional public health surveillance and reporting.

- Support long term care and home care enhancement.

- Support emergency preparedness and response and other population health improvement initiatives.

The key objectives of the health IT program guiding the implementation of a health information and quality infrastructure are:

- Ensuring the privacy and security of patients' individually identified health information, and supporting the right of New Yorkers to have greater control over and secure access to their personal health information.

- Providing public information about the quality and cost of care by payers and providers so consumers can compare costs and value.

- Using health IT as a tool to support better management of chronic disease, community-based long-term care, improved public health surveillance and reporting, and a modified certificate-of-need process to advance health care reform.

- Providing health IT tools required for validated quality measurement and reporting to support reimbursement reform, which is under way in the Medicaid program - the largest health care payer in the state.

- Helping prepare New Yorkers for health care emergencies by developing the capacity to receive and exchange health care information, such as medications and lab test results.

- Helping clinicians and providers in small practices, community health centers and rural and under-served areas close the health IT gap between them and larger or urban institutions. This requires the development of a sustainable financing plan, which includes public- and private-sector investment in health IT.

- Increasing the use of telemedicine, remote monitoring devices and other medical device applications to exchange information regardless of the venue where the patient receives services.

Section 2: Title Information

Journey Level Title

Health Program Administrator

Street Address

Empire State Plaza

Line 2

Corning Tower, Room 2164

City

Albany

State

NY

Zip

12237

Section 3: Supervisor Information

Name

Steven R. Smith

Title

OHITT Director of Operations (Research Associate)

Phone No.

5184745423

Email Address

srs04@health.state.ny.us

Supervisor's Background

Mr. Smith joined the newly created Office of Health Information Technology Transformation in August of 2007, reporting directly to Deputy Commissioner Lori M. Evans. In his capacity as Director of Operations, Mr. Smith has responsibility for the overall management and functioning of the office; including personnel management, budgeting and financial management and contracting and contract administration. Additionally, Mr. Smith is responsible for multiple Office initiatives such as management of the HEAL NY Phase 5 $106M grant process, the development of the HEAL NY Phase 9 grant application, management of the Department's Coordinating Council for Health IT, and also functions in support to a number of other Office initiatives.

Prior to joining the Department of Health, Mr. Smith was with System Administration for the State University of New York. As a member of the Office for Hospitals and Clinical Services, major areas of responsibility included: (1) Development and Implementation of University-wide (64 campus) privacy policies, practices and associated training materials for the handling of protected health information. Coordination with academic health science centers and hospitals to ensure compliance with Privacy, Security and TSC aspects of HIPAA. Collaborated with Office of University Counsel to develop and modify existing policies; (2) Supporting the development of Stony Brook Hospital's capital budget and strategic plan for $125M building expansion project, including emergency department, patient care tower, outpatient oncology services and inpatient surgical expansion; (3) Project management of the selection, procurement, implementation, customization, upgrade and maintenance of an electronic medical record (TouchWorks by Allscripts) at the SUNY College of Optometry for the Clinical Practice Group consisting of over 100 doctors, 200 support staff and approximately 150 students and (4) Development and implementation of SUNY's PAD Program for the 32 State-operated campuses including; development of internet-based tool to evaluate implementation priority of 2,947 buildings, (covering over 88.2 million square feet) and number of AEDs for implementation (over 1000).

Section 4: Mentor Information

Name

Mark Kissinger

Title

Deputy Commissioner, Office of Long Term Care

Phone No.

5184025673

Email Address

mlk15@health.state.ny.us

Street Address

Empire State Plaza

Line 2

Corning Tower

City

Albany

State

NY

Zip

12237

Mentor's Background

Prior to this appointment as Deputy Commissioner of the Office of Long Term Care, Mr. Kissinger, served as the President of the Home Care Association of New York State and as Deputy Secretary for Health and Human Services for Governor Pataki where he was the lead policy advisor on health and human service issues, including Medicaid, mental health services, long term care, welfare and children's services. During his career, Mr. Kissinger's assignments have included Senior Program Associate for both the New York State Governor's office and the New York State Senate Majority Leader's office. Mr. Kissinger earned a Bachelor of Arts degree from the University of Michigan in Political Science and has won many awards for his leadership and commitment within the human services field, including the Vision of Hope award from the Council of Family and Child Caring Agencies in 2005.

Is mentor in the same unit/office as the supervisor?

No

Previously a PMI Mentor?

Yes

Section 5: Career Ladder

Title	Negotiating Unit	Salary Grade	Salary
Health Program Admr	PEF	18	45862
Health Program Admr 1	PEF	23	59510
Health Program Admr 2	PEF	25	66173
Health Program Admr 3	PEF	27	73487
Health Program Admr 4	PEF	29	81432
Health Program Admr 5	M/C	M-4	85067

Section 6: Intern Assignments

Activity

Health Care Efficiency and Affordability Law for New Yorkers Capital Grant

Description

It is anticipated that approximately $50 million will be made available for another round of funding for health IT initiatives in New York State through the HEAL NY grant program. This is an extraordinary opportunity for the Department of Health to further incentivize and direct statewide policy around health IT interoperability and drive common standards across healthcare organizations. Through this funding it will be key to leverage all existing initiatives that are essential in creating a functional statewide health information exchange. Given that this phase of HEAL remains in the concept stage many directions are possible including a focus on primary care. Primary care physicians provide much needed care coordination and health services. It has been shown that good care coordination can reduce healthcare costs and improve patient outcomes. Integrating the care coordination abilities of health IT into primary care practices has enormous potential in terms of reducing healthcare costs and improving health outcomes in the population.

The HEAL NY Phase IX RGA will invest significant dollars in projects that will reduce the cost of healthcare and improve healthcare quality in New York State. The document will not only serve as a guide for healthcare organizations to apply for funding with the state, but also as a policy vehicle to advance sound health IT practices. A comprehensive design process will occur to draft an RGA that is consistent with the healthcare agenda of the governor, the commissioner of health and the best interest of health organizations across the state.

The intern will contribute as a working member of the HEAL Phase IX design team. The individual will also be responsible for applying relevant academic research and industry best practices to the RGA and presenting the application to the team. Accordingly, the intern will attend all RGA planning meetings and review and edit all RGA drafts. Speaking and taking questions at the applicant conference will also be required. Following the conference the intern will be responsible for assisting with compiling and answering questions regarding the RGA, and posting the answers to the department's website. Additionally, the intern will evaluate grant applications to determine whether they meet or exceed the requirements for funding.

Activity

Health Information Security and Privacy Collaboration (HISPC); Patient Ed

Description

The Health Information Security and Privacy Collaboration (HISPC) is a federal initiative to examine privacy and security related laws, policies and business practices that impact electronic health information exchange (HIE). New York, represented by the state Department of Health, is one of thirty-three states and Puerto Rico charged with bringing together a broad range of stakeholders to develop recommendations to support the private and secure exchange of health information. NYHISPC is led by a statewide steering committee of diverse leaders in health care, business and privacy policy, and is informed by a wide range of stakeholders (including clinicians, physician groups, health facilities and hospitals, payers, public health agencies, government health agencies, pharmacies, long-term care facilities and nursing homes, and consumer organizations) who have been engaged through working groups and other forums. NYHISPC offers an important opportunity to advance the understanding of how state and federal laws and organization-level business practices impact the privacy and security of HIE in New York. Significant variation exists between states in terms of the laws that govern the privacy and security of health information. It is also unclear which laws apply to health IT, due to the fact that no law has been specifically created yet to govern health IT or health information exchange. Within New York State there is a patchwork of laws that could apply to health IT activities. Baseline efforts by the New York State DOH have summarized and assessed the impact of those laws on health IT and what solutions can be implemented in order to address them as part of HISPC phase one. For phase three, New York State is a member of the Consumer Collaborative and the Consent I Collaborative.

New York has chosen to advance the development of sound privacy and security laws and privacy through the Consent I and Consumer Collaboratives. Multi-state proposals submitted to the Office of the National Coordinator for Health IT (ONC) are crafted to specifically accomplish this goal. Under the Consumer Collaborative proposal the state will develop and implement a healthcare consumer educational campaign that focuses on health information exchange and the privacy and consent options available to consumers. The project will also inform consumers of significant health IT policy and industry developments pertaining to personal health information access and management. Under the Consent I Collaborative proposal the state will be populating a multi-state matrix designed to inform a synthesis of varying state health information privacy laws and policies. This project will attempt to reconcile variations between states.

The intern will be responsible for attending and actively participating in Collaborative and state team meetings, conference calls, working sessions and discussions. It is also expected that the intern will assist with major data collection efforts and material design to satisfy the requirements of both projects. Additionally, emerging health IT related policy briefs, summaries and analyses will be provided to the teams, by the intern, as appropriate. Relevant policy topics include emerging Web 2.0 applications and the role of interoperability in privacy and security policy design.

Activity

Regional Health Information Organization (RHIO) Accreditation

Description

Currently, significant variations occur in health information exchange policies, including policies that buttress or support technical methodologies. In addition to variations in patient consent, data use and access policies, governance, commercial practices, etc., there are policy variations in the rules used for matching patients between information systems, authentication of entities sending and receiving data as well as authorization of individual's access to specific types of clinical information. All of these variations are multiplied when considering exchange between regional collaboratives and across multiple states. Health information exchange between regions, statewide and state-to-state require knowledge and trust that the policies governing health information exchange adequately meet the requirements of all of the organizations involved. A multi-state or nationwide accreditation process can significantly facilitate this process.

In order to ensure provider, patient and industry trust in health information exchange and create a nationwide regulatory solution rather than a patchwork of state regulations, it is necessary to accredit entities governing health information exchange in the public's interest. In New York and across other states, these entities are called Regional Health Information Organizations (RHIOs).

Accreditation is a process whereby entities or organizations governing health information exchange are accredited based on a set of criteria. To address the issue of accreditation a multi-state team will develop a regulatory solution by conducting research and analysis on an accreditation model

Through its association with the American Health Information Management Association (AHIMA) New York State, represented by the New York State Department of Health and the New York eHealth Collaborative (NYeC), will participate in a multi-state project that will develop the aforementioned accreditation process. This project consists of a twelve-month multi-state effort focused on developing an accreditation framework as a multi-state regulatory process. The scope of the accreditation framework will focus on the research questions listed above and the following three-part research and analysis:

1. An analysis and synthesis of four national initiatives (AHIMA: State-Level HIE Consensus Project, CCHIT: Network Workgroup HIE Criteria and Tests, AHRQ: Chartering Value Exchanges for Value-driven Health Care, and State eHealth Alliance Information Protection Taskforce) resulting in a clarification of the scope of each initiative with respect to individual state and multi-state health information exchange governance and privacy and security activities as well as recommendations regarding where and how these initiatives merge or align.

2. Identification, analysis and synthesis of self-regulatory or quasi-governmental accreditation models from health care such as the Joint Commission as well as from other industries.

3. Identification and assessment of other state level and regional health information exchanges, a part from the 11 states represented on the State Steering Committee, in the context of best practices and the role of the state government to inform the development of accreditation criteria.

The intern will initially be responsible for drafting and finalizing the research proposal for this project. Funding will be sought from ONC as a continuation of an existing contract with AHIMA. The intern will also be responsible for contributing significantly to the research conducted in this project. The intern will collect relevant data on the four aforementioned national accreditation initiatives (AHIMA, CCHIT, AHRQ and the State eHealth Alliance) and state HIE activities, and analyze and synthesize the information. The intern will also participate in relevant meetings, working sessions and discussions.

Activity

Health Information Technology Evaluation Collaborative (HITEC)

Description

The Health Information Technology Evaluation Collaborative (HITEC) is a multi-institutional effort to maximize the impact of HEAL NY (and other health IT projects in New York State) through the application of standardized outcome measures and rigorous evaluation methodology. HITEC will provide participating RHIOs with standardized surveys, standardized outcome measures, consulting on study design and other research methods for evaluation, statistical consulting, data analysis, and reports summarizing each RHIO's findings (with anonymous comparisons to other RHIOs). HITEC will also conduct cross-RHIO evaluations, thereby generating more generalizable findings. Regional and national dissemination of these findings will be a top priority.

Evaluating NYS investment in health IT is essential to demonstrate whether or not health care costs or quality have improved, or if initiatives are having other important impacts in healthcare. Health IT can potentially have an impact by reducing the cost of healthcare and by reducing the amount of duplicate and unnecessary procedures. Quality can be improved, for example, by rapidly reducing the recovery time of a patient from a surgery by better coordinating care. These are potential hypotheses that HITEC evaluation will consider.

The intern will support the data collection efforts of HITEC. This could include surveying projects and analyzing and aggregating data. The intern will also advise HITEC on the design of program evaluation efforts to ensure that projects are fairly and accurately measured and represented in the study. Finally, the intern will review and edit drafts of the final evaluation study(ies).

Activity

Portfolio Management - One region/group of HEAL Phase 5 Awardees

Description

Under the HEAL NY Phase 5 RGA community health IT organizations will receive funding in three categories. Applicants can apply under the Statewide Health Information Network for New York (SHIN-NY), Clinical Information Systems (CIS), or Information Tools for Clinicians, Consumers and the Community (3Cs) categories. Applicants in the SHIN-NY category will work together to build a network of networks statewide to interconnect physicians to exchange health information regardless of location or type of care provided. Only RHIOs may apply in the SHIN-NY category. Applicants in the CIS category may be a RHIO or a Community Health Information Technology Adoption Collaborative (CHITA). CHITAs are small collaborations of loosely affiliated healthcare organizations, but that exist for the purpose of ensuring that health IT adoption occurs and results in healthcare improvements by providing support services to healthcare providers. These projects will implement community-based health IT tools that standardize, analyze and deliver data for multiple purposes including improving healthcare quality, efficiency and affordability. The CIS category requires that applicants implement either a quality reporting use case or clinical decision support in an HIE environment use case. Additionally, clinical data must be the primary source of data used to address the use cases. Applicants in the 3Cs category can be either a RHIO or a CHITA. Awardees are required to implement community-wide interoperable electronic health records (EHRs). EHRs are required to be certified nationally by the Certification Commission for Health Information Technology Certification (CCHIT). Applicants will be required to demonstrate the utility of the system that they have implemented by addressing one of three use cases.

Due to the complexity and scope that the HEAL NY Phase 5 RGA requires of applicants, successful RHIOs and CHITAs will need to be monitored and tracked by the state. Supervising projects will ensure their connectedness to the state and federal health IT strategy and allow the Department of Health to provide support to the projects as appropriate. With many phase 5 awards possible, OHITT staff will be assigned successful projects to oversee. Each staff member will be responsible for more than one project.

The intern will function as part of the OHITT team, which includes OHITT staff and the Deputy Commissioner of Health for OHITT, that manages the HEAL NY Phase 5 project portfolio. The intern will be specifically responsible for managing a group or region that contains several awarded projects. Additionally, they will act as a resource and informer for their assigned projects. The intern will advise projects on current health IT policy and best practices on a state and federal level. Informing the OHITT team of projects' status and progress will also be a key responsibility.

Activity

Project Management Activities

Description

The intern will participate in efforts to instill and develop expertise in the area of project management, including monitoring, tracking and implementation of state healthcare and health IT initiatives and program priorities. He/she will be responsible for researching project management methods, making recommendations as to which methods are most effective and working with OHITT staff to identify areas in need of development of project management. He/she will act as a resource for staff in the area of project management.

Section 7: Development Activities

Intra-departmental Activities

The activities described above will constitute the major functional focus for the Public Management Intern. Additionally, the Intern will:

- Receive a full Department of Health Orientation, including: DOH goals and objectives, personnel issues, employee benefit package, overview of the Department and its various functions.

- Be provided extensive orientation to the Office for Health Information Technology Transformation which incorporates a variety of staff members with backgrounds ranging to clinical medicine to information technology to health systems management.

- Gain exposure to project management activities for a broad range of initiatives, above and beyond those for which s/he is directly responsible and involved.

- Attend relevant senior level meetings associated with the initiatives to which s/he has been directly involved.

Inter-departmental Activities

Please see the Rotational Assignment for inter-departmental components of the internship program.

External-Professional Activities

The Office is actively engaged with a number of external organizations with which the Intern is envisioned to actively participate. The New York eHealth Collaborative (NYeC)is a NYS non-for-profit corporation whose mission and organization was developed by a diverse group of health care leaders from across the state, based on a shared vision of the urgency to improve health care quality, safety and efficiency in NY. The Intern will have the opportunity to work with the Deputy Director related to activities of NYeC and to attend Board and Committee meetings.

The Health Information Technology Evaluation Consortium (HITEC) is a multi-institutional academic collaborative existing between institution in NYS, including Cornell University, Columbia University, the University of Rochester, the State University of New York at Buffalo, and the State University of New York at Buffalo. HITEC is comprised of a multi-disciplinary team of experts in the areas of informatics, evaluation methodology, health care quality, patient safety, health care economics and biostatistics. It is envisioned that the Intern will interact with HITEC, having extensive exposure to methodologies and processes associated with the evaluation of the HEAL NY V awardees' projects.

Additionally, the Office has extensive connection to national organizations and functions, such as the Office of the National Coordinator (ONC) and Certification Commission for Health Information Technology (CHITT). Intern exposure to the operation of entities such as these is expected as the Office has ongoing interactions.

The Intern will also have the opportunity to attend conferences and educational activities such as those sponsored by Healthcare Information and Management Systems Society (HIMSS) and the American Health Information Management Association (AHIMA).

Section 8: Rotational Assignments

Agency Code

50000

Location

Albany, New York

Program Area

NYS Office of Mental Health

Is rotation internal or external?

External

Duration

7-9 Weeks Intermittent

Description

The Intern will be completing a rotation at the New York State Office of Mental Health (OMH) in Albany, New York. OMH and DOH have been involved in a four year initiative to improve the quality and efficiency of psychotropic prescribing practices in NYS. The project is based on the adaptation and expansion of a successful OMH program to the Medicaid Population. OMH has developed the Psychiatric Services and Clinical Knowledge Enhancement System (PSYCKES), a web-based tool for presenting quality improvement data at all levels of the service system through a series of linked reports: state, regional, county, agency, program and recipient. The Intern, working under the direction of Thomas White, MD will be supporting the development and implementation of an educational campaign to support best practices, and the analysis of Medicaid data provided by the DOH to population PSYCKES. The Intern will be attending meetings associated with the project implementation and adoption as well as working with senior officials within OMH charged with system development and enhancement. Additionally, the Intern will work to support the transference of data between the DOH and OMH as set forth in the Cooperative Agreement effective September 1, 2007.

Agency Code

12000

Location

Albany, New York

Program Area

Office of Long Term Care

Is rotation internal or external?

Internal

Duration

7-9 Weeks Intermittent

Description

The second rotation will be with the Office of Long Term Care in the Department of Health. The Office of Long Term Care was created to develop and implement policy that will consistently support consumers accessing long term care services in New York State. The goal of this rotation will be to give the intern the experience of working closely with formulating and administering policies that promote a safe, cost-effective, and high quality long term care delivery system, specifically as it relates to health IT. The intern would gain experience in activities such as planning and developing innovative policy and regulatory initiatives to improve the quality and access to long term care services and office programs and initiatives.