Oregon Health Policy Board, Feb. 5, 2019

START IN A FEW MINUTES. THE MINUTES?>>OPPOSED?>>SHOULD WE HOLD OFF THIS
REPORT OR >>I CAN DO THE LIAISON UPDATE
AND >>WHY DON’T WE DO LIAISON AND
DO THE >>SO THE COMMITTEE DIGEST IS IN YOUR
PACKET. REPORTS TO ADD TO THESE OR MAKE
ANY COMMENTS ABOUT THE REPORTS?>>YEAH, I HAVE A FEW COMMENTS
AND I WILL INTERJECT WITH WHATEVER YOU
THINK>>OKAY.>>I WANTED TO MAKE A FEW
COMMENTS BACK FROM FAB. APPROVED POLICY INTO OUR
LANGUAGE FOR C CO2.0. RECOMMENDATIONS ABOUT USING
LOCAL HELP AUTHORITIES TO LEVERAGE INVESTMENTS. WE HAD DISCUSSIONS ABOUT
LEVERAGING COMMUNITY-BASED ORGANIZATIONS WHICH IS IMPORTANT
WORK. DIFFERENT IN THAT REALLY THE
ONLY AGENCY THAT’S CHARGED WITH TRUE POPULATION HEALTH, MEANING HEALTH OF THE
ENTIRE POPULATION. GLOBAL HEALTH AUTHORITIES TODAY. STOPS WITH THE POPULATION HEALTH
AT LOCAL HEALTH AUTHORITY. DELIBERATIONS THAT WE APPROVED
SEVERAL POLICIES THAT REFLECTED THIS
INTENT. CCO TO SPEND A PORTION ON
SAVINGS. CALL OUT LOCAL HEALTH
AUTHORITIES, THERE IS NO OTHER MECHANISM FOR POPULATION HEALTH
OTHER THAN WORKING WITH LOCAL HEALTH AUTHORITIES. SHARE FINANCIAL RESOURCES WITH
NONCLINICAL AND PUBLIC HEALTH PROVIDERS. REQUIRE SOME TYPE OF FORMAL
RELATIONSHIP BETWEEN A CCO AND LOCAL HEALTH AUTHORITY. REQUIRED CCO TO PARTNER WITH
PUBLIC HEALTH AUTHORITIES, NON-PROFIT HOSPITALS TO DEVELOP SHARED COMMUNITY
HEALTH ASSESSMENTS AND COMMUNITY GROUP. DISCUSSED THIS, CAME UP IN THE
FAB COMMITTEE SOME OF THESE POLICIES
WEREN’T REFLECTED TO OUR BEST UNDERSTANDING IN THE LANGUAGE OF
THE RFA. SENT TO OHA IN THE PUBLIC
COMMENT FROM FAB MEMBERS. WAS MEANT FOR SUPPLEMENTS BUT
HASN’T YET BEEN POSTED. A TRANSLATION INTO C CO2.0 IS
REALLY IMPORTANT. SYSTEM IN THE WORLD WITH THE
WORST OUTCOMES. WE HAVE A GREAT SYSTEM
TECHNOLOGICALLY. SYSTEM, MOST EXPENSIVE HEALTH
SYSTEM WITH THE WORST OUTCOMES IS WE DON’T SPEND ON SOCIAL DETERMINENCE OF
HEALTH LIKE OTHER COUNTRIES. HAVE THESE POLICIES. LOOKED AT THE LANGUAGE AND
DIDN’T SEE THIS ARTICULATED. THE RFA IS RESTRICTED IN PUBLIC
COMMENT. TERMS IS THERE A REMEDY AND
RECONCILE >>LET ME DIVE IN THERE A LITTLE
BIT. UP MORE OFF LINE. INCLUDING COMMENTS FROM COUNTIES
AND LOCAL PUBLIC HEALTH. WE DIDN’T ACCEPT ALL THE CHANGES
THAT WERE SUGGESTED BUT A LITTLE ONLINE OF WHERE WE MADE CHANGES AND
RELEASED THE FINAL TWO FRIDAYS AGO. INCLUDED IN THE ORIGINAL DRAFT
INCLUDING COMMUNITY EVENING GAUGEMENT PLAN EXPECTATIONS OF
HOW CCOs WOULD WORK WITH COMMUNITY PARTNERS. BUT IS IN SOME OF THE FINAL
DETAILS. RECEIVED FROM COUNTIES AROUND
REQUIRING CCOs TO HAVE CONTRACTS WITH LOCAL PUBLIC HEALTH
REQUIRING COUNTIES TO HAVE LETTERS OF SUPPORT. THE CURRENT RFA AROUND REQUIRING
MEMORANDUM OF UNDERSTANDING TO ESTABLISH THE SAME GOALS OF REQUIRING CCOs
AND PUBLIC HEALTH TO WORK TOGETHER ON A NUMBER OF THINGS
THAT YOU OUTLINED. OTHER CHANGES INCLUDING A COUPLE
RELATED WE’LL HAVE TO TAKE A LOOK AT THAT. MORE DOCUMENTS THAT SOME OF THIS
WAS IN THAT WASN’T IN THE ORIGINAL DRAFT. SPECIFIC QUESTIONS. SAME INFORMATION. THE BOARD TO BE IN. WANT TO BE RESPONSIVE BUT WE
WANT TO MAKE SURE EVERYBODY’S GIVEN THE SAME INFORMATION. WE WILL TAKE THOSE AND FUNNEL
THEM THROUGH OUR INTERNAL PROCESS AND RESPOND >>IS THERE A MECHANISM TO CLOSE
THIS >>WELL, I THINK IF THERE REALLY
IS A GAP, SOUNDS LIKE SOME OF THE COMMENTS WERE WITHOUT ALL OF
THE FINAL DOCUMENTS FOLKS NEED TO GO BACK AND TAKE A
LOOK AT THE FINAL DOCUMENTS. AND TAKE A LOOK AT THAT. WHERE WE DID NOT LAND IN A SPOT
WHERE THERE’S AGREEMENT BETWEEN EXACTLY WHAT PUBLIC HEALTH WAS
ASKING FOR AND WHERE WE THOUGHT THE BOARD WAS AT AND
THE RFA IF THE IDEAS REQUIRE CONTRACTS,
WE’VE CONSIDERED THAT AND DECIDED NOT TO PURSUE THAT
STATISTIC. WAS IN THE RECOMMENDATIONS, THEN
WE I THINK THAT IS A GAP. SUPPORT IN TERMS OF HOW WE
IMPLEMENT THE POLICIES WE DISCUSSED. CLOSE THAT GAP EITHER AT SOME
POINT IN THE PROCESS. REQUIREMENT WHICH CAPTURES A LOT
OF THE EXPECTATIONS IN TERMS OF HOW THE
CCO OPERATES. TOGETHER AND PIECES OF THAT IN
THE COMMUNITY ENGAGEMENT PLAN.>>JUST LISTENING AND SEEING
WHERE WE’RE AT IN TERMS OF THE CCOs, I THINK
THERE IS THIS TENSION BETWEEN COUNTIES. HEALTH, IT’S MOSTLY COUNTY
HEALTH>>YES, YEAH. INFRASTRUCTURE BY COUNTY. 0 WE ENDED UP WITH ALMOST A ONE
TO ONE CORRELATION BETWEEN THE TWO. TO DEAL WITH ONE COUNTY. CLOSEST TO THE HEALTH OF THE
POPULATION. TO THE RELATIONSHIP BETWEEN THE
CCOs AND THE COUNTIES. HAPPY TO DO SO.>>SHARED FINANCIAL RESOURCES
WITH >>IT’S DIFFERENT THAN MANDATE. THE LOCAL COMMUNITIES THE
FLEXIBILITY AND NOT BEING REQUIRED BY THE STATE OR
HAMSTRUNG IN A PARTICULAR WAY THEY ARE ACTUALLY GOING TO DO
THAT WORK. BEING A FAN OF PUBLIC HEALTH. HAVE TECHNICAL ASSISTANCE WHERE
THERE ARE COMMUNITIES AND BEST
PRACTICES WHEN CCOs AND HEALTH AUTHORITIES ARE REALLY
COLLABORATING WELL TOGETHER AND BEST PRACTICES IN THAT CONJOINED
SPACE THAT OTHER COMMUNITIES COULD LEARN
FROM OR WHERE THERE MAY BE TENSIONS THAT ARE UNDER PINNING
PART OF WHAT WE’RE DISCUSSING RIGHT NOW THAT COULD
BE RESOLVED.>>ABSOLUTELY. CENTER AND ABSOLUTELY CAN PLAY
THAT ROLE. THE COURAGE VERSUS REQUIRING A
CONTRACT AND WHAT THOSE TWO DIFFERENT
THINGS MEAN. RECOGNIZING THE COUNTY LANDSCAPE
IS CHANGING. RELINQUISHED PUBLIC HEALTH
AUTHORITY. WHAT THE COUNTY’S ROLE IS.>>ALL RIGHT, CARLA, THANK YOU
FOR THAT>>ALL RIGHT.>>YES, ROSINDA IS.>>YEAH. AVAILABLE IN ADDITION TO THE
PACKET. PART OF MY PERCEIVED
RESPONSIBILITY TO WE’RE TALKING MORE ABOUT THE
ROLE OF LIAISONS. WAS A COMMUNICATION FROM THE
HBQMC. WAS SUGGESTED THERE BE MORE
OVERT SUGGESTIONS ON MY PART AND COMMUNICATION COME FROM ME AS
THE LIAISON. IS POINT OUT GAPS OR ISSUES THAT
THEY’VE NOTICED IN THEIR WORK. SO THEY NOTICED THINGS GOING ON
IN OTHER REALMS OF MEASUREMENT IN
ADDITION TO HEALTH PLAN. I THINK THAT’S A REASONABLE
REQUEST AND ASK THAT OAH FIGURE OUT WHETHER THAT NEEDS TO BE IN A BILL OR THOSE
SORTS OF THINGS. OUT GAPS. SEE AND I WOULD AGREE A PLACE
WHERE HOSPITAL QUALITY IS OVERALL
MEASURED. THERE’S A VERY ROBUST GROUP OF
MATERNAL AND CHILDREN WHO CAME TO THE
MEETING SAYING LOOKS LIKE YOU ARE DOING GREAT STUFF. MOST PART, PASS ON THAT. THERE THAT DESERVES SOME
ATTENTION. LEVEL OF MEASUREMENT. THEIR PURVIEW TO WEIGH IN ON
WHICH OF THOSE SHOULD GO DOWN TO A CLINIC, OUR GOOD CLINIC LEVEL MEASURES. COMMITTEE IS WORKING ON THE SAME
ISSUE. REMEMBER THAT THERE’S A QUESTION
ABOUT WHO SHOULD BE WEIGHING IN AROUND MEASUREMENT WHEN IT COMES TO
PRIMARY CARE CLINIC. GAP IS AROUND EMPLOYERS WHO
MAYBE SELF INSURED IN THE COMMERCIAL MARKET. PIECE IS GOING UNREPORTED. ARE GOING TO EVENTUALLY BE
DISCUSSED. THERE’S A LOT OF PERFORMANCE
STUFF HEADED OAH’S WAY. OAH RESOURCES IN DEVELOPING NEW
MEASURES AND REALLY GREAT STUFF. AND HOW IS THIS ALL GOING TO
COME TOGETHER IF IT SHOULD? DON’T MEASURE. THE PLACE. THIS ALL TOGETHER? WE’LL TALK ABOUT IT MORE WHEN
JEFF TALKS ABOUT THE STRUCTURE DIAGRAM
THAT’S IN THE PACKET. REPRESENTATIVE, I DON’T THINK
THERE’S ANYTHING THAT WE NEED TO DO TODAY. PART OF THE COMMITTEE TO GIVE
YOU THEIR SENSE OF WHAT’S HAPPENING.>>SO YOU SAID IN ITEMS 2, 3 AND
5 THAT YOU ARE RECOGNIZING AND THE COMMITTEE IS RECOGNIZING A
GAP IN TERMS OF HOW HOSPITALS ARE BEING MEASURED IN THE >>CAN YOU SPEAK MORE ABOUT THE
REMEDY >>NOT MUCH. AGO. EFFORTS GOING ON AROUND
HOSPITALS. BROUGHT ALL THIS TOGETHER THAT’S
DISAPPEARED. AS OF A COUPLE YEARS AGO. THAT’S WHY I THINK IT’S
IMPORTANT TO FIGURE OUT FROM FOLKS INVOLVED WHAT’S GOING ON HERE AND WHAT SHOULD WE
DO. STAKEHOLDER GROUP, FOLKS WHO
WORKED FOR MANY OF THE HOSPITALS. THE MOST AT RISK CHILDREN OCCUR
IN A>>I WAS THINKING ABOUT OUR RETREAT DISCUSSION AND THE TOTAL
COST OF CARE CONVERSATION WE WERE TEED UP TO
CONSIDER AND ONE OF THOSE AREAS AROUND ON-GOING BOARD EDUCATION
FOR US TO UNDERSTAND THE SYSTEMS THEMSELVES AND THE UNDER PINNING
DATA THAT’S AVAILABLE TO US TO FOCUS OUR>>ABSOLUTELY. I’LL WORK WITH THE STAFF AND SEE
IF THIS IS SOMETHING WE MIGHT WANT TO THINK ABOUT PUTTING ON THE AGENDA NEXT
TIME ALSO.>>LET ME GIVE CREDIT WHERE
CREDIT IS DUE. COMMITTEE WHO IS WITH US TODAY
AND WHO IS REPRESENTATIVE AND WHO I AM
IMPRESSED.>>WE WILL NOT SHOOT YOU . REPORT IS IN THE DIGEST. AT THIS TIME. REGARDING THE COMMITTEE?>>GREAT. AND MADE A NUMBER OF CHANGES TO
THE FINAL RFA THAT WENT OUT
INCLUDING THINGS THAT WERE JUST ERRORS OR VERSION CONTROL
ISSUES. TO DO A DRAFT AND THEN A FINAL. LETTERS OF INTENT WERE DUE ON
FRIDAY. AND WE RECEIVED 24 LETTERS OF
INTENT COVERING THE ENTIRE PART OF THE STATE. HAVE TO DESCRIBE WHAT SERVICE
AREA IS AND THEN THE NEXT DEADLINE IS APRIL 22ND WHEN
APPLICATIONS ARE DUE. ORGANIZATION BUT IF THEY DO FILE
AN APPLICATION, IT HAS TO FOLLOW THE LETTER OF INTENT. NEXT COUPLE WEEKS WHERE
ADJUSTMENTS CAN BE MADE TO THE LETTER OF INTENT. WANT TO COME IN AND MAKE SOME
TWEAKS. STATE IS COVERED WITH THE
LETTERS OF INTENT. WHERE THERE’S FOLKS WHO WOULDN’T
BE COVERED BY CCO. ALL BUT ONE, THE CURRENT CCOs
REAPPLIED AS WELL AS A COUPLE ORGANIZATIONS THAT ARE LOOKING TO EXPAND OR CHANGE SO REALLY PLEASED DESPITE WHAT’S
BEEN GOING ON WITH CCO FINANCES AND WHAT THE BOARD’S BEEN
TRACKING SHOWS THE SYSTEM IS REALLY ROBUST THAT THIS WAS A
MARKET FOLKS WANT TO JOIN AND THE WORK WE’VE BEEN DOING AND
THE DIRECTION YOU ALL SET AS A BOARD IS ONE THAT FOLKS WANT TO
BE PART OF. YOU KIND OF WONDER IF YOU BUILD
IT, WILL THEY COME? DID OVER THE LAST YEAR IS
POINTING US IN THE RIGHT DIRECTION. ON APRIL 22ND. LAURIE HAS STARTED LAST WEEK. DAVE JOINED US AS THE NEW CHIEF FINANCIAL OFFICER AND HP DEPUTY
DIRECTOR. ARE HAVING A WHOLE BUNCH OF NEW
HANDS ON DECK WITH FOLKS THAT ARE REALLY
SMART.>>RECRUITMENT IS STILL UNDERWAY
FOR BEHAVIORAL HEALTH DIRECTOR. SERVING AS INTERIM DIRECTOR. DIRECTOR HAS NOW RETIRED OR
RETIRING THIS WEEK. THERE WHILE WE FINISH THAT
RECRUITMENT.>>WE HAVE HAD — POOL IS
PROBABLY TOO STRONG OF A WORD. FOLKS AND GOTTEN CLOSE TO A
COUPLE TIMES BUT FOR WHATEVER REASONS, HASN’T
WORKED OUT.>>I READ IN THE MEDIA THAT
THERE IS A SIGNIFICANT VARIOUS IN THE FORM
OF CCOs NOW I’M JUST WONDERING IF AT SOME
POINT THERE WILL BE SOME DISCUSSION
HERE OF WHAT’S GOING ON. OCCURRING AS A RESULT OF IT. IS TRANSITION YEAR. HAPPENS IN 2019. ISN’T CONTINGENT AND ISN’T
SUCCESSFUL? ANYTHING TODAY BUT I THINK
THAT’S SOMETHING THAT>>IN PARTICULAR, SIMILAR TRENDS
ACROSS CCOs, OTHER COMMERCIAL MARKET IF THERE’S TRENDS WITHIN CCO OR
COMMONALITIES ACROSS THE MARKETS. BEEN A CHALLENGE. BEEN MORE AGGRESSIVE
ARRANGEMENT. BEEN ABLE TO COME IN UNDER THE
3.4% OR NEGATIVE TREND. WITHOUT GOING INTO ALL THE CCO
2. 0 POLICIES, ONE OF THE THINGS
WE’RE ADVANCING AND PART OF
LEGISLATION IN THE SESSION IS TO INCREASE THE LINE
OF SIGHT ON THE FINANCES AS AN AGENCY SO WE CAN DO A BETTER APPLES TO APPLES
COMPARISON.>>AND I DON’T KNOW THE IMPACT.>>WHILE THAT’S GOING TO
INCREASE COST >>IT’S GOING TO COME BACK TO
THE >>WHAT DOES THAT MEAN FOR CCO?>>I’M CURIOUS ABOUT WHAT YOU’LL
BE UPDATING THIS BOARD, LIKE, THE QUALITY SO I RECOGNIZE HAVING SAID THAT
OR ASKING THE QUESTION, THERE’S A LOT YOU CAN’T DISCLOSE.>>WE’RE ANTICIPATING WE’LL GIVE
YOU REGULAR UPDATES LIKE TODAY. WE CAN’T BE SHARING CONFIDENTIAL
INFORMATION. DIFFERENT. BETWEEN NOW AND APRIL 22ND WHEN
THE APPLICATIONS COME IN. IN, I ANTICIPATE WE’D GIVE YOU
AN UPDATE THERE WILL BE A NUMBER OF STEPS
FOLLOWING THAT INCLUDING READINESS REVIEW PROCESS. UPDATES COME IN WHAT MONTH BUT >>WHEN YOU HAVE MULTIPLE
APPLICATIONS FOR SINGLE AREA, WHAT’S THE
EVALUATION PROCESS LOOK LIKE?>>YEAH, SO I REALLY CAN’T GET
IN THE CONVERSATION ABOUT WHAT THE EVALUATION PROCESS IS GOING
TO LOOK LIKE. APPLICATION CONSISTENTLY.>>OKAY.>>I’VE HEARD THE LAST COUPLE
DAYS AND THIS MORNING ABOUT THE TOPIC OF
DISRUPTIVE CHILDREN SCHOOL. CONVERSATIONS WE’VE HAD ABOUT
MENTAL HEALTH AND CHILDREN. SUCH AN OPPORTUNITY FOR SCHOOLS
AND CCOs TO BE LINED UP. SAID A SMALL GROUP OF CHILDREN
HAD MENTAL HEALTH BEHAVIORAL PROBLEMS. COULD HELP THEM. KNOW FROM — THERE’S SILOS
BETWEEN THE SCHOOLS AND HEALTH. DISCUSSION EVENTUALLY AND WHAT
CAN BE DONE TO HELP THE SCHOOLS?>>ARE WE READY TO MOVE ON TO
REPORTS?>>THEY ARE.FOR THE BOARD. IN TERMS OF WHAT WE’RE SHARING
WITH WHOM >>I’M COMFORTABLE WITH THE
DISCOMFORT OR THE NOT KNOWING AMBIGUITY.>>BETTER MAKE GOOD DECISIONS.>>I KNOW YOU WILL.>>GOOD MORNING.>>OKAY. AS WELL. THE WORK RELATED TO HEALTH
EQUITY METRICS. [INAUDIBLE] REPRESENTING A
VARIETY OF COMMITTEES AND WORK TEAMS WITHIN
THE OREGON HEALTH POLICY BOARD
STRUCTURE. OCTOBER AND HAVE A PRETTY MAJOR
TASK FOR US. I WANT TO COMMEND THE COMMITTEE
AND THE WORK THAT HAS BEEN DONE AND THE
RESEARCH THAT HAS HELPED TO MOVE OUR
THINKING FORWARD ON THIS. BEYOND THAT. WHAT WE CAN ACCOMPLISH IN THE
LONGER TERM. THAT WE HAVE — ARE WORKING ON A
PROCESS MEASURE. TENSION THERE AROUND TAKING THAT
APPROACH. PERIOD WE HAVE DECIDED TO FOCUS
THERE AS OPPOSED TO A SPECIFIC [INAUDIBLE]. CONVERSATIONS AROUND THE
FACILITY DATA. AND JON CAN SPEAK TO A GREATER
DEGREE ON ANALYSIS THAT WAS DONE AROUND OUTCOME MEASURES TO SEE HOW IT’S HELD UP
ACROSS ALL CCOs GIVEN THE SERVICE AREA
AND DEMOGRAPHICS OF THOSE SERVICE AREAS. MEASURES WOULD BE ARTICULATED. AT THIS POINT IN TIME, DOES NOT
RELY ON THE DISABILITY DATA. WORK WE’RE DOING TO RECTIFY THE
SITUATION OF THE FACT THAT WE DON’T HAVE ALL THE DATA THAT WE NEED AROUND
RACE AND ETHNICITY AND DISABILITY IN
THE SYSTEM. PROPOSING RECOMMENDATIONS TO FIX
THAT. THE FACT THAT WE HAVE
RESEARCHERS AND VERY GOOD PEOPLE WORKING ON THAT
ISSUE AND LOOKING TOWARDS MORE UPDATED
AND ACCURATE AND THOROUGH
INFORMATION AS WE MOVE INTO A LONGER-TERM CONVERSATION ABOUT
WHAT THESE MEASURES CAN BE. FOUR-MONTH PERIOD WE’RE NOT
GOING TO BE ABLE TO VET A MEASURE FOR THE
PEOPLE MOST IMPACTED BY HEALTH
DISPARITIES. INTO CREATING UNINTENDED
CONSEQUENCES. — SO WE HEARD ABOUT THAT. INTERPRETERS AND GREATER
UTILIZATION OF HEALTHCARE WORKERS? WITH INITIATIVES THAT WERE
ALREADY BEING PUSHED BY THE COMMUNITY SINCE WE’RE NOT ABLE TO DO THE APPROPRIATE
VETTING OF THAT. CONSEQUENCES, I JUST WANT TO PUT
AN EXAMPLE OUT THEREOF WHAT THIS COULD MEAN IF WE JUMP TO OUTCOME
MEASURE.THIS MEASURE. SMOKING SENSATION AS AN OUTCOME
MEASURE. THAT MEASURE, THIS IS RESEARCH
THEY ARE DOING IN CONJUNCTION WITH PROGRAM, DESIGN AND
EVALUATION SERVICES. ARE DOING AN EQUITY ANALYSIS
WHEN IT COMES TO OUTCOME MEASURES. THE DESIGN AND EVALUATION
SERVICES TO GET A BETTER UNDERSTANDING OF
RACISM HOW SO IF WE GO TO SMOKING
SENSATION, JUST AS AN EXAMPLE OF OUTCOME MEASURE AND DON’T TAKE
INTO ACCOUNT SOME OTHER INFORMATION, WHEN WE LOOK AT,
FOR EXAMPLE, THE AFRICAN AMERICAN COMMUNITY AND SMOKING SENSATION, THAT WE
SEE THAT WHEN YOU HAVE FOUR OF THE ACES, SMOKING
PREVALENCE GOES UP IN THAT COMMUNITY. SO SMOKING IN THAT COMMUNITY
DOUBLES BASED UPON THOSE FACTORS. WE’RE NOT ADDRESSING ACES AND
ACTS OF RACISM. IF WE’RE TALKING ABOUT TRULY
WANTING TO DISMANTLE THE FOUNDATION OF A SYSTEM OF
SYSTEMIC OPPRESSION AND RACISM, WE’VE GOT TO LOOK AT THE INITIATIVES
AND THE SO IF WE TAKE THAT CONCEPT AND
APPLY IT HERE WHEN WE’RE LOOKING AT PROCESS MEASURES, WHAT WE’RE LOOKING AT
IS CULTURALLY RESPONSIVE CARE IN FOUR COMMUNITIES THAT ARE MOST
IMPACTED BY HEALTH DISPARITIES. REASONS ARE IN THE SHORT-TERM SHORT-TERM-[ AUDIO DISCONNECTED
] >>I DID TOO.>>OKAY. OFF ON THE SIDE.>>RIGHT.>>THIS IS JENNIFER.>>OKAY. FIGURE OUT WHAT’S GOING ON WITH
THE PHONE IN THE ROOM. HEAR US ANY MORE. WHAT’S GOING ON.>>THANK YOU.>>WE’LL JUST WAIT A SECOND FOR
DR. McKELVEY TO REJOIN US.>>YES, DOC.>>THAT WAS WEIRD CAUSE I COULD
HEAR YOU THAT WAS STRANGE.>>SO YOU HEARD US.>>ALL RIGHT. PRESENTATION UNTIL WE GOT TO THE>>RIGHT. PRIORITIZED FIVE OF THE
RECOMMENDATIONS, THERE ARE 14 OR 15. THE WORK PLAN WILL BE AN IDEAL
TOPIC FOR THAT MEETING. ACCOUNTABILITY WITH THIS BOARD
WOULD BE VERY HELPFUL AS WELL. TO YOU TO BRING BACK A WORK PLAN
WHETHER THAT — I DON’T KNOW IF THAT WILL BE MARCH OR APRIL BUT
I THINK THAT WOULD BE A REALLY GOOD ROUTE FOR US TO
TAKE AND>>THERE’S STRATEGIES IN THERE
AND SOMEWHAT WORK FLOW AND GETTING WORK FLOW BETTER FOR FOLKS ENTERING THE
DATA THAT ARE LONGER TERM. THROUGH WITH PAT AND FIGURE OUT
HOW DO WE PRIORITIZE WHICH THINGS
BEFORE.FIRST TIME. METRICS AT THE TIME WE’RE TRYING
TO >>WORK PLAN ON RELIABILITY WITH
THE >>MAYBE THAT’S — WHEN I HEARD
THE QUESTION AND MY RESPONSE WAS
AROUND RACE, ETHNICITY, DISABILITY
DATA. UNDERSTOOD THE QUESTION. IS THE STARTING POINT. OUT WITH TIMING AND RESOURCES.>>THAT’S THE DATA COLLECTION
PIECE WHAT THE WORKER IS WORKING ON IS THE
MEASURES. HAVE TO DO AS AN>>THIS IS CARLA. COMMITTEE WAS TO ALSO MAKE SURE
WE ADDRESS THE DISPARITIES RELATED
TO GEOGRAPHY. AND SO I KNOW WE CAN PULL DATA BY
ZIP CODE. DATA AND LOOK AT THE STATE AND
SEE WE’RE THE PUSH BACK I WOULD PUT ON THE
EXAMPLE OF THE SMOKING IS I THINK YOU ARE GOING TO FIND DISPARITIES IN SMOKING
GEOGRAPHICALLY. DIFFERENT IN EACH ZIP CODE OR
VARIETY OF ZIP CODES. IN WORKING WITH THE METRICS PUT
FORTH PREVIOUSLY IS I FEEL LIKE THE
CCOs HAVE TO IDENTIFY WHY THOSE METRICS
ARE NOT BEING MET AND TO HELP LOCAL
AREAS TO FACILITATE WHAT NEEDS TO BE DONE IN ORDER TO HELP WITH
THOSE. SO THE QUESTION ABOUT UNDERLYING
ISSUES IS SOMETHING THAT NEEDS TO BE ADDRESSED
WITHIN THOSE PURVIEWS ADDRESSING THE ZIP CODE AREAS.>>THANK YOU. THAT REGARDING THE
EXAMPLEEXAMPLE, OUR PRIMARY CONCERN WAS UNINTENDED
CONSEQUENCES AROUND RACE AND ETHNICITY. IT WAS NOT INTENDED TO BE AN
ACROSS THE BOARD EXAMPLE. WANT TO HAVE UNINTENDED
CONSEQUENCES ON POPULATIONS OF PEOPLE THAT ARE MOST IMPACTED BY SOCIAL INEQUITIES
AND HEALTH DISPARITIES. AND THEN ALSO WHEN WE TALK ABOUT
ZIP CODE, WE STILL HAVE WITHIN ANY
ZIP CODE, WITH ANY URBAN OR RURAL, WITHIN
ANY SOCIAL ECONOMIC CLASS, YOU STILL
FIND WITHIN THAT ADDITIONAL
DISPARITIES AS IT SO SOME OF THOSE, FOR EXAMPLE,
EDUCATION OR ECONOMICS, WEALTH DO NOT
NECESSARILY SERVE AS PROTECTIVE FACTORS. WILL STILL SEE DISPARITIES
AROUND RACE >>CAN I CHIME IN REAL QUICK?>>I JUST WANT TO EMPHASIZE AND
I KNOW I MISSED PART OF WHAT LEANN HAD SAID EARLIER. SAYING, WE CAN DEFINITELY DRILL
DOWN INTO VARIOUS METRICS BY ZIP CODE
AND VARIOUS OTHER GEOGRAPHIC BREAKOUTS. ISSUE UNTIL THE DATA, THE SOURCE
DATA FROM MMIS IS FIXED IS THAT
MISSING INFORMATION. HALF OF ANY KIND OF INFORMATION
AROUND RACE, ETHNICITY FOR FOLKS, WE
WILL HAVE A HARD TIME COMING UP WITH ANY
KIND OF VALID MEASURE ASSOCIATED WITH IT AND WOULD BE HARD PRESSED TO REALLY
HAVE THE CCOs WORK ON INFORMATION THAT IS REALLY ONLY
HALF THERE. FRONT OF YOU OF CURRENCY AND
ONLY HALF OF THEM ARE LABELED AND SOMEBODY
ASKING YOU HOW MUCH MONEY YOU HAVE. BILLS BUT THE REST OF THEM YOU
DON’T KNOW. THIS QUALITATIVE IS A STRATEGIC
APPROACH. IT REALLY IS FOCUSED ON MAKING
SURE SOME OF THE INFRASTRUCTURE THAT WAS NECESSARY TO ADDRESS
ANY EQUITY OR DISPARITY CONCERNS IS THERE. THAT UP SHORTLY WITH SOME DATA.>>TWO QUESTIONS. DISCUSSION WAS THAT I THINK SOME
CCOs >>THEY MIGHT HAVE SOME DATA
FROM THEIR CLINICS. THE SECOND ISSUE. THERE THAT WOULD BE USEFUL FROM
A PILOT POINT OF VIEW TO START TO TEST
SOME OF THESE OTHER THINGS? THE OTHER THING I THINK I’VE
EXPRESSED CONCERN. IMPLEMENTING TRANSFORMATIVE
STUFF. 0 OR ACOSTA. ACTIVITIES ARE GOING TO BE
WORRIED ABOUT EQUITY. BASELINE FROM A FEE FOR SERVICE
DOMINATED SYSTEM. YOU DON’T HAVE TWO POINTS. AND THAT’S CONTRIBUTED TO THE
PROBLEMS WE HAVE. WAY TO SAVE A SAMPLE OR HAVE
SOME WAY TO LOOK BACK AT 2019, 2018-19, ET
CETERA, >>JON HAD STARTED. WERE MAKING, JON. HALF OF THE WORK PLAN, IT WILL
BE TOTALLY NECESSARY TO WORK WITH SOME OF THE PLACES THAT
MIGHT HAVE SOME DATA AVAILABLE TO TEST OUT MEASURES. WE’RE TALKING ABOUT GETTING
INFORMATION FROM THE PROVIDERS THAT CURRENTLY THERE’S NO WAY TO
GET FROM THE PROVIDERS. THERE’S NO WAY TO INCLUDE ANY
RACE AND ETHNICITY INFORMATION ALONG WITH THOSE CLAIMS. AS WE’RE TRYING TO COME UP WITH
A MORE QUANTITATIVE MEASURE. AND I’M NOT GOING TO MAKE
PROMISES IT WILL BE ON THE REPORT THAT WE
ISSUE. WORKING ON RELATED TO KIDS WHERE
WE HAD TO COLLAPSE DATA FROM A NUMBER OF DIFFERENT SOURCES
ACROSS OHA AND DHS. DATA FROM SOME OF THE OTHER
SOURCES AND FILL IN A LOT OF THE GAPS THAT WE CURRENTLY HAVE. THE CCO MEASURES. US TO HAVE MORE COMPLETE
INFORMATION TO ATTACH IF WE’RE ABLE TO COMPLETE
THIS PROJECT IN TIME. TO ADDRESS HOW DO WE GET THAT
INFORMATION ON A PERSON LEVEL BACK DOWN TO THE CCOs. SUCH WE’D HAVE TO WORK THROUGH. GUYS TALKED ABOUT EARLIER. REAL WELL AND PUTTING TOGETHER
ACTIVE QUALITY IMPROVEMENT STRATEGIES. WHEN WE ROLL THESE METRICS OUT
AND THERE’S PIECES MISSING LIKE THAT, THAT THE CCOs HAVE HELPED FILL IN
THOSE GAPS. ARE COLLECTING THE DATA THAT
THIS MAY BE THE WAY TO HELP RESOLVE THE
ISSUE THEY ARE LOOKING AT HERE.>>I JUST WANT TO VOICE MY TOTAL
I RECOGNIZE THE CONVERSATIONS AROUND THE COMPLEXITY AND THE
GALLERY AND THE INFORMATION. BEEN HAVING THIS CONVERSATION
FOR SO LONG AND IF OUR SYSTEMS CANNOT
ADAPT TO EVEN ASKING THE QUESTIONS AT THE DELIVERY SYSTEM
LEVEL, USING THAT INFORMATION AND WE WILL NEVER MAKE THE KIND
OF PROGRESS WE’RE HOPING FOR. HAVING A PROCESS MEASURE. A WORK PLAN AND WE’RE ELEVATING
THE IMPORTANCE OF THE WORK PLAN. ME WHICH IS WHY ARE WE HERE NOW? FEEL LIKE WE’RE THIS FAR BEHIND
THE 8 BALL HAVING THIS CONVERSATION IN
2019, 2020, 2021. THIS BOARD HOLDING
ACCOUNTABILITY AND RESPONSIBILITY FOREIGN INSURING
THAT PROGRESS IS BEING MADE AND NOT GETTING SO CAUGHT IN THE
COMPLEXITIES OF EVERYTHING WE’RE TRYING TO CREATE. VOICE MY DISAPPOINTMENT TO THE
PROGRESS AND ENCOURAGE US TO KEEP IT SO WE DON’T CLUNKER FOR MANY OF US IN THIS
WORK. WE HAVE BROUGHT SOME THINGS TO
THE FOREFRONT. AND WE NEED TO KEEP MOVING
FORWARD.>>ALSO I APPRECIATE YOUR COMMENTS
ON UNINTENDED CONSEQUENCES. WE KNOW THERE ARE CONSEQUENCES
THAT ARE HAPPENING WITH RESPECT TO
DISPARITIES AS WE SPEAK. ALSO THINK THAT NOT ALL OF THEM
ARE HYPOTHETICAL.>>THEY ARE PROBABLY OUT THERE.>>RIGHT. ARE NOT HYPOTHETICAL. THAT USED TO BE CALLED
UNINTENDED PREGNANCY. THAT THAT’S HAPPENING IN THE
CLINICAL STUDY ATTEMPTING TO REACH THAT
METRIC. STUDY TO DIVERSE CULTURES OF
WOMEN DOES >>THANK YOU. THE DATA IS THERE. THE QUESTION I KEEP FEELING IS
YES I’D LOVE TO SEE THE WORK. SO WE’RE NOT REVISITING THIS
CONVERSATION AGAIN. HOLDS ACCOUNTABLE IN 2021 THAT
WE GET TO WE CAN’T GET TO OUTCOMES AND
PROCESS >>ABSOLUTELY. THAT IS ABSOLUTELY OUR GOAL. RESEARCH IS TELLING US
PARTICULARLY BY DR. KAMARI JONES AROUND THE SOCIAL DETERMINENCE OF EQUITY — OF OPPRESSION AND RACISM THAT
THE SYSTEM WAS BUILT UPON THAT WE
COULD END UP NOT GETTING TO WHERE WE NEED TO GET EVEN WITH OUTCOME MEASURES. I THINK OUR COMMITTEE IS REALLY
WILLING TO DO IS HOW DO THOSE THINGS
INTERACT? PUT US IN THAT SITUATION. HAS MORE TIME TO LOOK AT ALL OR
AS MANY AS THE IMPACT THE ELEMENTS AS
POSSIBLE, WE DON’T JUST MISS THE OUTCOME PIECE, ABSOLUTELY, WE DO
NOT.>>I’M LOOKING AT THE TIME. AND THE TECHNICAL DIFFICULTIES.>>I THINK THIS IS A GOOD
CONVERSATION FOR US TO HEAR. I DON’T THINK WE GOT TO THE
POINT OF WHAT EXACTLY DOES THAT MEAN AND WHAT THE WORK PLAN FOR
THE BOARD LOOK LIKE. AS WHAT ARE SOME THINGS THE
BOARD CAN BE DOING IN CONVERSATIONS AND NOT JUST GET US TO A MEASURE FOR 2020 BUT
ALSO BE THINKING ABOUT HOW DO WE LAY THE
GROUNDWORK FOR WHERE DO WE NEED TO BE IN AND MAYBE THAT’S LONGER THAN A
ONE-YEAR PLAN.>>I’M SORRY, I WAS ON MUTE. SUPPOSED TO BE INFORMATIONAL. WORK OF THE GROUP AND WE LOOK
FORWARD TO CONTINUING TO GET PROGRESS REPORTS.>>I AM. THE VIDEO RUNS A LITTLE BIT
BEHIND THE AUDIO.>>OKAY. EARLIER, I HAVE CHANGED ROLES AT
LEAST ON INTERIM BASIS. LITTLE BIT YESTERDAY. GOING THROUGH THIS HIGH LEVEL
ROAD MAP>>YEAH. MONTH DURING YOUR RETREAT AND
BEGAN TALKING WITH YOU ABOUT THE COST
GROWTH BENCH MARK. TOGETHER A ROAD MAP. GUYS TO FILL IN WHERE YOU MAY
NEED MORE DETAIL OR WANT TO PULL BACK OR DIVE IN DEEPER. MEETINGS FROM TODAY. YEAR BECAUSE AT THAT POINT WE
HOPE TO ACTUALLY KNOW WHAT’S GOING TO BE PUT FORTH IN
LEGISLATION. DIFFERENT WAY THAN WE CAN RIGHT
NOW WHERE IT’S A LITTLE BIT MORE
DEFUSED AS WE’RE FIGURING OUT WHERE WE’RE HEADED. THAT REALLY HAS FIVE BIG BUCKETS
IN IT. SUBJECT TO THE COST GROWTH BENCH
MARK. THAT WOULD FALL INTO THIS
BUCKET. WE’RE COMMUNICATING WITH
EVERYBODY WHO COULD BE ENGAGED IN THIS WORK. INTERNALLY AND EXTERNALLY WHY IS
THIS WORK IMPORTANT? TO EXPLAIN WHY THIS WORK IS
IMPORTANT AND WHY IT’S IMPORTANT NOW. IN THAT. DATA INFRASTRUCTURE AND IN
PARTICULAR, TRYING TO ASSESS, AGAIN, NOT
ENTIRELY KNOWING WHAT WILL END UP HAPPENING DURING LEGISLATIVE SESSION BUT
WHAT DATA WE CURRENTLY HAVE THAT COULD BE USED TOWARD MEASURING THE COST GROWTH
BENCH MARK AND WHAT ADDITIONAL DATA WE
THINK WE MIGHT NEED. IT WILL BE DEFINING THE
GOVERNANCE PROCESS IN TERMS OF NOT REALLY
NAMING WHO WOULD BE DOING THE WORK NECESSARILY BUT WHAT ROLES AND
RESPONSIBILITIES ARE GOING TO BE ENGAGED IN THE COST GROWTH BENCH
MARK WORK. HEALTH POLICY BOARD WILL HAVE
AND THE COMMITTEES AND POTENTIALLY OTHER
GOVERNMENT AGENCIES. IN THIS WORK, PROBABLY ONE OR
MAYBE TWO THAT ARE ACCOUNTABLE FOR DOING THE WORK. A D.J. — PIECES WE’D LIKE TO PULL INTO
THE SO HOW WOULD THAT TIE? CALLS TO ACTION WAS A HIGHER
DEGREE OF TRANSPARENCY. HAD IDENTIFIED. WE DID HAVE A VERY INFORMATIVE CONVERSATION, JON AND LAURIE AND
I AND JEREMY WAS PART OF IT FOR A
LITTLE BIT WITH MILL BANK. STATES THAT HAVE BEEN WORKING ON
COST GROWTH BENCH MARK TYPE WORK. THOSE TWO OTHER STATES. WORK THESE WERE THE BUCKETS WE
DECIDED MADE THE MOST SENSE. SHE’S BEEN DOING WITH OTHER
STATES AS WELL.>>JUST TAKE A STEP BACK. RECOMMENDATIONS AND TWO,
DIRECTING US TO THERE’S LEGISLATION AND WE’RE
TRYING TO FIGURE OUT HOW WE GEAR UP AND
DIRECT SO THIS IS BROADLY WHAT WE’RE
CAPTURING IN THE FEASIBILITY WORK OF HOW DO WE LAY THE
GROUNDWORK BETWEEN NOW AND JULY? RIGHT NOW, IT SETS UP A BROAD
STAKEHOLDER GROUP COMMITTEE THAT WOULD DEVELOP AN IMPLEMENTATION PLAN TALKING WITH LEGISLATURES, THEY
ANTICIPATE THE BOARD HAS A ROLE IN THAT. ANYTHING, THE PUBLIC PROCESS
BUSINESS PLAN AND HOW TO MAKE THE FINAL
DECISIONS THIS IS REALLY WHAT WE’RE TRYING
TO IDENTIFY AS THE PREWORK LEADING INTO THAT SO WE CAN
LAUNCH THAT PUBLIC PROCESS AS FAST AND AS QUICKLY
AS POSSIBLE. THE BILLS ON THURSDAY AND TO
FILL THEM IN WITH FEEDBACK AND LET THEM KNOW THAT THE POLICY
BOARD ENDORSED THIS RECOMMENDATION AND ARE READY TO
GO. NATIONAL INTEREST IN THIS. AROUND COSTS. EXCITING FOLKS. CREATE A COST BENCH PROGRAM. MORE TIME THAN TRYING TO
ACTUALLY RUN THEIR PROGRAM. LOOKING AT OREGON AS WE MOVE
FORWARD. OTHER STATES. EDUCATION FROM THE BOARD AND
JULY. ARE DESCRIBING. IS A VERY, VERY BIG UNIVERSE. COMPONENTS OF BOARD EDUCATION
THAT ARE >>I THINK IT’S KIND OF EMBEDDED
IN THOSE FIRST TWO BULLETS. WE ALREADY HAVE. COMMON TRENDS. CAN DO AROUND BETTER TAPPING
INTO OUR DATA AND INFORMING YOU ALL AND CREATE SOME PUBLIC DIALOGUE. HELPING GET THE BOARD UP TO
SPEED ON COMMON UNDERSTANDING OF TRENDS AND WHAT’S GOING ON OUT
THERE?>>DO YOU ANTICIPATE THAT THERE
WILL BE A SECTION OF OUR AGENDA EACH
MONTH DEDICATED IN THIS ROAD MAP? WITH YOU, CHAIR, BUT THROWING
THAT OUT >>OKAY.>>KRISTEN AND JON HAD A
COMMENT. GOING ON THROUGHOUT THIS
ELEMENT. REPAIR REPORT. IDENTIFIES PRIMARY CARE GROUPS
USING COMMERCIAL DATA THAT HAVE LOW
COST AND HIGH QUALITY. COST AND LOW QUALITY.>>WELL, WHAT ARE WE GOING TO DO
WITH IT? THINK IT’S GOING TO BE. BE NICE TO INCORPORATE.>>I’LL BE QUICK. DOESN’T FEEL TIED TO THE HEALTH
POLICY BOARD.>>THAT’S WHAT WE’LL BE TALKING
ABOUT ON THURSDAY. WHERE THEY ARE ANTICIPATING THE
WORK LAND. BROAD STAKEHOLDERS. AND CERTAINLY, FOR SOME REASON,
IF THINGS ARE GOING A DIFFERENT DIRECTION, CERTAINLY, WE DON’T WANT TO
WASTE YOUR TIME.>>OKAY. WANT TO DO THE LEGISLATIVE AND
THEN TAKE >>I THINK WE HAD A LITTLE BIT
OF A >>OKAY.>>HOLLY’S ON THE PHONE. PARTICIPANT LINE. ALL RIGHT. IF>>MAYBE WE CAN TAKE A BREAK.>>SEEMS LIKE THE VOTES ARE
LINING UP>>OKAY. 10 MINUTES AT THE MOST.>>WE CAN HEAR YOU.>> I’LL GIVE YOU A CALL BACK ON
THE>>OKAY. JUST MUTE FOR NOW.>>HEY, HOLLY.>>I HOPE IT’S OKAY, I’VE ONLY
REALLY >>WE JUST CAME OFF MUTE.>>JUST TO LET YOU KNOW, PAT IS
ALSO DOING HIS BEST TO GET THERE IN PERSON. BRIDGES RIGHT NOW. UPDATE. WE ARE. SESSION FROM OHA. HOLDERS THAT WE ARE STILL
WORKING ON. BILLS IN YOUR PACKET OF
INFORMATION. TIME WITH A QUESTION. SENATE BILL 22, WHICH IS TO HELP US BUILD
OUT THE STANDARDS FOR BEHAVIORAL HEALTH HOMES. HEALTH POLICY AND ANALYTICS
HOUSEKEEPING BILL. THE WORK OF MENTAL HEALTH’S
ADVISORY GROUP. WITH THE HOSPITAL ASSOCIATION SO
THAT WE CAN HAVE A MORE ROBUST DATA SET
FOR AND TO MAKE SURE THAT SOURCE OF
DATA IS RELIABLE. WE HAVE A PLACE HOLDER BILL HB
2266. ALLOWS US IF WE NEED A BILL
LATER IN SESSION, IT GIVES US A LOT OF OPPORTUNITY. PURPOSE FOR IT. PLACE FOR THE CCO 2.0 FIXES THAT
WE’VE BEEN TALKING ABOUT. DESCRIBE MORE TO YOU WHERE WE’RE
HEADED WITH THAT AS WELL AS, OF COURSE, JEREMY. PREPARING RIGHT NOW THAT IS
LOOKING AT CCO FINANCIAL REGULATION AND TRANSPARENCY. WE SHOULD HAVE SOME LANGUAGE TO
PUT IN AN AMENDMENT WITHIN THE NEXT
WEEK OR SO. MEDICAID PACKAGE, MEDICAID
FUNDING PACKAGE. SEPARATE BILL THAT WILL BE
DISCUSSING IN THE LEGISLATURE THIS WEEK. 2037, 2038 AND 2039 ALL RELATE
TO TECHNICAL FIXES FOR PEB OEB THAT
WERE RECOMMENDATIONS TO MOVE FORWARD. WORKER COMMISSION. COULD ALSO HELP DESCRIBE WHERE
WE’RE HEADED FOR THAT. IN THE NEXT COUPLE OF WEEKS
WHERE WE’RE REALLY TRYING TO MAKE THE
FORENSIC EVALUATION PROCESS MORE FAIR AND
EFFICIENT. WE CURRENTLY HAVE. HOSPITAL UNDER THE 370 PROVISION
OR AID AND ASSIST PROVISION. STATE HOSPITAL TRULY NEED
HOSPITAL LEVEL OF CARE. TREAT THEM AND RESTORE THEM IN
THEIR COMMUNITY. BILLS, SB 27 IS OUR SAFE
DRINKING WATER FEE RESTRUCTURING AND INCREASE
BILL. OUT OF COMMITTEE THIS WEEK. WE’RE WORKING CLOSELY ON THAT
AND HOPEFULLY WILL BE MOVING THAT THIS WEEK. COMPONENTS THAT WE’VE BEEN
TALKING ABOUT. OF TOBACCO PRODUCTS. RELINQUISHING YOUR PUBLIC HEALTH
AUTHORITY AS A COUNTY. HOUSEKEEPING BILL. AREAS TO WHICH YOU WANT MORE
INFORMATION. DESCRIPTION YOU WANT TO GIVE ON
THE FINANCIAL REGULATION AND
TRANSPARENCY OR THE CCO 2.>>YEAH, JUST A COUPLE, I GUESS,
COMMENTS. TWO SEPARATE VEHICLES. I WILL BE TESTIFYING AS WELL AS SUBCOMMITTEE AROUND THE PACKAGE
THIS THURSDAY. POLICY OPTION PIECES COMING OUT
OF THE BOARD’S REPORT ARE IN THE —
LOOKING FOR THE NUMBER NOW. WHICH IS WHAT I COMMENTED ON
EARLIER TODAY AROUND CREATING MORE APPLES TO APPLES
COMPARISON. THE COMMERCIAL INSURANCE
REPORTING REQUIREMENTS, NOT NECESSARILY ALL THE INSURANCE
REQUIREMENTS. GETTING FEEDBACK ONCE WE HAVE
AMENDMENTS >>I DON’T NEED ANY INFORMATION
TODAY ON IT BUT IN THE FUTURE I’D LOVE AN
UPDATE ON WHAT HAS HAPPENED TO THE BILLS THAT CAME OUT OF THE 4005 PROCESS,
THE TRANCE PARTICIPATE SEE AND DRUG SUPPLY CHAIN. VERY UNIQUE GROUP. HAPPENED WITH THE CONCEPTS AND
ALL THAT CAME OUT OF THAT. BILLS THAT ARE MOVING FORWARD
THAT I FIND VERY INTERESTING.>>I LOOK FORWARD TO A DAY OHA
AND HOUSING AUTHORITY AND EDUCATION HAVE A FORUM TO COME
TOGETHER TO TALK ABOUT BILLS THAT IMPACT EACH OTHER.>>THANKS, DAVID. BILLS THAT ARE MOVING THROUGH
AND BEING DISCUSSED IN THE LEGISLATURE.BACK TO AND DISCUSS. ACROSS STATE AGENCIES IN THE
COORDINATED AND WE’D BE HAPPY TO COME BACK
AND THERE’S A WHOLE SLEW OF
PHARMACY-RELATED >>THE CHAIR — IS HOPING TO TRY AND GROUP
BILLS SCHEMATICALLY. PHARMA BILLS ON THE HOUSE SIDE. THAT’S HOW THE HOUSE IS
INTENDING TO MOVE THOSE BILLS. WILL HEAR FROM HITOC.>>SORT OF.>>GREAT.>>AMY, I’M THE VICE CHAIR OF
HITOC AND >>AND SUSAN WORKS WITH OHA AND OFFICE
OF HEALTH I-T. COVER TODAY. YOUR PACKET THAT HAVE SOME OF
THE DETAILED STATUS UPDATES. AND JUST A REMINDER ON HOW OUR
WORK CONNECTS.AND GOALS. TALKING ABOUT THE PROGRESS IN
2018 AND AND LOOKING FOR ALL OF YOUR
INPUT ON THOSE PRIORITIES FOR 19 AND IF WE NEED SO HOPEFULLY, PEOPLE CAN JUMP
RIGHT IN AND ASK QUESTIONS AS WE GO THROUGH THE MATERIAL. RIGHT SLIDE. JUST TO TALK ABOUT HOW HEALTH
I-T CONNECTS TO OUR TRANSFORMATION EFFORTS. WORK WE’RE TRYING TO DO, HAVING
THE RIGHT PATIENT INFORMATION IS CRITICAL TO THAT AND HAVING THE
ABILITY TO COLLECT THAT INFORMATION, SHARE THAT
INFORMATION AND DO THE APPROPRIATE ANALYSIS IS ALSO AN
APPROPRIATE ASPECT AS WE WORK TOWARDS THAT COORDINATED CARE
MODEL. THAT’S A LITTLE BIT CHALLENGING
AS WE BUILD OUT THAT INFRASTRUCTURE. HIGHLIGHTS SOME OF THOSE AREAS
OF CHALLENGE THAT WE HAVE AHEAD OF US. THE CCO 2. SO WE REALLY LOOK AT HIT AND
WHAT ARE THE CORE FOUNDATIONAL PIECES? FORWARD EVEN THOUGH IT’S A BIT
DIFFICULT THE FIRST PART OF IT IS ABOUT MAKING SURE WE HAVE
ELECTRONIC HEALTH RECORDS THAT ARE AVAILABLE. BIT IN DETAIL LATER IS,
PARTICULARLY, IN THE BEHAVIORAL HEALTH WORLD, THAT’S PROBABLY A
LITTLE MORE CHALLENGING THAN IN OTHER AREAS. COURSE OF TIME OF THE INCENTIVE
PROGRAMS FOR THE ELECTRONIC MEDICAL RECORDS. ON THERE. OF THE KEY CORE ELEMENTS OR
FOUNDATIONAL PIECES THAT ARE CRITICAL TO IT. THAT INFORMATION AND MAKE IT GO
BETWEEN DIFFERENT ORGANIZATIONS? THAT DATA AVAILABLE, HOW DO WE
DO ANALYSIS AND LOOK AT SOME OF THE METRICS THAT ARE AVAILABLE
ONCE WE PULL THAT ALL TOGETHER. SO THAT’S THE CORE OF WHAT WE’RE
AFTER AND WORKING SO AS WE CONTINUE TO BUILD OUT
THE INFRASTRUCTURE, GETTING INTO
THOSE ITEMS IS WHERE WE SEE THINGS GOING.
A COUPLE OF INTERESTING POINTS, I THINK IF YOU LOOK ACROSS THE
STATE, THERE’S WIDE VARIATION IN TERMS OF WHERE PEOPLE ARE.
THERE ARE SOME PEOPLE WITH VERY SOPHISTICATED AND WELL-UTILIZEED
ELECTRONIC MEDICAL RECORDS. THEY’RE LOOKING AT OTHER THINGS
LIKE SOCIAL DETERMINANTS OF HEALTH, AND THERE’S PLACES WHERE
IT’S IN PLACE AND PEOPLE AREN’T USING IT.
AND YOU GO ALL THE WAY TO SOME OF THE BAIFL HEALTH STUFF, WHERE
THERE’S NOT EVEN NECESSARILY ELECTRONIC MEDICAL RECORDS
AVAILABLE YET. SO THAT DISPARITY CREATES
CHALLENGES IN HOW WE SHARE THAT INFORMATION. SO PART OF OUR WORK WITH HITOC
IS MAKING SURE WE’RE TRYING TO UNDERSTAND THAT LAND CAPE AND
HOW WE CAN HELP THOSE AREAS THAT ARE LAGGING BEHIND AS WELL AS
PROMOTE THAT ADVANCED USE AND KEEP THAT MOVING FORWARD. I’M SUSAN OTTER.
I APOLOGIZE FOR BEING A LITTLE LATE.
I DECIDED TO TAKE THE BUS. ABOUT AN HOUR AND A HALF FROM
HAWTHORNE. 35th.
ANYWAY.>>JUST AS A REMINDER, THE HITOC
WAS CREATED BY LEGISLATURE IN 2009,
AND THEN BY ADDITIONAL LEGISLATION IN 2015, HITOC WAS
MOVED UNDER THE PURVIEW OF THE OREGON HEALTH POLICY BOARD. I THINK YOU’RE AWARE YOUR
RESPONSIBILITIES, YOU CHARTER HITOC, HELP SET OUR GOALS AND
PRIORITIES FOR THE YEAR, APPOINT MEMBERS, AND
THEM APPROVE OUR STRATEGIC PLAN. HITOC’S RESPONSIBILITIES ARE TO
REALLY SURVEY AND LOOK AT THE LANDSCAPE
OF HIT WITHIN THE STATE OF OREGON AS WELL AS TRY AND STAY CONNECTED AT WHAT’S
— TO WHAT’S GOING ON AT THE FEDERAL LEVEL.
THERE ARE POLICIES THAT CERTAINLY IMPACT WHAT WE’RE
DOING HERE IN OREGON. WE ALSO DO WORK TO COME TOGETHER
WITH THAT OVERALL HIT STRATEGY FOR THE STATE, AND THEN HELP
OVERSEE THE WORK THAT OHA IS DOING TO IMPLEMENT THAT
STRATEGY. WE ALSO APPRECIATE THE RECENT
APPROVAL OF SOME ADDITIONAL MEMBERS FOR HITOC.
WE’RE LOOKING FORWARD — WE HAVE OUR FIRST MEETING THIS THURSDAY
WITH THAT NEW MEMBERSHIP. HITOC NOW HAS 15 PEOPLE ON IT,
AND WE MEET EVERY OTHER MONTH. SO THANKS FOR GETTING US THAT
ADDITIONAL PEOPLE WITH SOME CHANGES — PEOPLE MOVING IN
DIFFERENT ROLES, WE WERE DOWN IN OUR NUMBERS, SO IT’S NICE TO GET
THAT FULL GROUP BACK AND WE TRIED TO FOCUS ON SOME ADDITIONS
AROUND BEHAVIORAL HEALTH AND DENTAL, AND DIVERSE MEMBERS, SO
I THINK WE’RE LOOKING FORWARD TO HAVING THAT BROADER GROUP OF
PEOPLE COME TOGETHER. THIS IS A REMINDER SLIDE ON WHAT
OUR OVERALL VISION AND GOALS ARE FOR HEALTH I.T.
I THINK MOST OF YOU HAVE SEEN THIS BEFORE.
OUR EXTREMIC PLAN WAS PRESENTED TO — STRATEGIC PLAN WAS
PRESENTED IN THE FALL OF 2017, THAT STRATEGIC PLANTAR
GETS THE 2017-2020 TIME FRAME.
IN JUST TO RUN THROUGH THE GOALS, THE TOP FIRST GOAL IS
ABOUT HAVING THE ABILITY TO SHARE PATIENT INFORMATION ACROSS
THE CARE TEAM. THAT IS MAKING SURE AS PEOPLE
MOVE BETWEEN DIFFERENT PROVIDERS, THAT THAT INFORMATION
FROM WHAT HAPPENED PREVIOUSLY IS AVAILABLE TO THEM.
THE SECOND GOAL IS TO USE THAT DATA TO MAKE SYSTEM IMPROVEMENTS
AND HOW DO WE TAKE AND MOVE INTO THE
POPULATION HEALTH ARENA AND LOOK AT THAT KIND OF IN AGGREGATE
ACROSS EVERYWHERE. AND FINALLY, HOW DO WE LET THE
PATIENTS CONTRIBUTE AND PARTICIPATE IN THAT AND BE PART OF HAVING THAT HELP
INFORMATION AVAILABLE. AS I SAID BEFORE, A LOT OF OUR
WORK IS FOCUSED IN THAT AREA, YOU HAVE TO GET EVERYTHING
FLOWING BEFORE YOU CAN START TO SHARE IT AND MAKE IT AVAILABLE
TO PATIENTS. I KNOW THERE’S A LOT OF INTEREST
IN THAT CONSUMER ASPECT OF IT, BUT WE NEED TO DO A LOT OF THAT
BASE STRUCTURE WORK BEFORE WE’RE READY TO DO ALL THAT
SHARING AND MAKE IT AVAILABLE TO CONSUMERS.
SO WITH THAT I’M GOING TO TURN IT OVER TO SUSAN, WHO IS GOING TO TALK
MORE ABOUT SOME OF OUR PRIORITIES AND THE WORK DONE IN
2018.>>GREAT. THANKS, ERIC. SO OUR STRATEGIC PLAN SEEKS TO
SUPPORT THE HEALTH SYSTEM TRANSFORMATION PRIORITIES THAT
THE HEALTH POLICY BOARD HAS SET FORWARD IN THE ACTION PLAN FOR
HEALTH REFRESH THAT THE GOVERNOR HAS SET FORTH, AND IT’S HER
PROIRT FOR CCO 2.0. AND TO REFLECT THE VALUES OF OHA
INCLUDING ACCOUNTABILITY AND TRANSPARENCY. SO THIS SLIDE SHOWS YOU A
CROSSWALK OF THE PRIORITIES, THE POLICY PRIORITIES FROM THOSE
AREAS. AND THE HIT STRATEGIC PLAN FOCUS
AREAS IN OUR 2017-2020 STRATEGIC PLAN.
SO YOU CAN SEE WE’RE FOCUSED ON SPREADING HEALTH INFORMATION
EXCHANGE AND SUPPORTING ADOPTION, WHICH ERICK HAS TALKED ABOUT, SUPPORTING
HIGH-VALUE DATA SOURCES. THAT INCLUDES THINGS LIKE PUBLIC
HEALTH RENTAL INDUSTRIES, THE PRESCRIPTION DRUG MONITORING
PROGRAM IS ONE I’LL TALK MORE ABOUT THAT WE’VE WORKED ON.
AND ALSO LOOKING INTO SOCIAL DETERMINANTS OF HEALTH. AND ADDING SOCIAL DETERMINANTS
OF HEALTH DATA INTO THE SORT OF CARE
COORDINATION SPHERE. THAT’S AN AREA THAT WE’LL TALK
MORE ABOUT THAT WE’RE JUST STARTING TO EXPLORE WITH HITOC
IN 2019, AND WANT TO GET YOUR FEEDBACK ON.
WE WANT TO LEVERAGE HEALTH I.T. TO PROMOTE HEALTH EQUITY AND
WE’RE FOCUSED ON IMPLEMENTING CORE HEALTH I.T. INFRASTRUCTURE.
THAT INCLUDES THE EMERGENCY DEPARTMENT INFORMATION EXCHANGE,
WHICH HAS BEEN LIVE SINCE 2015. OUR STATEWIDE PROVIDER
DIRECTORY, WHICH IS LAUNCHING LATER THIS YEAR.
AND OUR CLIP CALL QUALITY METRICS REGISTRY, WHICH JUST
LAUNCHED THIS LAST MONTH. WE ALSO ARE LOOKING TO SUPPORT
VALUE-BASED PAYMENT WITH HEALTH I.T. EFFORTS.
A LOT OF OUR WORK AROUND THAT HAS BEEN AROUND THIS CLINICAL
QUALITY METRICS REGISTRY, HAVING AN EFFICIENT WAY TO COLLECT
THOSE METRICS FROM PROVIDERS, AND MAKE THEM AVAILABLE TO CCOs,
TO OHA, TO MEDICARE, AND TO OTHER PAYERS. AS WELL AS OUR POLICY PRIORITIES
FOR CCO 2. 0 INCLUDE A POLICY AREA AROUND
HEALTH I.T. THAT CCOs NEED FOR THEIR
VALUE-BASED PAYMENT. THE FOURTH AREA HERE IS
SUPPORTING SHARED GOVERNANCE FOR LONG-TERM SUSTAINABILITY AND
ALIGNMENT. AND I REALIZE I NEED MY GLASSES. THE WORK WE’VE BEEN DOING ON
SHARED GOVERNANCE, WE’LL TALK MORE
ABOUT, OUR PUBLIC-PRIVATE PARTNERSHIP IN OREGON FOR HEALTH
I.T. CALLED THE HIT COMMONS. WE’RE EXCITED ABOUT THAT WORK.
SPREADING PATIENT ACCESS TO DATA, AND REPORTING ON OHA’S PROGRESS AND
THE HIT ENVIRONMENT. I WANT TO GIVE YOU A SENSE OF
HOW WE’RE TRYING TO MAKE SURE WE’RE ALINEUPING WITH THE
PRIORITIES AND VISION YOU HAVE, AND THAT’S OUR QUESTION FOR YOU
TODAY AS WE LOOK AT OUR 2019 PRIORITIES.
WE WANT TO MAKE SURE WE’RE IN ALIGNMENT WITH THE WORK YOU ALL
ARE DOING. ANY QUESTIONS ON THIS PIECE?>>[INDISCERNIBLE] EITHER SOCIAL
DETERMINANTS ORECK AT THE, DOES THAT INCLUDE LOOKING AT WAYS TO
MAKE UP FOR OUR LACK OF DATA ON THE
ENROLLMENT SIDE?>>WE WOULD LOVE TO BE ABLE TO
TAP INTO RACE ETHNICITY DATA IN ELECTRONIC HEALTH RECORDS TO THE
EXTENT THAT IT IS. BUT WE DON’T HAVE SYSTEMS RIGHT
NOW TO COLLECT THE DATA PROPERLY.
SO THAT’S SOMETHING THAT WE’D LIKE — LOVE TO EXPLORE FURTHER.>>I THINK WE HAD — EARLIER WE
HAD CONVERSATIONS ABOUT CREATING THAT DATA, IMPROVING THAT DATA COLLECTION
SYSTEM [INAUDIBLE] ACHIEVING HEALTH EQUITY.
>>I’M MAYBE AROUND TO THE PLACE WHERE IMPROVING THAT SYSTEM IS LIKELY
TO BE LESS EFFECTIVE THAN FINDING ALTERNATIVE SOURCES OF
DATA.>>I THINK WE NEED TO CHARGE —
WE DON’T HAVE DATA ON RACE, ETHNICITY, AND DISABILITY THEN
WE HAVEN’T EVEN STARTED TO TAP THE ISSUE OF HEALTH EQUITY. WE SHOULD HAVE SOME TYPE OF
DATA, RELIABLE DATA.>>CAN YOU SAY MORE ABOUT THAT
ABOUT YOUR COMMENT ABOUT OTHER
SOURCES?>>I’VE BEEN TRYING TO ENGAGE
WITH THE STRUCTURE, I DON’T KNOW, SIX MONTHS, YOU PROBABLY
KNOW WE HAVE ABOUT A 50% REFUSAL RATE TO PROVIDE THE DATA FROM
THOSE WHO WERE SIGNING UP, AND WE HAVE A FEDERAL PROHIBITION ON
REQUIRING THAT — AN ANSWER TO THAT QUESTION BEFORE BEING ABLE
TO MOVE ON WITH ENROLLMENT. AND THERE IS CERTAINLY NOTION
THAT AN ENROLLMENT SPECIALIST CAN BE BETTER TRAINED TO NOT TAKE NO FOR AN
ANSWER AT LEAST INITIALLY. I’M DUBIOUS THAT WE CAN TURN
THAT REFUSAL RATE FROM 50% TO 5%.
SO IT MAKES ME WONDER IF THERE ARE — IF WE SHOULDN’T BE
LOOKING AT ALTERNATIVE WAYS TO GET THE SAME THING.
OVER SAMPLING IN THE CENSUS TO FIGURE OUT WHAT’S THE [INDISCERNIBLE]
HEALTH RECORDS, TO THE EXTENT THAT DATA
EXISTS. SOMETHING THROUGH CCOs, I’M NOT
SURE WHAT, THAT’S WHAT I’D LIKE US TO — AS AN AGENCY TO GO TRUE, WHAT —
RATHER THAN GET DIALED INTO, WE’VE GOT TO FIGURE OUT HOW TO GET THAT 50%
REFUSAL RIGHT DOWN. COULD WE GET BETTER RESULTS BY
DOING SOMETHING DIFFERENT.>>I HEARD PART OF THAT EARLIER DISCUSSION, I KNOW THAT FROM A
HEALTH PERSPECTIVE, THAT DATA IS ALSO DIFFICULT TO GATHER EVEN
FROM OTHER SOURCES. IT IS A CHALLENGE TO FIGURE OUT
HOW TO TRY AND SOURCE GOOD DATA FROM THAT.
>>BUT TO YOUR POINT, YOU’RE RIGHT, AT A 50% WE HAVE NO IDEA — WE DON’T
KNOW WHAT WE’RE DOING.>>I WANTED TO TALK ABOUT SOME
OF THE PROGRESS WE MADE IN 2018 IN HITOC.
IT WAS A BUSY YEAR FOR HITOC, PARTICULARLY WITH CCO 2.0 AND
NOT A SURPRISE TO YOU, I’M SURE. WE’VE LOOKED AT OUR MEETING
HOURS AND CALCULATED ABOUT HOW MANY OF OUR — HOW MANY HOURS WE
HAD OF SUBSTANTIVE DISCUSSION, ABOUT A QUARTER WERE SPENT ON
CCO 2.0 PRESENTATIONS. AND INPUT SESSIONS THIS YEAR.
SO WHAT WAS GREAT ABOUT THAT WAS IT KILLED TWO BIRDS WITH ONE
STONE FOR HITOC, IT ENABLED HITOC TO GET UP TO SPEED ON POLICIES AROUND
VALUE-WAYED PAYMENT PRIORITIES, SOCIAL DETERMINANTS OF HEALTH,
IMPROVING THE BEHAVIORAL HEALTH SYSTEM AND TO THINK ABOUT
HOW OUR HEALTH I.T. POLICIES FOR CCO 2.0 SUPPORTED THOSE OTHER
AREAS. SO THAT WAS A GREAT PART OF
2018. HITOC ALSO CONVENED TWO AD HOC
STAKEHOLDER LISTENING SESSIONS ON OUR HIT POLICY PRIORITIES,
AND WE HAD GREAT ATTENDANCE ACROSS A WIDE DIVERSITY OF
MEMBERS, WHICH WAS GREAT. WE ALSO INITIATED SOME STRATEGY
WORK AROUND BEHAVIORAL HEALTH AND HEALTH INFORMATION EXCHANGE.
OUR APPROACH AS WE’RE CALLING NETWORK OF NETWORKS, WE EXPECT
TO CONTINUE BOTH OF THOSE IN 2019, SO WE’LL TALK MORE ABOUT
THAT LATER. AND THEN WE RECEIVED REPORTS ON
OREGON’S HEALTH I.T. EFFORTS AND REVIEWED NEW DATA, HEARD FROM
STAKEHOLDERS ON THE EVOLVING HEALTH INFORMATION EXCHANGE
LANDSCAPE, SPENT TIME REVIEWING PROPOSED FEDERAL POLICIES AROUND
A TRUSTED EXCHANGE FRAMEWORK, AND FINALLY AS ERICK MENTIONED
WE FILLED THE SIX VACANCIES WITH YOU ALL IN DECEMBER. I WANTED TO HIGHLIGHT ONE AREA
OF PROGRESS BEFORE WE MOVE ON TO OUR 2019 PRIORITIES. SO WHEN WE CAME TO YOU IN
SEPTEMBER OF 2017 WITH OUR STRATEGIC PLAN, WE HAD TWO NEW
AREAS IN THAT STRATEGIC PLAN. ONE WAS AROUND OUR
PUBLIC-PRIVATE PARTNERSHIP, THE HIT COMMONS.
AND THE OTHER WAS AROUND OUR HEALTH INFORMATION EXCHANGE
STRATEGY OF NETWORK-TO-NETWORKS. THE HIT COMMONS IS A
PUBLIC-PRIVATE PARTNERSHIP MEANT TO ACCELERATE AND ADVANCE
STATEWIDE HEALTH I.T. EFFORTS. IT’S COSPONSORED BY OHA AND THE
OREGON HEALTH LEADERSHIP COUNCIL AND JOWNTLY FUNDED BY OHA, CCOs,
PARTICIPATING HEALTH PLANS, AND HOSPITALS.
SO WE HAVE A GREAT FUNDING MODEL WHERE WE’RE ABLE TO BRING 90%
FEDERAL MATCHING FUNDS AND STATE FUNDS FOR THE MEDICAID SHARE AND
OUR HOSPITALS AND COMMERCIAL HEALTH PLANS ARE BRINGING THE
SHARING THE COST FOR THE REST OF THE —
THROUGH ASSESSMENTS. THE EMERGENCY DEPARTMENT
INFORMATION EXCHANGE WAS FOUNDATIONAL WORK THAT STARTED IN 2015, AND WE TOOK
THAT PUBLIC-PRIVATE GOVERNANCE MODEL AND EXPANDED IT, LAUNCHING IN
JANUARY 2018. SO WE LAUNCHED THE GOVERNANCE
BOARD IN JANUARY 2018, WE’VE HAD A
CRAWL-WALK-RUN STRATEGY, SO WE STARTED VERY SMALL IN TERMS OF
THE ADMINISTRATION OF THAT, THE OREGON HEALTH LEADERSHIP COUNCIL
STAFF REALLY HAVE STAFFED THAT WORK.
TOWARDS THE END OF 2018 THEY ACTUALLY — WE MOVED INTO MORE
OF OUR WALK PHASE, OUR LATE CRAWL, MAYBE, AND THEY FORMED A SINGLE ENTITY LLC, SO NOW HIT
COMOPS IS ITS OWN ORGANIZATION AS A
SINGLE MEMBER WITH OHLC AS A MEMBER.
THEY’RE WORKING TO HIRE A COUPLE STAFF, SO WE’RE STARTING SMALL,
BUT WE’RE GETTING GOOD TRACTION. WE CONTINUE TO SEE A SPREAD OF
PREMANAGED STATEWIDE. EDDIE IS — CONNECTS ALL OREGON
HOSPITALS AS WELL AS WASHINGTON HOSPITALS AND SOME OTHER
NEIGHBORING STATES, WITH HOSPITAL EVENT
NOTIFICATIONS. SO I COULD DO A WHOLE
PRESENTATION ON EDDIE AND WE DECIDED NOT TO FOCUS ON THAT
TODAY, BUT I WANT TO MENTION WHAT IT IS.
WE BRING IN HOSPITAL EVENT DATA OUT OF THE ELECTRONIC HEALTH
RECORDS FOR ALL HOSPITALS. THAT INCLUDES EMERGENCY
DEPARTMENT AND HOSPITAL ADMITS AND DISCHARGES. THAT INFORMATION IS THEN
AVAILABLE REAL TIME BACK TO THE EMERGENCY DEPARTMENT.
WHEN THEY REGISTER A PATIENT, IT CHECKS THE SYSTEM, IF THEY’VE
BEEN A HIGH UTILIZER OF SERVICES IT SENDS BACK A NOTIFICATION
SAYING, THIS PERP HAS BEEN SEEN IN ALL OF THESE DIFFERENT
EMERGENCY ROOMS, ON THESE DATES FOR THESE REASONS.
IT ALSO INCLUDES CARE GUIDELINES THAT USERS CAN INPUT, SAYING IF THIS
PERSON SHOWS UP IN THE EMERGENCY ROOM, HERE’S WHAT YOU NEED TO
KNOW WITH THEIR CARE. AND WE’RE VERY EXCITED, WE’VE
BEEN ABLE TO CONNECT PRESCRIPTION DRUG MONITORING
PROGRAM DATA IN AS WELL. SO NOW EDDIE ALERTS FOR 27 OF
OUR EDs INCLUDE OPIOID PRESCRIPTION
INFORMATION FOR INDIVIDUALS THAT HAVE TRIGGERED PARTICULAR THRESHOLD OF OPIOID
USE. SO PREMANAGE IS THE TOOL THAT
HAS THE SAME DATA AS EDDIE, BUT IT’S
USED BY THE CCOs, THE CLINICS, THE HEALTH PLANS.
WE’RE SEEING BROAD USE OF THAT ACROSS ALL CCOs NOW. MANY OF OUR COMMERCIAL — MOST
OF OUR MAJOR COMMERCIAL HEALTH PLANS IN OREGON WE HAVE ABOUT
200 PRIMARY CARE CLINICS, WE HAVE DENTAL, WE HAVE BAIFL
HEALTH, WE HAVE NOW FOUR TRIBAL CLINICS ON PREMANAGE. AND WE’RE REALLY EXCITED ABOUT
HAVING ONE TOOL THAT ALL SORTS OF —
ALL THE DIFFERENT CARE TEAM MEMBERS ARE USING TO LOOK AT
THAT PATIENT THAT’S BEEN HIGH UTILIZING OR IS AT RISK FOR
HOSPITALIZATION. THEY CAN ENTER CARE HISTORIES AS
WELL. THIS HAS BEEN AN EXCITING TOOL
THAT’S BEEN IN PLACE STARTING IN 2017, AND WE JUST CONTINUE TO
SEE SPREAD OF THAT. I’D LIKE TO TALK A ALSO BIT
ABOUT THE SECOND INITIATIVE, THE PRESCRIPTION DRUG MONITORING
PROGRAM INTEGRATION INITIATIVE. IT’S A GOOD EXAMPLE OF
PARTNERSHIP AND THE ROLE HEALTH I.T. PLAYS IN INTEGRATING INTO A
PROVIDER’S WORK FLOW AND THE VALUE OF THAT.
BEFORE I DO THAT, ANY QUESTIONS ABOUT EDDIE OR PREMANAGE?>>IS EDDIE MANDATORY OR
VOLUNTARY?>>EDDIE IS VOLUNTARY.
THE EXCITING THING ABOUT I SHOULD SAY THE INTERESTING THING
ABOUT THE HEALTH I.T. COMMONS AND THE WAY THIS PUBLIC-PRIVATE PARTNERSHIP STARTED IS WE
INCENTIVIZED HOSPITALS TO PARTICIPATE, TO MAKE THE
DECISION TO PARTICIPATE BECAUSE WITHOUT STATEWIDE HOSPITAL DATA,
THE SYSTEM WAS GOING TO BE LESS USEFUL. SO WE WERE ABLE TO PUT GRANT
MONEY INTO THE FIRST YEAR. IF THE OREGON HEALTH LEADERSHIP
COUNCIL GOT THE AGREEMENT OF 75% OF THE HOSPITAL TO PARTICIPATE.
THEY WERE ABLE TO — THE GREAT THING ABOUT THE HEALTH
LEADERSHIP COUNCIL AND THE SITUATION IS THEY HAVE
RELATIONSHIPS AND INFLUENCE OVER LEADERSHIP IN MANY OF OUR HEALTH
SYSTEMS, AND WE’RE ABLE TO EVEN USE PEER PRESSURE TO GET
ALL OF THE HEALTH SYSTEM AND HOSPITAL LEADERSHIP TO AGREE TO
PARTICIPATE. NOBODY WANTED TO BE THAT ONE
THAT DIDN’T. AND THEY WERE UNABLE TO GET 100% COMMITMENT EARLY ON IN 2015.
SO WE HAVE OTHER STATES THAT ARE REALLY JEALOUS OF WHAT WE HAVE
IN OREGON, AND HAVE ASKED US WHAT WAS THE SECRET SAUCE. AND SOME OF IT IS THAT, YOU
KNOW, OREGON HEALTH LEADERSHIP COUNCIL SORT OF PEER PRESSURE
COMPONENT. AND THEN THE CCOs AND HEALTH
PLANS, THAT’S VOLUNTARILY FOR THEM TO USE PREMANAGED, HOWEVER
WE’RE REQUIRING AS PART OF OUR CCO 2.0 POLICIES THAT THE NEXT
ROUND OF CCOs PARTICIPATE.>>CAN YOU SPEAK TO WHY 27
EMERGENCY DEPARTMENTS ARE INCLUDED IN THE
OPIOID –>>SURE.
I’M GOING TO TALK MORE ABOUT THE INITIATIVE.
THE EDDIE ALERTS CAN COME INTO A HOSPITAL SYSTEM IN EITHER UP AT
THE GREATED INTO THE ELECTRONIC HEALTH RECORD OR TO A SECURE
FACTOR PRINTER. WITH THE OPIOID INFORMATION FROM
THE PDMP, THAT’S VERY STRICT CONTROLS OVER WHO RECEIVES IT. AND SO IT’S ONLY AVAILABLE FOR
THE HOSPITALS THAT HAVE INTEGRATED THEIR EDDIE ALERTS
INTO THEIR ELECTRONIC HEALTH RECORDS ABOUT A LITTLE MORE THAN
HALF HAVE. BUT WE STILL HAVE SOME THAT ARE
SMALL HOSPITALS, NOT ALL, THAT ARE GETTING IT TO A SECURE
PRINTER. WE HAVE SOME FEDERAL — SOME
STATE GRANT FUNDS FOR RURAL HOSPITALS THAT THEY CAN USE TO
HELP SUPPORT UP AT THE GRACE COSTS. AND THAT’S AVAILABLE THROUGH THE
HOSPITAL ASSOCIATION’S ROLE FOUNDATION — RURAL FOUNDATION.
SO WE’RE REALLY TRYING TO GET THOSE LAST OTHER HOSPITALS ON,
SO — AND THEN OF THE HOSPITALS THAT HAVE IT INTEGRATED NOT ALL
HAVE GOTTEN THE PAPERWORK SIGNED.
THE BARRIER END ES UP BEING THE LEGAL AGREEMENT, MUCH MORE SO
THAN THE — IN TERMS OF THE TIME IT TAKES TO GET THROUGH THOSE.
MORE SO THAN THE TECHNOLOGY.>>THE HIT [INDISCERNIBLE] ARE
THERE SPECIFIC AREAS THAT WE SHOULD BE –>>YEAH, THE HIT COMMONS HAS
PARTICULAR AREAS OF FOCUS BOTH FOR ITS
EDDIE PREMANAGED WORK AND FOR IT’S PDMP INTEGRATION WORK.
IN TERMS OF EDDIE, THEY ARE SUPPORTING LEARNING
COLLABORATIVES AND COMMUNITIES, THEY FOUND THAT THE MOST
EFFECTIVE WAY TO MAKE SURE FOLKS ARE USING
THIS TOOL AND DOING IT IN A COORDINATED WAY IS TO ENGAGE
LOCALLY, SO THERE ARE REGIONAL LEARNING COLLABORATIVES THEY’RE
SUPPORTING AND EXPANDING, THAT’S ONE AREA. THERE — THAT’S ONE OF THE MAIN
AREAS.>>ARE THERE INITIATIVES THE
COLLABORATIVE SEES ITSELF?>>YES, THANKS FOR THAT.
I FORGOT TO MENTION. ONE OF THE OTHER THINGS THE
COMMONS DID THIS YEAR WAS DEVELOP A PROPOSAL REVIEW
PROCESS. WE’VE GONE THROUGH THAT PROCESS,
WE’VE REQUESTED THAT THE HIT COMMONS SUPPORT THE OREGON
PROVIDER DIRECTORY WHEN WE ROLL THAT OUT THIS YEAR.
WE WOULD CONTINUE TO OWN THAT PROGRAM, BUT WE WOULD LOOK TO
THEM TO HELP WHAT WE CALL ADOPTION AND SPREAD OF THAT
PROGRAM. AND THEY’VE AGREED TO HELP US
WITH A USE CASE TEST. SO THAT IS A PIECE THEY’RE
TAKING ONE STEP INTO THAT. AND THERE’S SOME INTEREST IN OUR
NETWORK OF NETWORKS, SO SPREADING HEALTH INFORMATION
EXCHANGE STATEWIDE, AND WHERE THE HIT COMMONS MIGHT TAKE
ANOTHER — A PIECE OF THAT WORK. SO THOSE ARE THE TWO THINGS THAT
THEY HAVEN’T APPROVED ANYTHING ON THE NETWORK OF NETWORK STA STATEWIDE HIE,
BUT THAT’S SOMETHING WE’VE TEED UP FOR THEIR CONSIDERATION THIS
YEAR.>>I THINK IT’S PART OF THEIR
CRAWL-WALK-RUN STRATEGY THAT TRIED NOT TO SET A HUGE AGENDA
AND REALLY BE SELECTIVE ABOUT PICKING ONLY A COUPLE THINGS AND
NOT SAYING, HERE’S A WHOLE BUNCH OF STUFF WE COULD WORK ON.
THAT’S WHY WE SEE THIS FOCUS WITH EDDIE AND PREMANAGED WORK
AND A COUPLE OF THINGS ON THE HORIZON.
BUT NOT A LOT MORE THAN THAT. I WOULD EXPECT WE’D PROBABLY SEE
THAT DEVELOP A LITTLE FURTHER DURING THE NEXT YEAR OR TWO AS THAT PACE PICKS
UP.>>IT’S RELATIVELY NEW, AND AN
EXCITING VENTURE, AND KUDOS TO SUSAN AND HITOC FOR HELPING GET
IT OFF THE GROUND. I THINK — WE HAVE FEDERAL
DOLLARS WE CAN BRING TO THE TABLE, BUT WE HAVE NO SHORTAGE
OF VENDORS WHO WOULD LIKE TO TELL US WE SHOULD BUY X, Y, OR
Z. THIS ALLOWS US TO HAVE A FORUM
WITH OUR STAKEHOLDERS TO DECIDE WHEN AND — WHEN IS THE RIGHT
TIME TO TAKE OFF WHICH NEXT INITIATIVE AND MAKE SURE THERE’S
BUY-IN AS OPPOSED TO JUST BEING TOLD BY THE STATE.
SO I THINK THERE’S — THEY’RE TRYING TO GET IT OFF THE GROUND,
BUT I THINK IT’S GOING TO BE A HUGE TOOL FOR THE
STATE.>>AND I SHOULD ALSO SAY THE
IDEA OF A PUBLIC-PRIVATE PARTNERSHIP HAS BEEN IN OUR
STRATEGIC PLAN SINCE 2010. AND SO THIS IS SOMETHING WE AT
HITOC AND HITOC AND THE STATE HAVE BEEN EXCITED ABOUT.
WE SEE THIS AS A PATH TO OUR LONG-TERM SUSTAINABILITY FOR
STATEWIDE HEALTH I.T. SO THAT BUY-IN AND GOING SLOW
ENOUGH SO FOLKS ARE ALL REALLY REALIZING THAT VALUE AND BOUGHT
IN IS A COMPONENT OF SUSTAINABILITY.>>YOU SET UP THE DISESH DISERN.
>>CAN YOU SAY THAT QUESTION –>>YOU SAID YOU SET UP AN LLC
FOR COMMONS?>>THE OREGON HEALTH LEADERSHIP
COUNCIL DID, YES.>>IT WAS MORE OF A DECISION ON
THE HEALTH LEADERSHIP COUNCIL’S SIDE THAT IT WAS STARTING TO
VENTURE INTO MANAGING I.T. PROJECTS THAT WAS BEYOND THEIR
CORE COMPETENCY — COMPETENCY SO THEY
SET IT UP AS A SEPARATE LLC.>>IT’S A PUBLIC-PRIVATE
PARTNERSHIP, SO WE HAVE A SPECIFIC PART OF THE GOVERNANCE BOARD, WE HAVE A ROLE
ON THE GOVERNANCE BOARD. WE ARE ALSO CONTRIBUTEING
CONSIDERABLE AMOUNT OF THE FUNDING.
BECAUSE WE’RE CONTRIBUTING THE MEDICAID SHARE.
AND MEDICAID CAN TAKE UP A CONSIDERABLE AMOUNT OF THE SHARE .>>– THE STRUCTURE SIDE
[INDISCERNIBLE]>>IT HELPS WITH THE PROCUREMENT
AND ACCELERATION OF SOME OF THOSE PROCESSES, CONTRACTING AND
THINGS LIKE THAT.>>WE STILL MAINTAIN STRONG
ACCOUNTABILITY, GRANT AGREEMENTS [INDISCERNIBLE]
>>OKAY. SO I WANTED TO HIGHLIGHT SOME OF
THE EXCITING WORK WITH THE HIT COMMONS AND THE PRESCRIPTION DRUG MONITORING
PROGRAM, INTEGRATION INITIATIVE, AND WE’LL TURN TO OUR 2019
PRIORITIES. THIS IS YOU.
THANKS. ONE OF THE INITIATIVES FROM THE
HIT COMMONS IS AROUND INTEGRATION OF THE PRESCRIPTION
DRUG MONITORING PROGRAM. SO THIS PROGRAM HELPS PROVIDERS
MAKE DECISIONS BY LETTING PROVIDERS
OR AUTHORIZED DELEGATES, DELEGATED
USERS SEE DRUG — CONTROLLED DRUG
HISTORIES. AND PART OF THE PROBLEM
HISTORICALLY IS THAT YOU HAVE TO GO THIEW A SEPARATE WEBSITE.
SO WHEN I’M IN MY ELECTRONIC HEALTH RECORD, I KNOW I SHOULD
BE LOOKING AT THE HISTORY, BUT I HAVE TO LOG
OUT, GET ON TO A SEPARATE WEBSITE, GET OUT MY PHONE, LOOK FOR MY PASSWORD FOR
THE PDMP, LOG ON, THEN SEARCH FOR
THE CLIENT. AND SO IT’S A REALLY CUMBERSOME
PROCESS, AND SO WHAT THIS INTEGRATION HAS
DONE IS ALLOWED THE USERS TO GET THAT INFORMATION RIGHT WITHIN
THEIR WORK FLOW, WHICH IS HUGE. BECAUSE YOU’RE NOT GOING TO USE
IT IF IT’S NOT EASY TO USE. SO CURRENTLY WE HAVE MORE THAN
3,700 PRESCRIBERS AND 200 PHARMACISTS
INTEGRATED AS OF TODAY, AND THERE ARE 12,000 PRESCRIBERS IN THE QUEUE
FOR 2019. AND I AM HOPING I’M ONE OF
THOSE. IF YOU LOOK AT — THIS IS THE
PDMP REGISTRATION. YOU’LL SEE A HUGE BUMP FROM 2017
TO 2018, A LOT OF THAT HAS BEEN AROUND LEGISLATIVE MANDATE.>>THERE’S A LIGHT LINE ON THE
TOP.>>SO AS OF 2018, ALL
PRESCRIBERS WERE AT 83%. AND THEN THE TOP 2,000
PRESCRIBERS ARE UP AT 96% OF JUST BEING REGISTERED.
THAT DOESN’T MEAN PEOPLE ARE ACTUALLY USING THE SYSTEM. AND THEN IF YOU LOOK AT THIS
ONE, THE HIT COMMONS SUCCESS METRIC WAS LOOKING AT A 30% INCREASE IN THE NUMBER
OF QUERIES, AND THAT HAS BEEN MET.
SO THE CIRCLE LINE AT THE BOTTOM, WHICH YOU CAN SEE IN YOUR PACKET ARE
THE ONES THAT WERE INTEGRATED AND SO YOU CAN SEE THAT WENT
FROM ZERO BECAUSE THERE WAS NO INTEGRATION UP TO 30,000,
THERE’S ALSO BEEN A HUGE STEEP INCREASE IN
THE EDDIE INTEGRATION OF SEEING WHAT THOSE PRESCRIPTIONS ARE FOR THOSE
HIGH-UTILIZEING PATIENTS. AND THEN THE QUERIES FOR —
THROUGH THE WEB PORTAL HAVE INCREASED SOME,
BUT NOT AS STEEPLY AS THE OTHER ONES.>>[INAUDIBLE]
>>THAT’S A GREAT QUESTION.>>– FIGURE OUT WHAT WAS GOING
ON ON THE PRIVATE SIDE.>>I DON’T RECALL THE EVENS TO
THAT QUESTION. I KNOW IT’S COMPLICATED AND
THEY’RE NOT REQUIRED TO INCLUDE THEIR
PRESCRIPTIONS. AND I DON’T WANT TO MISSTEP IF I
REMEMBER IT INCORRECTLY. LET US GET BACK TO YOU WITH
THAT. ONE THING I WANTED TO MENTION IS
THERE WAS A SURVEY OF PRESCRIBERS FOR THE PDMP, AND
THE TOP TWO BARRIERS TO PDMPs WERE TIME, 72% SAID I DON’T USE
IT BECAUSE I DON’T HAVE TIME TO GO IN AND TO THE WEB PORTAL AND
CLICK EVERYTHING. AND THE SECOND TOP AREA WAS
FORGOTTEN PASSWORD, 59% SAID I DON’T USE
IT BECAUSE SOMETIMES I FORGOT MY PASSWORD.
INTEGRATING INTO THE WORK FLOW, HAVING A BUTTON IN YOUR
ELECTRONIC HEALTH RECORD WHEN YOU’RE LOOKING AT A PARTICULAR PATIENT TO PUSH AND GET THEIR
PDMP RECORD IS — REDUCES PROVIDER
BURDEN, ADDRESSES THOSE BARRIERS, AND I THINK HELPS WITH SOME OF OUR — IN A
SMALL WAY WITH PROVIDER BURNOUT, AT LEAST
WE CAN HELP THEM MAKE SURE THEY GET THE
DATA THEY NEED.>>AND THEN THERE’S BETTER CARE.
>>AND THEN THERE’S BETTER CARE, THANK YOU. THE WHOLE POINT OF THE PDMP IS
TO ENSURE THAT PRESCRIPTION — PRESCRIBERS HAVE THE INFORMATION
THEY NEED TO MAKE THE RIGHT DECISION.>>ANY OTHER QUESTIONS ON ANY OF
THE 2018 WORK BEFORE WE TALK ABOUT
2019? OR ANY OTHER QUESTIONS?
IT’S BEEN A GOOD DISCUSSION SO FAR.
GREAT. WE’LL JUMP INTO OUR 2019
PRIORITIES. WE’RE GOING TO GO THROUGH I
THINK ALL BUT ONE OF THESE IN A ALSO BIT MORE DETAIL, AND THEN
WE’LL COME BACK TO THE SLIDE AT THE END.
I WON’T SPEND A LOT OF TIME GOING OVER IT, I THINK WE’LL
TALK ABOUT ALL OF THESE EXCEPT FOR THE ONE ON DASHBOARDS AND
MILESTONES, BUT WE’LL COVER THAT.
SO WE’LL JUST YUMP INTO THE 2019 PRIORITIES WITH AMY TALKING
ABOUT THE SOCIAL DETERMINANTS OF HEALTH.
>>I THINK ONE OF THE IMPORTANT THINGS — THIS IS A NEW AREA OF
FOCUS FOR HITOC, FOR 2019. WE TOUCHED ON IT A LITTLE BIT IN
2018. AND WE’VE HAD SOME INITIAL
DISCUSSIONS. ONE OF THE AREAS WHERE IT’S
CRITICAL IS REALLY TO NUMBER ONE, BE ABLE TO
CAPTURE AND PUT THE DATA IN SOME KIND OF ELECTRONIC FORMAT. AND THEN ONCE THAT DATA IS
THERE, WE CAN HELP COORDINATE CARE BETWEEN
PROVIDERS AND SOCIAL DETERMINANTS OF HEALTH
ORGANIZATIONS WITH IDEALLY THE IDEA BEING THAT WE CAN ACTUALLY
HAVE SOME KIND OF HEALTH INFORMATION
EXCHANGE BETWEEN THOSE ORGANIZATIONS.
THE HIT TOOLS ARE ALSO USEFUL FOR MANAGING THE REFERRALS FOR
ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH. AND THEN EVENTUALLY USING THAT
DATA FOR RISK MODELING AND POPULATION
MANAGEMENT. FOR 2019, HITOC IS GOING TO BE
HAVING A PANEL DISCUSSION WITH ORGANIZATIONS PILOTING THE HIT
FOR THAT SOCIAL DETERMINANTS OF HEALTH WORK. REALLY TO HELP US UNDERSTAND
WHAT ARE THE CURRENT EFFORTS, AND THEN
WHAT OUR POTENTIAL ROLE IS IN THE FUTURE. HITOC IS CONSIDERING THE
RECOMMENDATIONS FOR FUTURE WORK, POSSIBLY
THROUGH A WORK GROUP, AND IT MAY ALSO BE
INCLUDED IN A STRATEGIC PLAN UPDATE FOR 2019.
>>DO YOU HAVE A CANDIDATE LIST OF SOCIAL DETERMINANTS OF HEALTH
[INDISCERNIBLE]>>RIGHT NOW WE’RE NOT
CONSIDERING ADDING A NEW SYSTEM TO COLLECT
DATA. WHAT WE’RE LOOKING AT ARE WHAT
ARE THE ASSESSMENTS THAT ARE CURRENTLY BEING USED, THERE ARE
SEVERAL DIFFERENT ONES WE’VE HEARD OF.
SOME OF WHICH ARE INTEGRATED INTO THE ELECTRONIC HEALTH
RECORDS. WHICH IS REALLY EXCITING.
BEING ABLE TO CROSSWALK THE DATA IN THOSE ASSESSMENTS TO CODES OR
STRUCTURED DATA, INCLUDING SOMETHING CALLED
Z CODES. THAT ALLOWS FOLKS TO TAKE DATA
IN AND TRANSFER IT TO ANOTHER SYSTEM AND IT COULD BE
ENTEPRENEUR RED THAT, YOU COULD COLLECT IT AND INTERPRET IT AND
ANALYZE IT. SO WHAT WE’RE LOOKING AT IS WHAT
IS ALREADY HAPPENING, IS THERE A NEAT TO COME TOGETHER AROUND
ALIGNING CODE SETS, OR SPREADING BEST PRACTICES FOR SPECIFIC
TOOLS, SO WE’RE REALLY JUST STARTING TO GET THE LAY OF THE
LAND. WE APPROACH DEVELOPING A NEW
DATA SYSTEM VERY CAREFULLY. IT TAKES US A LONG TIME TO DO
ANYTHING LIKE THAT. SO –>>[INDISCERNIBLE]>>ONE OF THE OTHER THINGS
THAT’S CHALLENGING IS TECHNOLOGY QUESTION, OR IS IT A CLINICAL INNOVATION OR
QUESTION THAT WOULD GO — OR AN ANALYTIC QUESTION THAT WOULD GO
TO A DIFFERENT ORGANIZATION WITHIN OHA?
SO ONE OF THE THINGS WE’RE DOING IN OHA IS WE HAVE A SOCIAL
DETERMINANTS WORK GROUP ACROSS STAFF SO WE MAKE SURE WE DON’T
TAKE ON SOMETHING IF IT NEEDS TO BE IN A DIFFERENT OFFICE. SO IT’S POSSIBLE CODE SETS AND
ALIGNING AROUND CODEFINITIONS IS SOMETHING THAT WAS IMPORTANT,
THAT MIGHT FALL TO HITOC OR HIT. IT MIGHT LAND SOMEWHERE ELSE.>>[INDISCERNIBLE]
>>THE OTHER CONCERN THAT HAS BEEN BROUGHT UP, WE KNOW IS AROUND A
TRUST FRAMEWORK FOR SHARING INFORMATION.
SO SOCIAL DETERMINANTS OF HEALTH PROVIDERS ARE TYPICALLY NOT
HIPAA COVERED ENTITIES, SO WHAT IS THE CONSENT NEEDED TO BE ABLE TO CAPTURE
THIS INFORMATION AND SHARE SOMETHING WITH A PHYSICAL HEALTH
PROVIDER FOR THEIR PATIENT? THAT’S SOMETHING WE’VE ALSO —
ALSO BEEN ASKED TO TAKE SERIOUSLY AND GET THINKING ABOUT
SOON ERA THEY’RE THAN LATER. THOSE ARE TWO THINGS THAT HAVE
COME UP SO FAR. [INDISCERNIBLE]>>STARTING.
>>IT’S A CHALLENGE, AND WE’VE HEARD THIS, WE MET WITH ONE
ORGANIZATION, WE’RE BUILDING OUT A CONNECTION,
CCOs FOR REFERRAL. THEY EMPHASIZE, THEY’VE TON WORK
— THIS IS COMMUNITY BY COMMUNITY, BECAUSE EVERY
COMMUNITY HAS A DIFFERENT SET OF RESOURCES AND DIFFERENT REFERRAL
PATTERN, SO YOU HAVE TO BUILD THIS ON THE TBROWND IF YOU WANT
TO GET IT RIGHT AND MAKE SURE. BUT THAT MAKES IT ALL THE MORE
COMPLICATED.>>AND WHEN WE HAVE OVERLAPPING
[INDISCERNIBLE]>>YOU CAN GET HOUSING, CRIMINAL JUSTICE, [INDISCERNIBLE]>>I WORK ON THE FRINGES OF THIS — THE PRIVACY ISSUES HERE ARE
REALLY DAUNTING. AND YOU CAN IMAGINE SOMEONE
MIGHT SAY — I DON’T WANT HOSPITAL EMERGENCY ROOMS TO KNOW
ANYTHING ABOUT ME. WHAT IS THE INDIVIDUAL’S PRIVACY
RIGHTS VERSUS THE SYSTEM’S RIGHTS TO [INDISCERNIBLE] NIECE ARE VERY, VERY TRICKY
ISSUES. I HOPE THEY MODERNIZE HIPAA.
HERE YOU HAVE SOMETHING STRUGGLING ON HOW TO SUPPORT THE SCHOOL. [INDISCERNIBLE]>>I THINK ONE ADDITIONAL ROLE
ALSO IS FOR CLIENTS TO ACTUALLY UTILIZE
SOMETHING THROUGH INFORMATION TECHNOLOGY TO ACCESS RESOURCES. SO IF YOU HAD COMMUNITY LEVEL
RESOURCES THAT SOMEONE AS WE GET TO THE
NEXT SLIDE AROUND EXPLORING PATIENT
ENGAGEMENT, IN CHICAGO THEY HAVE — THEY GO
THROUGH THEIR PATIENT PORTAL INTO THEIR ELECTRONIC HEALTH
RECORD AND THEN CAN LINK TO RESOURCES THAT ARE
CONSTANTLY UPDATING ELECTRONICALLY INSTEAD OF GOING
TO THE SOCIAL WORKER’S OFFICE AND PULLING THE PURPLE BINDER OFF
THE SHELF.>>I THINK OUR CHALLENGE IN THIS
AREA WILL BE WHERE DO WE FOCUS ONCE WE HAVE MORE OF THE LAY OF
THE LAND. I THINK IT’S SO NEW, THERE’S SO
MANY EXCITING THINGS HAPPENING. WE WANT TO BE JUDICIOUS ABOUT
WHAT WE FOCUS ON SO THAT WE’RE ADDING
VALUE. AND GETTING AT THINGS THAT ARE
URGENT .>>SO IN 2019 HITOC PROPOSES TO
DIVE MORE DEEPLY INTO THE PATIENT EXPERIENCE WITH HEALTH INFORMATION
TECHNOLOGY. THERE’S DEFINITELY HUGE VALUE
THAT HIT CAN BRING PATIENTS TO IMPROVE
THEIR HEALTH. THERE’S BOTH IMPROVING PATIENT
ENGAGEMENT WITH THE CARE TEAM, THROUGH THE PORTAL THAT WE TALKED ABOUT.
THINGS LIKE SCHEDULING, DIRECT MESSAGING WITH YOUR PATIENT CARE TEAM, IT
ALSO HELPS PATIENTS COLLECT AND TRACK THEIR OWN HEALTH INFORMATION, SO BEING
ABLE TO SEE NOTES, LABS, X-RAYS, REMIND
A PATIENT REMINDING THEMSELVES OF SOMETHING THEY WANTEDDED TO
ASK ABOUT FROM A PRIOR VISIT. HITOC’S WORK SO FAR HAS INCLUDED SUPPORTING OPEN NOTES, WHICH IS
WHERE PROVIDERS CONFIGURE THEIR PORTAL SO THAT THE PATIENTS CAN ACTUALLY SEE
THE FULL TEXT OF THE NOTE FROM THE VISIT.
WE’VE EXPLORED HIT FOR PATIENT ENGAGEMENT AS PART OF CCO 2. 0, AND THEN WE’VE ALSO INCREASED
ON HITOC THE CONSUMER
REPRESENTATION. FOR 2019, HITOC WORK, WE’RE
HAVING A PANEL DISCUSSION WITH MULTIPLE ORGANIZATIONS TO BETTER
UNDERSTAND CURRENT EFFORT AND HITOC’S
POSSIBLE ROLE.>>[INDISCERNIBLE] THE RULES I THINK NEED TO BE
LOOKED AT. THERE’S RESTRICTIONS ON SHARING
SCREEN SHOTS. YOU CAN UNDERSTAND THAT. WHEN IT’S ABOUT PATIENTS, WHICH
LOOK ON THE SCREEN WORKS BEST? COMMUNICATING WITH PATIENTS,
YOU’RE GOING TO HAVE TO COMMUNICATE MORE BROADLY. MEASURING OF COURSE HOW WELL
THIS IS WORKING FOR PATIENTS, CREATES A WHOLE METRIC ISSUE
WHICH WE’RE BEGINNING TO WADE INTO, AND NOT SURPRISINGLY
FIND DISAPPOINTING RESULTS. IT’S ONE THING TO TURN OPEN
NOTES ON, IT’S ANOTHER THING FOR PATIENTS TO BE ABLE TO FIND
THEIR NOTES. AND OF COURSE THERE’S SOME
MEMBERS WHO GO, I DON’T CARE ABOUT NOTES.
I’M NOT GOING TO SPEND ANY TIME OR MONEY ON THAT.
AT WHAT POINT DO THEY BECOME ACCOUNT SENATE BILL SO I THINK — I’D
URGE YOU AS YOU LOOK AT YOUR ENGAGEMENT
PROCESS, [INDISCERNIBLE] THEY’RE NOT USED
TO THAT. THERE ARE CUSTOMERS THAT HAVE
BEEN [INDISCERNIBLE]>>I THINK WE’LL HAVE MORE
BUY-IN ALSO IN THE FUTURE AS SOMEONE TOLD ME RECENTLY, PATIENTS ARE YOUR
CHEAPEST EMPLOYEE, RIGHT, SO AS PATIENTS ARE PUTTING IN THEIR
OWN INFORMATION AND THE SYSTEM CAN INGEST THAT
INFORMATION, THAT’S FREE LABOR AND IT’S MORE ACCURATE DATA.
SO I THINK THAT WILL BE HELPFUL.>>OKAY.
THE THIRD AREA THAT WE’RE FOCUSING ON OR — IN 2019 IS
WRAPPING UP SOME OF OUR BEHAVIORAL HEALTH, HEALTH I.T.
WORK. WE UNDERTOOK A SCAN SURVEY OF
BEHAVIORAL HEALTH AGENCIES AND ALSO
FOLLOW-UP INTERVIEWS TO GET MORE IN-DEPTH INFORMATION. THOSE RESULTS CAME TO HITOC AND
HITOC REQUESTED THAT WE CONVENE A BEHAVIORAL HEALTH WORK GROUP
OF EXPERTS TO PRIORITIZE WHAT WE DO WE NEED TO
DO MOVING FORWARD. SO THAT WORK GROUP BROUGHT ITS
RECOMMENDATIONS TO HITOC IN 2018. AND THEN HITOC EXPECTS TO
CONVENE THE BEHAVIORAL HEALTH WORK GROUP TO
STAGE AND HELP ADVISE OHA ON THE FEASIBILITY OF SOME OF THOSE
RECOMMENDATIONS. AND DEVELOP A WORK PLAN THAT
WILL COME BACK TO HITOC. AT WHICH POINT HITOC WOULD MOVE
INTO ITS OVERSIGHT ROLE AND REALLY OVERSEEING THE WORK UNDER
THAT AND GETTING REPORTS ON THAT — ON THOSE STRATEGIES. SO THE IT’S POSSIBLE IF WE DO A
2019 STRATEGIC PLAN UPDATE IT WOULD COME BACK TO THIS BODY, WE
MAY WANT TO INCLUDE FURTHER DETAILS ABOUT THE BEHAVIORAL
HEALTH STRATEGIES, WE MAY WANT TO HOLD THAT UPDATE UNTIL NEXT
YEAR IF WE DON’T HAVE ENOUGH SUBSTANTIVE THINGS.
I WANTED TO SHARE A FEW QUICK RESULTS FROM OUR BEHAVIORAL HEALTH SCAN. WE SURVEYED ALLY SENSED
BEHAVIORAL HEALTH AGENCIES, SO AGENCIES
THAT HAVE A LICENSE BEHAVIORAL HEALTH PROGRAM IN OREGON, THIS DOESN’T INCLUDE
YOUR MENTAL HEALTH COUNSELORS THAT AREN’T LICENSED FOR —
THROUGH THE STATE OR WHAT HAVE YOU, SO IT’S LICENSED BEHAVIORAL
HEALTH AGENCIES. WE HAD ABOUT A HALF — 50%
RESPONSE RATE, OR CLOSE TO THATMENT WE FOUND THAT 76% OF
AGENCIES HAD SOME KIND OF ELECTRONIC HEALTH RECORD. MANY OF THEM WERE NOT USING THAT
FOR ALL THEIR WORK, HOWEVER. MANY OF THEM ALSO HAD PAPER
PROCESSES. SO WE CALLED THEM PARTIALLY
IMPLEMENTED. THESE WEREN’T NECESSARILY
CERTIFIED ELECTRONIC HEALTH RECORDS THAT MEET FEDERAL STANDARDS FOR INNER
OPERABILITY AND OTHER FUNCTIONALITY.
OF THOSE THAT HAVE AN ELECTRONIC HEALTH RECORD, THEY ARE CHALLENGED BY
FINANCIAL COSTS AND INABILITY TO EXCHANGE INFORMATION.
OF THOSE WHO DON’T HAVE AN ELECTRONIC HEALTH RECORD, THEY
WERE MOSTLY SMALLER ORGANIZATIONS AND THEIR B
BARRIERS CAME DOWN TO MOSTLY RESOURCES.
WE ALSO ASKED ABOUT HEALTH INFORMATION EXCHANGE. AND FOUND THAT THE WAY THE SLIDE
IS ORGANIZED, THE MORE PAPER
PROCESSES OR LESS ELECTRONIC ARE ON THE BOTTOM, AND THE MORE EXCHANGE THROUGH
ELECTRONIC MECHANISMS ARE AT THE TOP. THE ORANGE AND YELLOW ARE
AGENCIES THAT USE THAT METHOD, SOME OR MOST OF THE TIME.
AND THE BLUE IS NONE OF THE TIME.
SO YOU CAN SEE IF YOU BLUR YOUR EYES, THAT MOST PEOPLE ARE USING
NONELECTRONIC METHODS TO EXCHANGE INFORMATION.
AND MOST ARE NOT USING ANY REAL SUBSTANTIVE ELECTRONIC METHODS,
LIKE PREMANAGE, HEALTH INFORMATION EXCHANGE, EPIC CARE
EVERYWHERE, OR SHARED ELECTRONIC HEALTH RECORD.
SO WE DO HAVE SOME USING DIRECT SECURE MESSAGING WHICH IS A
HIPAA COMPLAINT SECURE EMAIL. AND WE HAVE SOME USING SECURE
EMAIL, BUT MANY ARE FAX, E-FACTS AND EVEN
PAPER. SO THIS IS JUST A SNAPSHOT OF
SOME OF WHAT WE’RE TALKING ABOUT WITH THAT DIGITAL DIVIDE.
THAT FEW OF OUR LICENSED BEHAVIORAL HEALTH AGENCIES HAVE
ROBUST ELECTRONIC MEANS TO EXCHANGE INFORMATION.
>>I THINK THE OTHER INTERESTING THING IN THE BEHAVIORAL HEALTH
WORLD TO HIGHLIGHT IS THAT WE’VE TALKED A LOT ABOUT THE [INDISCERNIBLE]
THEY’RE GENERALLY — THERE’S 30, 40, 50
DIFFERENT SYSTEMS IN THAT ENVIRONMENT.
THERE’S NOT AN EPIC BIT THAT EVERYBODY IS ON.
SO IF YOU LOOK AT THE MEDICAL SIDE, WE HAVE SUCH A HUGE PRESENCE,
PEOPLE COULD USE CARE EVERYWHERE AND START TO SHARE STUFF
READILY. EVEN IN THE BEHAVIORAL HEALTH
WORLD, EVEN WHERE THERE IS ADOPTION, IT’S NOT NECESSARILY THAT SYSTEMS
INTEGRATE WELL OR CAN TALK TO EACH OTHER WELL.
IT FURTHER COMPLICATES THE SHARING OF INFORMATION.
>>IS THAT A FINANCIAL BARRIER FOR EPIC IMPLEMENTATION?>>PART OF THE CHALLENGE IS THE
NEEDS OF BEHAVIORAL HEALTH AGENCY HAS FOR RECORDS DON’T FIT
WELL IN THE MEDICAL HRs BECAUSE THEY’RE LOOKING AT
LONGER-TERM CARE PLANNING, THEY’RE LOOKING AT PROGRESS
TOWARDS MEETING GOALS, SOME OF THOSE KINDS OF CHARTING THAT
THEY’RE DOING IN THEIR — FOR BEHAVIORAL HEALTH.
>>IT DOESN’T FIT –>>SOME ARE USING EPIC BUT NOT
WELL. THEY’RE STILL USING PAPER
PROCESSES OR WE EVEN HAVE ORGANIZATIONS THAT HAVE HALF,
THEY MIGHT HAVE MENTAL HEALTH ON AN ELECTRONIC HEALTH RECORD AND
THEIR SUBSTANCE USE TREATMENT ON PAPER OR A SEPARATE ELECTRONIC
HEALTH RECORD.>>IT LOOKS LIKE AN INCREDIBLE
BUSINESS OPPORTUNITY FOR EPIC. JUST OREGON.
>>IT’S MORE COMPLICATED. I’VE BEEN SURPRISEED AS — THE
CONCERNS THE MENTAL HEALTH FOLKS HAVE ABOUT THE PHYSICAL HEALTH
FOLKS SEEING THEIR RECORDS. WHEN EPIC DOES DO THIS, OR THE
BIGGER VENDORS DO THIS, THEY HAVE THESE BREAK THE GLASS
PROCESSES. SO THE PRIMARY CARE DOCTOR, I
WANT TO SEE A PSYCHIATRIST’S NOTE, I HAVE TO BREAK THE GLASS,
I CAN LOOK AT THE NOTE, BUT THERE’S A REPORT GOING TO THE PSYCHIATRIST AND OTHER PEOPLE
SAYING IT’S DOING SOMETHING HE SHOULDN’T BE DOING.
HE MAY BE DOING SOMETHING HE SHOULDN’T BE DOING. SO IT — WE’VE GOT THESE PRIVACY
ISSUES SOME MENTAL HEALTH PATIENTS DON’T WANT THEIR
PRIMARY CARE DOCTOR –>>SOME THINGS WE DO TO PROTECT
THE STIGMA OF — PREVENT THE STIGMA
OF MENTAL HEALTH CREATES A STIGMA.
>>THE BENEFITS ARE GREATER BUT IT VERY DIFFICULT TO CALM THE
PEOPLE WHO ARE WORRIED ABOUT THE RISK RISKS.
AND THEY’RE HYPOTHETICAL. I GO TO ORGANIZATIONS NOW
COMMONLY AND I ASK THEM, THE MEDICAL RECORDS —
THERE’S A PROCESS HERE WHERE WHEN
SOMEBODY ASKS FOR THEIR RECORD AND THEY HAVE METH RECORDS YOU HAVE TO CHECK WITH
THE MENTAL HEALTH CLINICIAN IF THEY WANT TO GIVE THEM A RECORD
OR A SUMMARY. HOW OFTEN DO THEY SAY SUMMARY?
THE ANSWER SO FAR HAS BEEN NEVER. SO IT’S THERE FOR A HYPOTHETICAL
BUT IT NEVER, OR VERY RARELY APPEARS TO BE USED.
>>THERE’S A SAME RESTRICTION AROUND HIV. [INDISCERNIBLE]>>THIS ISSUE AROUND PRIVACY
KEMPS CAME UP IN OUR TOP BARRIERS.
SO IF YOU GROUP THESE TOGETHER, THE TOP BARRIERS ARE AROUND
RESOURCES. AND PRIVACY. SO FINANCIAL COST IS NUMBER ONE,
THIS IS BARRIERS TO SHARING ELECTRONIC HEALTH INFORMATION, TWO, PRIVACY AND
SECURITY, TECHNICAL RESOURCES, SO
RESOURCES, CONCERNS OVER LIABILITY, BACK TO PRIVACY,
TECHNICAL INFRASTRUCTURE IS NOT ENABLED, REGULATION, ETC. SO A LOT OF WHAT WE HEARD, OUR
SURVEY AND OUR INTERVIEWS, AND WE HEAR ALL THE TIME FROM STAKEHOLDERS IS THE
RESTRICTIONS AROUND SUBSTANCE — SHARING SUBSTANCE USE TREATMENT
INFORMATION, THAT REQUIRE PROACTIVE CONSENT ARE CONFUSING, AND SO ORGANIZATIONS
HAVE — ARE UNCLEAR HOW TO NAVIGATE
THOSE REGULATIONS. AND EVEN WHEN THEY ARE CLEAR
ABOUT THEM, THAT’S — IT’S DIFFICULT TO MANAGE CONSENT AND
ALL OF THAT. A LOT OF TIMES MENTAL HEALTH AND
SUBSTOPS USE INFORMATION IS COME BIPARTISANNED, AND SO WHO THE
REQUIREMENTS APPLY TO CAN BE CHALLENGING.
ONE OF THE THINGS THAT WE’RE EXCITED TO DO IS WE’RE WORKING
ON A PROVIDER TOOL KIT AROUND 42 CFR PART TWO, SO
MODEL CONSENT FORM, AND FAQ AND SOME OF THAT, WORKING WITH OUR
BEHAVIORAL HEALTH POLICY UNIT AND OHAs.
WE’RE GETTING VERY CLOSE TO TYPELY RELEASING A DRAFT FOR
STAKEHOLDER REVIEW. THE TOP RECOMMENDATIONS OF THE
BEHAVIORAL HEALTH WORK GROUP AFTER LOOKING AT OUR SCAN DATA,
AND OUR INTERVIEWS, WAS TO SUPPORT
BEHAVIORAL HEALTH AGENCIES WITHOUT AN HR OR
INSUFFICIENT ONE, TO GET ONE. SO OUR WORK GROUP WAS CONCERNED
ABOUT THE DIGITAL DIVIDE AND ALSO CONCERNED ABOUT MAINTAINING
DIVERSITY IN THE BEHAVIORAL HEALTH PROVIDER COMMUNITY, SO YOU HAVE SMALL ORGANIZATIONS
THAT ARE REALLY EFFECTIVE WORKING WITH SPECIFIC
POPULATIONS. THOSE NEED TO BE SUPPORTED WITH
SUPPORTS AROUND ELECTRONIC HEALTH RECORDS AS WELL AS THE LARGER ORGANIZATION.
SECONDLY TO CONTINUE OUR EXISTING WORK ON HEALTH
INFORMATION EXCHANGE, WE PRIORITIZED BEHAVIORAL HEALTH
AGENCIES WITH THINGS LIKE PREMANAGE, AND
THEY’RE VERY EXCITED TO HAVE THOSE OPPORTUNITIES TO SEE
INFORMATION ACROSS PROVIDERS AND GET HOSPITAL EVENT INFORMATION,
FOR EXAMPLE. AND THERE’S RECOMMENDATIONS
AROUND ADDITIONAL STRATEGIES. BEHAVIORAL HEALTH AGENCIES AND
PROVIDERS WANT A BETTER UNDERSTANDING OF THE — WHAT IS
— WHAT DO I GET WITH MY ELECTRONIC HEALTH RECORD?
WHAT SHOULD I EXPECT? WHAT’S OUT THERE?
WHAT ARE THE OPTIONS AROUND HEALTH INFORMATION EXCHANGE?
A BETTER UNDERSTANDING OF THE LANDSCAPE AS WELL AS WHAT TOOLS ARE BEING
USED IN OREGON TO HELP AGENCIES NAVIGATE THIS.
AND THEN FOURTH IS MODERNIZING STATE REPORTING SYSTEMS TO ALLOW FOR
IMPROVED INTEROPENNABILITY. SOME WORK IS UNDERWAY IN SOME OF
THESE AREAS, INCLUDING OUR STATE REPORTING SYSTEMS.
THE BEHAVIORAL HEALTH AGENCIES ARE SUBJECT TO SIGNIFICANT
REPORTING REQUIREMENTS THAT NEED TO COME OUT OF THEIR ELECTRONIC OR CLINICAL
SYSTEMS, AND THEY TALKED A LOT ABOUT THE CHALLENGES OF
NAVIGATING WITH THEIR VENDORS AROUND THAT REPORTING.
SO OUR PROPOSAL IS TO CONTINUE THE WORK WITH THE BEHAVIORAL
HEALTH WORK GROUP, HAVE THEM HELP WORK PLAN OR ROAD
MAP FOR SOME OF THE SPECIFIC APPROACHES
UNDER THESE FOUR RECOMMENDATIONS.
WORKING WITH OHA STAFF ON FEASIBILITY, AND THEN KICKING
OFF SOME ADDITIONAL WORK.
ANYTHING ELSE ON BEHAVIORAL HEALTH BEFORE WE MOVE TO THE
NEXT AREA? OKAY.
THE LAST ONE WE WANTED TO COVER BEFORE WE REVIEW — TALK ABOUT
DASHBOARD AND REVIEW PRIORITIES IS CONTINUING THE WORK AROUND
STATEWIDE HEALTH INFORMATION EXCHANGE. AND OUR DIRECTION AROUND A
NETWORK OF NETWORKS. OUR GOAL IS THAT WE HAVE A
MINIMUM SET OF DATA AVAILABLE WHEREVER PATIENTS RECEIVE CARE
OR SERVICES ACROSS THE STATE. WE HAVE MANY DIFFERENT HEALTH
INFORMATION EXCHANGE EFFORTS GOING ON, WHICH WE CALL
NETWORKS. SO PREMANAGE AND EDIE IS ONE, WE
HAVE REGIONAL HEALTH INFORMATION EXCHANGES, EPIC-TO-EPIC, AND CARE EQUALITY
ACROSS DIFFERENT VENDORS. SO WE WANT TO BUILD ON THE
EXISTING HEALTH INFORMATION EXCHANGE INVESTMENTS AND CONNECT
AND COORDINATE ACROSS AMERICAS. AS WELL AS FILL GAPS, IF THERE
ARE GAPS, FOR FOLKS WHO DON’T HAVE ACCESS TO HEALTH
INFORMATION EXCHANGE. THIS WORK INCLUDES COORDINATING
STAKEHOLDERS TO DEVELOP THE NECESSARY FRAMEWORK, WORKING ON INNER
OPENABILITY, ENSURING — AND CONSIDERING
NEUTRAL ISSUE RESOLUTIONS. WE BEGAN THE WORK IN NETWORK OF
NETWORKS IN 2018 WITH A PANEL AT OUR
APRIL 2018 MEETING. WE CHARTERED, HITOC CHARTERED A
GROUP, OUR TECHNICAL DEFINITIONS GROUP COMPLETED ITS WORK IN FALL
OF 2018, THEIR FIRST RECOMMENDATION WAS DON’T CALL IT
A NETWORK OF NETWORKS. SO THIS TITLE MAY BE CHANGING AS
WE GET INTO THIS WORK. THEIR POINT WAS THAT NETWORKS
REALLY EXCHANGE INFORMATION IN
COORDINATING ACROSS NETWORKS IS ITSELF MAYBE NOT A NETWORK.
THAT MAY BE COORDINATION EFFORTS, THAT MAY BE POLICIES THAT MAY LOOK
LIKE SOMETHING THAT’S NOT ITSELF A
HUB.>>IT’S NOT ELECTRONIC.
>>THAT’S RIGHT. WHAT WE’RE DOING IS IDENTIFYING,
GIVEN ALL OF THE HEALTH INFORMATION EXCHANGE EFFORTS WE
HAVE IN OREGON, HOW DO WE BEST CONNECT AND COORDINATE ACROSS
THEM. AND THE ANSWER MAY BE THEY’RE
ALREADY CONNECTING TO EACH OTHER, SO WE NEED TO PROVIDE A
CONVENES ROLE AND THE RIGHT POLICIES.
SO –>>I WAS CONFUSED.
I THOUGHT ELECTRONIC WOULD BE SAYING NETWORK-TO-NETWORK.
>>EXACTLY. SO WE MAY BE CHANGING THE NAME.
WE HAVEN’T OFFICIALLY CHANGED IT YET.
THE OVERARCHING GOAL IS STATEWIDE HEALTH INFORMATION
EXCHANGE. HOW DO WE MAKE SURE WE’RE
ACHIEVING THAT. THE OTHER PART OF THE
RECOMMENDATIONS THAT HITOC AND OUR DEFINITIONS GROUP MADE WAS
TO FOCUS ON USE CASES. SO HIGH-VALUES CASES.
DON’T BITE OFF THE WHOLE APPLE, LOOK AT WHAT’S — WHERE IS THE
GREATEST OPPORTUNITY AND FOCUS ON
ADVANCING THAT. SO AN EXAMPLE OF THE USE CASE
WOULD BE CLOSED LOOP REFERRALS ACROSS PROVIDERS, SO THEY KNOW WHEN A REFERRAL HAS
BEEN RECEIVED AND A SERVICE HAS BEEN GIVEN.
THAT IMPACTS SOCIAL DETERMINANTS OF HEALTH AS WELL. ANOTHER USE CASE WOULD BE
CONFLICTS CARE UTILIZATION. MORE TO COME, SOME OF THE WORK
WILL BE IDENTIFYING THOSE — THAT USE CASE AND THEN DRILLING
DOWN TOWARDS SPECIFIC STRATEGIES.
WE PLAN TO CONTINUE THIS IMPORTANT WORK IN 2019. AND IDENTIFY THAT OUR NEXT
PROJECTS AND PARTNER IDEALLY WITH HIT COMMONS AROUND HOW THEY CAN HELP ADVANCE THIS
WORK.>>THIS IS THE 2019 PRIORITIES
WE’VE TALKED ABOUT THE TOP FOUR
BULLETS AS I MENTIONED EARLIER, WE ARE GOING TO DO WORK ON A
DASHBOARD THAT HAS THE CORE INDICATORS OF ARE WE MAKING
PROGRESS, ARE WE MAKING PROGRESS IN THE RIGHT PLACES, DO WE NEED
TO ADJUST CORE, SO THERE’S FOCUS ON THAT.
WE’LL ALSO EVALUATE IF WE WANT TO DO AN UPDATE TO THE STRATEGIC
PLAN DURING 2019, AS I MENTIONED AT THE BEGINNING WE FOCUSED ON 2017-20, BUT THERE
MAY BE AN OPPORTUNITY TO DO UPDATES IF WE WANT TO
INCORPORATE MORE OF THE SOCIAL DETERMINANTS OF HEALTH WORK, FOR
EXAMPLE, AS WE LEARN MORE ABOUT THAT.
SO WE’LL EVALUATE THAT DURING THE UPCOMING YEAR AS WELL.
I WANTED TO GET YOUR FEEDBACK, DOES THIS LOOK LIKE THE RIGHT
SET OF PRIORITIES BASED ON YOUR GOALS, AND ARE WE ON THE RIGHT
TRACK HERE. SO I WOULD BE INTERESTED IN
COMMENTS OR THOUGHTS.>>A QUESTION AROUND SYSTEM
INTEGRATION. WHETHER OR NOT THAT’S HITOC.>>ORAL HEALTH IS DEFINITELY A
PART OF OUR SCOPE. IT’S A KEY COMPONENT TO THE
STATEWIDE HEALTH INFORMATION EXCHANGE.
SO THE NETWORK OF NETWORKS IS REALLY LOOKING AT CONNECTING
ACROSS PHYSICAL BEHAVIORAL, AND ORAL HEALTH IN PARTICULAR.
AND THEN WE’RE EXPLORING THE SOCIAL DETERMINANTS PIECE.
WE’VE THOUGHT ABOUT DO WE NEED TO DO, LIKE WE DID A BEHAVIORAL
HEALTH WORK GROUP, DO WE NEED TO DO AN ORAL
HEALTH SCAN AND CONVENE THAT GROUP AS WELL? AND WE HAVE NOT COMMITTED TO
THAT YET. ORAL HEALTH PROVIDERS HAVE BEEN
ABLE TO PARTICIPATE IN FEDERAL INCENTIVES AROUND ELECTRONIC
HEALTH RECORD ADOPTION, WHERE BEHAVIORAL HEALTH PROVIDERS HAVE
NOT. SO IT WAS REALLY — BEHAVIORAL
HEALTH IS A MUCH MORE UNKNOWN AREA.
BUT I’D LOVE YOUR THOUGHTS ON ORAL HEALTH.>>I’D LOVE TO SEE THAT.>>WE DO HAVE ORAL REPUTATION ON
HITOC.>>I’M ALSO CURIOUS ABOUT A MORE
ACTIVE [INDISCERNIBLE] IS THERE SOMETHING A LITTLE BIT
MORE GUIDING ORIENTED, OR — I’M
LOOKING FOR THE [INDISCERNIBLE]>>WE WOULD LOVE TO COME BACK TO
THE POLICY BOARD AS WE GET INTO OUR EXPLORATORY WORK AND TELL
YOU WHAT WE THINK THE RIGHT FOCUS AREAS ARE AND GET FEEDBACK
FROM YOU ALL. WOULD YOU LIKE — WOULD THAT
MAKE — SO YOU SHOULD THINK ABOUT WHETHER YOU’D LIKE TO HAVE
US BACK. IT’S A BIG WORLD, THERE’S A LOT
OF POSSIBILITIES FOR HEALTH I.T. TO ADD VALUE AROUND SOCIAL
DETERMINANTS OF HEALTH. AND I THINK WE’LL HAVE — WE’VE
ALREADY HAD SOME THEMES ARISING, WE’LL HAVE SOME — MORE AS WE
GO. BUT I WOULD SAY MIDYEAR WE’D BE
ABLE TO COME BACK AND SAY, THIS IS WHERE WE THINK THE REAL BANG FOR THE BUCK
IS.>>[INDISCERNIBLE]
>>IS HEALTH EQUITY IN THE SUBSET OF SOCIAL DETERMINANTS –>>IT IS, YES.
>>I THINK IN CCO 2.0 WE’VE BEEN CONSISTENTISH IN TRYING TO USE
THE PHRASING SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY.
>>OKAY.>>SUSAN, THIS IS KARLA.
I’M ALWAYS IMPRESSED WITH THE WORK YOUR GROUP DOES.
JUST REALLY FEELS LIKE A VERY — YOU HAVE ACCOMPLISHED SO MUCH, AND
REALLY LIKE THE DIRECTION YOU’RE HEADED.
SO THANK YOU FOR THE GOOD WORK.>>THANK YOU.>>SINCE YOU USE THE TERM
DASHBOARD AND MILESTONES, YOU MENTIONED [INDISCERNIBLE]
ANOTHER THING I THINK THE VENDORS COULD DO IS GIVE YOU
DATA. EWE GOT THE PERMISSION OF ALL
THE EPIC CUSTOMERS IN OREGON,
ORGANIZATIONAL DATA OR DEFIED DATA AND YOU CAN START TO SEE,
HOW MANY NOTES ARE BEING OPENED? WHAT’S HAPPENING ACROSS THE
STATE? MAYBE YOU CAN CALL THE FOLKS UP
IN BRITISH COLUMBIA WHO I THINK ARE IMPLEMENTING EPIC ACROSS THE
PROVINCE. HOW DOES OREGON COMPARE TO EPIC
ELSEWHERE, IF THEY WOULD BE WILLING TO DO THAT? AND THEN OF COURSE EVENTUALLY,
THE OTHER VENDORS, THEY NEED TO COME INTO
— THEY NEED CONSISTENT DEFINITIONS IN
METRICS. SO YOU GET A SENSE OF, HOW [INDISCERNIBLE] WITHOUT
IDENTIFYING ANY SPECIFIC ORGANIZATION.
>>I KNOW EPIC HAS SOME INTERESTING SUMMARY DATA, WE’VE
SEEN AT LEAST FROM ONE SYSTEM THAT SHARED SOME OF THAT, IT
WOULD BE INTERESTING TO AGGREGATE IT.>>ALL RIGHT, WELL THANK YOU SO
MUCH FOR THE COMMENTS. AND I THINK WE’RE READY TO MOVE
INTO OUR LAST SECTION. ANY OTHER COMMENTS BEFORE WE DO
THAT?>>THANK YOU.>>IT LOOKS LIKE YOU’RE LEADING
THIS DISCUSSION. IS THAT CORRECT? [INDISCERNIBLE]>>I ACTUALLY THINK THE WORK OF
HITOC, IT’S AN EXCITING COMMITTEE, THEY NEED A LIAISON.
SOMETHING TO THINK ABOUT.>>THANKS, KARLA.
THIS IS JEFF SCROGGIN AND I’M GOING TO TALK A LITTLE BIT ABOUT
OUR COMMITTEE LIAISON STRUCTURE, DIAGRAM, DESIGN AND SOME OF THE
MORE INFORMATION WE ADDED INTO THE EARLIER POINT YOU MADE, I
WORKED WITH DR. MCKELVEY ON THIS, SO IF YOU HAVE A TOUGH
QUESTION, I’M GOING TO REFER IT TO THEM FOR INPUT AS WELL.
JUST TO PUT YOU BOTH ON NOTICE. FOLLOWING THE RETREAT I KIND OF
FOCUSED ON TWO COMPONENTS FOR THIS.
IDENTIFYING THE ROLES OF LIAISONS BETTER, AND IDENTIFYING
THE BOARD’S RELATIONSHIP TO ITS COMMITTEES AS WELL AS THE
PRIORITY WORK. AS YOU CAN SEE, I’VE LISTED THE COMMITTEES IN THEIR ACRONYM
FORM, BUT BELOW YOU CAN SEE THE ACRONYMS, THOSE ARE LINKS YOU
CAN GO DIRECTLY TO THE WEBSITE FOR ANY OF THOSE COMMITTEES. THEY’RE ALL STATUTORILY UNDER
THE OREGON HEALTH POLICY BOARD ONE WAY OR ANOTHER.
ADDITIONALLY, THE BOARD HAS STATUTORY AUTHORITY TO ESTABLISH
COMMITTEES THAT IT SEES FIT AND NECESSARY AND HAS ESTABLISHED A
HEALTH EQUITY COMMITTEE. SO THOUGH THAT’S NOT A STATUTORY
COMMITTEE, IT’S LISTED IN THE — ON THIS DIAGRAM FOR YOUR
WRETCHES AS THE HEALTH EQUITY COMMITTEE. I TRIED TO SHOW THE BOARD’S
PRIORITY POLICY FOCUS AREAS, THAT IT — AND THE RETREAT LAST
MONTH BY IDENTIFYING THEM IN GREEN.
SO I’VE GOT CHILDREN’S HEALTH IN A BOX AND HEALTH CARE COST, BENCH WORK
MARK IN A BOX, AND I HIGHLIGHTED THE HEALTH EQUITY COMMITTEE AND HEALTH
EQUITY MEASUREMENT COMMITTEE IN GREEN SO YOU CAN SEE THE
ALIGNMENT BETWEEN THE BOARD’S PRIORITY POLICY FOCUS AREAS AND
THESE COMMITTEES. THAT’S NOT TO SAY EACH ONE OF
THESE COMMITTEES IN BLUE DOESN’T ALSO WORK ON THE BOARD’S
PRIORITY COMMITTEE POLICY. WE PUT A BOX AROUND THIS TO BE
CLEAR THAT OHA STAFFS THESE COMMITTEES FOR THE MOST PART AND
LEAVES THE STAFFING AND — LEADS THE STAFFING AND COORDINATION.
YOU’RE OVERSIGHT OVER THEIR DEVELOPMENT SO YOU CAN SEE YOUR
ROLE IN THAT OAF SIGHT WITH THE OREGON HEALTH AUTHORITY.
ALSO PUT THE OREGON HEALTH AUTHORITY AS THE LINK BETWEEN
THE CHILDREN’S HEALTH WORK AND THE HEALTH CARE COST
SUSTAINABILITY WORK. I THINK THIS WILL BECOME MORE
FLESHED OUT AS WE PROGRESS IN THE SESSION AND WORK PLANS COME
FORWARD, THIS THERE MAY BE BODIES THAT ARE IDENTIFIED THAT
WE WANT TO HAVE LEEEE SONS TO, BUT
RIGHT NOW THOSE BODIES HAVEN’T BEEN IDENTIFIED OR ESTABLISHED.
AND THEN LAST THING I WANTED TO SHARE I HAVE THE METRIC AND
SCORING COMMITTEE ON THIS DIAGRAM, EVEN THOUGH IT DOESN’T
REPORT DIRECTLY TO THE BOARD, THEY ARE — WORK WITH THE HEALTH
PLAN QUALITY METRICS COMMITTEE. IT’S A BACK AND FORTH
RELATIONSHIP THOUGH I THINK IN STATUTE THE METRICS COMMITTEE
HAS OVERSIGHT OVER THE METRICS AND SCORING COMMITTEE.
I ALSO WANTED TO CLEARLY SHOW WHERE THE HEALTH EQUITY
MEASUREMENT WORK IS IN THIS WORK.
YOU CAN SEE IT’S TIED IN THROUGH THE METRICS AND SCORING
COMMITTEE, HEALTH PLAN QUALITY METRICS COMMITTEE, HEALTH EQUITY
COMMITTEE, AND PUBLIC HEALTH ADVISORY BOARD, WHICH WE DO THAT
BY MAKING SURE THERE ARE COMMITTEE MEMBERS ON THOSE
COMMITTEES IN THIS COMMITTEE. SO EACH ONE OF THOSE COMMITTEES
HAS SOME BUY-IN AND MEMBERS WHO ARE ABLE TO COMMUNICATE DIRECTLY
ABOUT THE WORK THAT IS BEING DONE.
SO THE WORK THAT LEE ANN BRIEFED THIS MORNING IS THAT WORKERS.
IS THERE ANY QUESTIONS ABOUT THE DIAGRAM?
>>[INDISCERNIBLE]>>YEAH, EARLY LEARNING COUNCIL
IS A PUBLIC — THE BOARD HAS BEEN INVOLVED WITH IN THE PAST
AND THERE MAY BE JOINT MEETINGS, THERE IS A PRESENTATION WE
TALKED ABOUT AND SHARE SOME OF THE WORK.
BUT I DIDN’T WANT TO SAY THE EARLY LEARNING COUNCIL IS
STAFFED BY THE OREGON HEALTH AUTHORITY.
WE WORK WITH THE EARLY LEARNING COUNCIL, BUT OBVIOUSLY IT’S NOT
STAFFED DIRECTLY. SO IT’S OFF TO THE SIDE THERE
AND COORDINATED FASHION. AND I ASSUME THAT WILL BE A KEY
COMPONENT OF THE CHILDREN’S HEALTH WORK PLAN.
>>IT WOULD BE FAIR TO SAY THAT’S — THAT LINKAGE IS CALLED
OUT BECAUSE OF THE CHILDREN’S HEALTH EMPHASIS, THERE ARE OTHER SIMILAR INDIRECT
LINKAGES THAT AREN’T CALLED OUT BECAUSE THEY’RE NOT KEY TO
[INDISCERNIBLE]>>VERY MUCH SO. THERE’S LOTS OF THOSE .
>>I THINK EVENTUALLY THERE WILL BE A MEASUREMENT PIECE IN THE
HEALTH CARE COST.>>OH, YES.
>>IT WOULD BE A REALLY IMPORTANT PIECE.
YOU KIND OF DEALT WITH THAT IN TERMS OF THE EQUITY, HOW YOU —
EVENTUALLY THERE’S GOING TO NEED TO BE THAT KIND OF DOTTED LINE CONNECTING COST TO
THE MEASUREMENT PROCESSES.>>ABSOLUTELY.
I THINK THAT’S RIGHT. WE’LL HAVE ARROWS AND DOTTED
LINES. I’M GOING TO FRIENDSHIP IT OAF,
UNLESS THERE’S OTHER QUESTIONS ABOUT THE DIAGRAM.
NEXT TIME IT WILL BE PRINTED ON A 3D PRINTER SO YOU CAN SEE ALL
THE DIMENSIONS. [LAUGHTER]
>>THERE’S YET APP EVEN MORE [INDISCERNIBLE] BLOW IT UP [INDISCERNIBLE] SHOW THE WHOLE WEB OF HOW THE
WORK GETS DONE. FROM POLICY TO DELIVERY.
>>AND WE CAN SHARE THAT GRAPHIC WITH THE BOARD. THE ONLY OTHER THING I’D MENTION
ABOUT THE FIRST PAGE, WE TRIED TO LIST THE CURRENT LIAISONS
THERE. AND THERE’S SOME TO BE
DETERMINED, NOT APPLICANT. IF YOU FLIP IT OVER, I WORKED
WITH SCAR LA ABOUT — KARLA, DR. MCKELVEY, AND SHE IN HER HOLE
AND MARC OVERBECK AS THE LEAD STAFF OF THAT COMMITTEE ON WHAT
WOULD BE IMPROVED LAPPING WANT FOR THIS SECTION OF THE
STRUCTURE AROUND WHAT THE EXPECTATIONS IS FOR LIAISONS. I WON’T READ THIS VERBATIM BUT
I’LL CALL OUT KEY COMPONENTS. WE USUALLY TRY AND USE CONSENSUS
TO ESTABLISH THESE. IF YOU DON’T WANT TO DO IT, YOU
WOULD BE THE WRONG PERSON TO DO IT. WE WANT COMMITTEE CHAIRS AND OHA
STAFF TO WORK WITH BOARD LIAISONS TO
IDENTIFY WHAT WORKS BEST WITH THE LIAISON AND COMMITTEE.
WE DIDN’T ESTABLISH AN INFLEXIBLE STRUCTURE BECAUSE WE
THINK IT’S DIFFERENT BY COMMITTEE.
WHAT THE PUBLIC HEALTH ADVISORY BOARD IS DIFFERENT NEEDS FROM
ITS BOARD LIAISON IS DIFFERENT THAN WHAT THE HEALTH PLAN
QUALITY METRICS NEEDS FROM ITS LIAISON, WHICH IS DIFFERENT THAN
WHAT THE HEALTH CARE WORK FORCE COMMITTEE NEEDS FROM ITS
LIAISON. SOME OF THE THINGS THEY NEED ARE
SIMILAR. ONE OF THE THINGS THAT’S JUST
LOGISTICAL IS MEETING SCHEDULES TO ALLOW BOARD MEMBERS TO TAKE
PART. COMMITTEES THE BOARD WILL WORK
WITH BOARD LIAISONS TO DETERMINE A CADENCE AND MEETING SCHEDULE
THAT WORKS FOR COMMITTEE MEETINGS — AND THE BOARD MEMBER
WHO IS A LIAISON. WE WANT TO BE REALLY CLEAR, THE
EXPECTATION IS NOT THAT BOARD MEMBERS OF LEE SAY ONS ARE
COMMITTING TO TIME COMMITMENT THEY DON’T KNOW ABOUT.
THE IDEA IS YOU’LL BE ABLE TO WORK WITH THAT COMMITTEE TO
DETERMINE NOT JUST THE SUBSTANCE OF YOUR PARTICIPATION, BUT ALSO
THE LOGISTICAL COMPONENT OF YOUR PARTICIPATION.
AND MOST OF THE COMMITTEES THIS HAS WORKED WELL, AND IT’S WORKED
WITH EL FOR OUR BOARD LIAISONS. SOME OF THE ROLES THAT THE
LIAISON SHOULD HAVE IN THE BELT POINTS,
ATTEND IN PERSON OR BY PHONE, AND DO
REGULAR UPDATES TO THE BOARD REGARDING THE COMMITTEE THAT THEY’RE LIAISON,
AND PARTICIPATE IN SOME OF THE
HIGHER LEVEL DELIVERABLE PLANNING FOR THE COMMITTEE, LIKE
A CHARTER OR THE WORK PLANS, TO ENSURE THAT THOSE COMMITTEES ARE
ADDRESSING THE BOARD’S PRIORITIES IN THEIR LONG-RANGE
PLANNING. WE HAVE ANOTHER BULLET AROUND
PROVIDING OTHER UPDATES REGARDING ANYTHING
OF SUBSTANCE TO THE LIAISON WITH THE CHAIR.
SO THERE’S ALWAYS AN OPPORTUNITY FOR YOU AS A BOARD LIAISON TO
REACH OUT TO THE CHAIR OF THE BOARD AND SAY, I’VE NOTICED
THIS, OR I WAS WONDERING ABOUT THIS.
THE CHAIR IS OPEN TO HEARING AND SPEAKING FOR KARLA — I’M
SPEAKING FOR KARLA NOW, ANY ISSUES YOU’D LIKE TO IDENTIFY FOR THE BOARD’S
PURVIEW. I THINK THAT’S ALL I WANT TO
HIGHLIGHT ON THE BACK OF THIS PAGE.
WE USED TO HAVE A STRUCTURE WHERE MAYBE THERE WAS A
DIFFERENCE BETWEEN A LIAISON AND QUOTE, UNQUOTE, MONITOR.
I THINK THAT RESULTED IN CONFUSION.
WHAT WE’VE DOP IS ERASE THAT MONITOR ROLE AND SAY THERE’S A
LESION THAT’S FLEXIBLE TO MEET THE NEEDS OF THE LIAISON, THE
BOARD, AND THE COMMITTEE.>>[INDISCERNIBLE]
>>NOW I’M SO TEMPTED. I KNOW THE BOARD DISCUSSED AT
THE RETREAT MORE IDENTIFICATION OF
COMMITTEES AND FURTHER DESCRIPTION OF THESE ROLES, AND
I DO THINK AT OUR NEXT RETREAT WE CAN TAKE A LONGER AMOUNT OF
TIME AND POTENTIALLY DO A MORE DELIBERATIVE PROCESS.
WE’VE CONTINUED TO DO SINCE WE ESTABLISHED THIS STRUCTURE IS
BUILD IT. THAT’S WHAT WE’RE CONTINUING TO
DO. I HAVE MORE DEFINITION AND
UPDATE THE DEFINITION AND CONTINUE TO FRANKLY PUSH BOARD
MEMBERS TOWARDS LIAISON ROLES THAT THEY FEEL THEY MIGHT BE
PRODUCTIVE IN.>>[INDISCERNIBLE] THE TWO-WAY
FLOW OF INFORMATION, TAKING INFORMATION
UP THAT OCCURS IN THIS BOARD AND SAY,
CCO 2.0 IS HAPPENING. TIME TO GET ON BOARD.
START THINKING ABOUT THIS. AND GENERATE A BUTCH OF
DISCUSSION. I THINK VERY VIGOROUS
DISCUSSION, BROUGHT IT UP — AND I THINK IF
THAT TWO-WAY FLOW INFORMATION IS IMPORTANT, BOTH TO SET THE
PRIORITY FOR COMMITTEES BUT ALSO TO BRING THAT UP FOR OUR
DELIBERATION.>>TO PROVIDE ONE OTHER UPDATE
ABOUT THE LANGUAGE, AFTER HAVING SOME BACK AND FORTH WITH OUR FORMER CHAIR ZEKE
AND RSMOZINDA, ARE YOU STILL ON THE LINE WITH US? SHE MIGHT HAVE HAD TO DROP OFF.
I THINK THERE’S A WILLNESS FOR THEM TO FIND A WAY TO
PARTICIPATE AS LEE 8 SOPS FOR THE HEALTH EQUITY COMMITTEE.
I THINK THEIR SCHEDULES ARE DEPEP DENT, AND THEY WANT TO
MAKE SURE IT WORKS AND THEY WANT TO BE CLEAR WITH THEIR ROLES AND
WHO IS BACKUP AND WHO IS PRIMARY.
BUT I THINK THEY’RE MOVING FORWARD IN THOSE ROLES SO LONG
AS WE CAN IDENTIFY THOSE THINGS.>>[INDISCERNIBLE]>>CORRECT.
AND I THINK WE’LL WORK WITH THE HEALTH EQUITY COMMITTEE TO
DETERMINE A DATE THAT WORKS BEST FOR EVERYBODY.
THAT SAID, I DON’T THINK WE’VE HAD A LOT MORE COMMITMENTS FOR
SOME OF THE OTHER COMMITTEES, OR THE OTHER ROLES AND
RESPONSIBILITIES, WHICH IS A TOUGHER PORT OF THE
CONVERSATION. I’M HAPPY TO TURN IT OAF TO DR. MCKELVEY.
>>[INDISCERNIBLE] BY WHAT STRUCTURE ARE YOU THINKING ABOUT
HELPING LINE UP THE ASSIGNMENTS FOR THOSE [INDISCERNIBLE]?>>PICK YOUR FAVORITE.
AND HAVE THEM WORK WITH THE COMMITTEE TO FIGURE OUT A TIME TO — IF
YOU’RE TRAVELING, THIS WOULD BE BY
PHONE, MAKE SURE [INDISCERNIBLE]
>>BEFORE WE GET EVEN FURTHER INTO THE ANSWER, I WANT TO CHECK AND SEE
IF — I WANTED TO SEE IF HE HAD A CHANCE TO REVIEW THIS OR HAD
ANY QUESTIONS ABOUT IT. OSCAR, ARE YOU WITH US?>>KARLA, DO YOU HAVE GUIDANCE
IN TERMS OF COMMUNICATION –>>SO I HAVE REACHED OUT TO THE
PEOPLE WHO HAVE INDICATED INTEREST.
AND I THINK WITH THE HEALTH EQUITY COMMITTEE THAT THE BIG BARRIER
HAS BEEN [INDISCERNIBLE] I THINK AS SOON AS WE RESOLVE THAT WE HAVE A LIAISON
AND A BACKUP LIAISON. I THINK WE PROBABLY HAVE A
BACKUP LIAISON FOR THE HEALTH CARE WORK FORCE COMMITTEE SO THAT PRIMARILY
LEAVES HITOC I THINK.>>IT MIGHT BE HELPFUL TO SEND
OUT TO THE FULL BOARD STERLING POINTE
DISERN FULL BOARD [INDISCERNIBLE]
>>I’LL DO THAT.>>THE COMMITTEE MEETING TIME IS
A BARRIER, IF THEY COULD LET US KNOW THAT.
SO WE COULD SEE WHAT WE CAN DO AROUND THAT.>>THE BENEFIT TO THESE
COMMITTEES REPORTING TO STATUTORILY IS YOU HAVE ROLE IN
WHEN AND HOW THEY MEET.>>THANK FOR SAYING THAT OUT
LOUD.>>I DON’T THINK WE NEED TO
IDENTIFY — THERE’S A LINE THAT SAYS THERE’S EXPECTATION THAT
EVERYBODY SERVES AS A LIAISON. BUT GIVEN THERE’S PROBABLY TWO
OTHER BODIES OF WORK THAT ARE GOING TO COME FORWARD, IT MAY NOT BE NECESSARY
TO DECIDE TODAY WHO IS GOING TO LIAISON.
I THINK THE ONLY ONE THAT IS OUTSTANDING THAT MAY BE SUITED
FOR A LIAISON ROLE AND HEALTH AND INFORMATION TOLL OVERSIGHT
COUNCIL.>>CAN WE SPEAK A LITTLE BIT ON
MAYBE [INDISCERNIBLE]>>[INDISCERNIBLE] IT SEEMS TO ME THE BETTER
STRUCTURE IS TO BE THE LIAISON TO THE STANDING COMMITTEES TO BRING TWO IN, TO
THOSE COMMITTEES THE PIECES THAT COME OUT OF THOSE BODIES OF
WORK. I THINK THOSE REPRESENT MORE
BODIES OF WORK THAN THEY DO ORGANIZATIONAL STRUCTURES.
>>IT SOUND LIKE HITOC IS GOING TO DO SOME REALLY IMPORTANT
STUFF OVER THE NEXT YEAR.>>QUESTION FOR JEFF ON HITOC. OR MAYBE IT’S JUST — THE NATURE OF BEING A LIAISON. DO YOU BELIEVE THE ROLE OF THE
LIAISON INHERENTLY LEADS ITSELF TO A PLACE WHERE THERE COULD BE
CONFLICTS OF INTEREST, OR BECAUSE IT’S A COMMUNICATION
ROLE IS THAT LESS LIKELY TO BE A CHALLENGE?
>>I THINK IT’S LESS LIKELY TO BE A CHALLENGE. SUE DONE, DO YOU HAVE A TAKE ON
IT?>>SINCE I’M HERE, I’LL MENTION
FOR HITOC, WHAT WE’VE REALLY ENJOYED WHEN WE HAD A LIAISON WAS HAVING SOMEONE
TALK ABOUT WHAT’S HAPPENING AT THE BOARD, SO GIVE THE DEBRIEF
FROM WHAT’S GOING ON AT THE BOARD, AND THEN CARING OR
THINKING ABOUT HEALTH I.T. DURING YOUR BOARD MEETINGS WHEN
YOU’RE MEETING. BECAUSE HEALTH I.T. IS SOMETHING THAT CAN SUPPORT
ALL SORTS OF PARTS OF SYSTEM TRANSFORMATION, AND IT’S
SOMETHING THAT FOLKS DON’T THINK ABOUT OR THINK ABOUT LATER OR
ASSUME THERE’S TECHNOLOGY IN PLACE. SO WHAT WE FOUND IS HAVING
SOMEBODY — OUR LIAISON KEEP HEALTH I.T. IN MIND AS YOU’RE
HEARING FROM OTHER COMMITTEES, OR YOU’RE THINKING ABOUT OTHER
WORK, CAN REALLY HELP US MAKE THOSE CONNECTIONS.
WE CERTAINLY TRY TO TRACK WHAT THE BOARD IS DOING. WE HAD OUR LIAISON, WE HAD A
HALF AN HOUR CHECK-IN MEETING WITH THAT LIAISON ONCE EVERY
OTHER MONTH AHEAD OF OUR HITOC MEETINGS.
AND SHE WAS OFTEN UNABLE TO ATTEND IN PERSON, SHE’D CALL IN
OR WE WOULD TALK IN THAT PREMEETING ABOUT WHAT PARTS IN
THAT MEETING WERE REALLY IMPORTANT FOR HER TO STAY ON THE
PHONE FOR, IF SHE HAD OTHER PRIORITIES.
SO I THINK FOR HITOC IT’S — I THINK IT’S A LOW LIFT IN TERMS
OF BEING THE LIAISON. AGAIN, WHEN WE’RE TALKING ABOUT
EXPLORING SOCIAL DETERMINANTS OF HEALTH, I THINK OUR HITOC LIAISON COULD
BE BRINGING THAT UPDATE TO YOU ALL AND SAYING, HERE’S WHAT WE
HEARD AT HITOC, AND WHERE WE THINK WE MIGHT BE GOING.>>[INDISCERNIBLE] [LAUGHTER]>>OSCAR APPARENTLY IS ON THE
PHONE BUT HE’S IN LISTEN ONLY MODE.
SO HE SENT ME AN EMAIL SO I’M GOING TO SHARE THAT WITH YOU.
HE HAS THREE POINTS HE’D LIKE TO MAKE.
ONE IS IT WOULD NOT MAKE SENSE FOR THE HEALTH EQUITY COMMITTEE
TO HAVE ITS RETREAT WITHOUT A BOARD LIAISON WHO CAN
PARTICIPATE. NUMBER TWO, IT MIGHT BE GOOD TO
CONSIDER HAVING AN OHA STAFF MEMBER ALSO
BE PART OF THE HEALTH EQUITY COMMITTEE AND NOT JUST OEI
STAFF. I THOUGHT WE DID HAVE AN OHA
STAFF MEMBER ON THAT? ANYWAY, NUMBER THREE, I WOULD BE
HAPPY TO CONTINUE ENGAGING WITH HEALTH
EQUITY EK IF THE MEETING TIME COULD BE REVISITED TO MEET MY SCHEDULE.
>>I THINK YES TO THE 1st TWO. NO PROBLEMS FOR THAT.
WE’LL TAKE A LOOK AT THE THIRD ONE. AND TALK TO OSCAR AND MAYBE SORT
OUT WHAT THE MEETING SCHEDULES ARE FOR THE BOTH OF THEM.
WE DON’T HAVE TO LAND THESE FOR ALL OF THESE TODAY EITHER, BUT I
DID WANT TO COME BACK — AT LEAST MAYBE THE HITOC ONE.>>DO WE NOT HAVE AN OHA STAFF
MEMBER ON THE HEALTH EQUITY COMMITTEE?
>>WE HAVE AN OHA STAFF WHO STAFFED THE COMMITTEE.
>>OKAY.>>I WOULD NEED TO UNDERSTAND
THAT COMMENT A LITTLE BIT BETTER THAN I THINK I DO.>>[INDISCERNIBLE] I THINK FOR THE RECORD HB 4005
INCLUDED A REPRESENTATIVE OF OREGON’S
HEALTH POLICY BOARD. I THINK THAT’S GOING TO CONTINUE
THROUGH 2019 AND INTO 2020.
THEY MADE IT CLEAR WE’RE GOING TO REVEEP AND KEEP GOING.
I REALLY LOVE DOING THAT. AND I’M — WOULD I WANT TO
CONTINUE DOING THAT. AND THERE ARE LIMBED THINGS THAT
COME UP THAT I’M HAPPY TO HELP WITH.
SO THOSE ARE FUN THINGS. AND THEY MAYBE SHOULDN’T BE IN
HERE, BUT YOU NEED TO KEEP THOSE.
>>WE’RE THE ONLY GAP — THE COST PIECE, WE’RE NOT SURE HOW
THAT’S GOING TO PAN OUT IN TERMS OF STRUCTURE.
CHILDREN’S PIECES OF BODY OF WOULD, THAT WE NEED TO WORK ON WHAT THE
AGENDA IS. IS IT JUST HITOC WE’RE TRYING TO
–>>YEAH, AND WE CAN DO IT
TENTATIVELY, WE CAN PLEAT WITH HITOC AND SEE IF IT SCOPES OUT IF IT’S SOMETHING
YOU’RE INTERESTED IN.>>I TRIED TO OPEN THE BARN DOOR
AS FAR AS I COULD, BUT THE HORSE COULDN’T GO THROUGH.
>>I WANT TO LEARN MORE.>>I THINK — I DON’T FEEL IT’S
AN AREA WHERE I BRING A LOT OF — ANYWAY.>>I DON’T THINK IT REQUIRES A
LOT OF CONDISPENT EXPERTISE. IT’S REALLY A COMMUNICATION
FUNCTION. ESPECIALLY IF HITOC IS GOING TO
BE TALKING ABOUT SOCIAL DETERMINANTS OF HEALTH, IT’S REALLY — HOW WE
SIFT THROUGH THAT CONVERSATION AND BRING THAT TO THE BOARD. IS THAT RIGHT IN THE.
>>YEAH, ABSOLUTELY.>>YOU’RE NOT GOING TO ASK
SOMEONE TO CODE, RIGHT?>>NO, THERE’S NO CODING
REQUIRED. AND WE’RE ALSO, WE’VE DEVELOPED
A GREAT ORIENTATION MATERIALS FOR OUR NEW HITOC MEMBERS, SO
THERE’S A LOT OF STUFF ALREADY READY.
HITOC MEETS EVERY OTHER THURSDAY — FIRST THURSDAY OF EVERY OTHER
MONTH FROM 12:30 TO 3:45 HERE IN PORTLAND
DOWNTOWN. SO THAT’S OUR SCHEDULE. SO WE’RE MEETING ON FEBRUARY
7th. SO THURSDAY, THIS WEEK.
>>I’LL JUST SAY IT OUT LOUD IN CASE THIS IS — PEOPLE ARE
THINKING ABOUT IT, I KNOW THERE’S A LOT OF INTEREST IN
TERMS OF THE COST WORK. AT LEAST FOUR PEOPLE HAVE SAID I
DON’T WANT TO HOLD MY SEAT FOR THAT, AND I THINK WE NEED A
GIANT TOURNAMENT AT SOME POINT IN JULY IF WE NEED TO DO
LIAISONS, BUT I THINK WE COULD MAKE ADJUSTMENTS AS THE YEARS GO ON.>>WE TRIED TO PUT 90 HERE YOU
CAN BE A LIAISON FOR MORE THAN ONE.
>>I HAVE A LOT OF INTEREST IN A LOT OF THESE AREAS, AND IT’S
ABOUT THE COMMITMENT AND THE TIME.
ONCE I COMMIT I’M ALL IN.>>THIS IS OSCAR, CAN YOU HEAR
ME NOW? I FIGURED OUT TECHNOLOGY. SO I WAS CUTTING IN AND OUT SO I
APOLOGIZE IF I DIALED BACK IN, SO I’M SURE I MISSED SOME OF THE
CONVERSATION. I DID HEAR THAT KARLA RELAYED A
PRETTY HIGH LEVEL MY THOUGHTS, WHICH ARE MORE CONNECTED TO THE
HEALTH EQUITY COMMITTEE, AND IT SOUND LIKE YOU’RE REFERRING MORE NOW TO HITOC.
SO — JUST TO GIVE IT MORE CONTEXT ABOUT WHAT I WAS TRYING TO CONVEY IT
THROUGH EMAIL THROUGH KARLA WAS REALLY
MAKING SURE THAT WE DIDN’T MOVE FORWARD WITH HAVING THE HEALTH
EQUITY COMMITTEE DO ITS RETREAT. I KNOW I SAW THAT ON THE NOTES
COMING UP TO, AND I DIDN’T SEE A DATE. BUT BASED ON JUST CHECKING IN
WITH ONE OF THE COCHAIR, IT SOUNDS LIKE IT’S COMING UP IN
MARCH, IN EARLY MARCH, AND I WANT TO MAKE SURE WE HAVE A
LIAISON THAT’S ESTABLISHED AND THAT IS GOING TO BE ABLE TO
ATTEND AND PARTICIPATE, BECAUSE I THINK IT WOULD BE A MISSED
OPPORTUNITY IF THE HEALTH EQUITY COMMITTEE SPEND AS FULL DAY
DOING THIS RETREAT WITHOUT THAT BOARD
LIAISON. SO I’M MAKING SURE WE WORK TO
CONNECT THAT. AS FAR AS MY OTHER POINT ABOUT
MAKING SURE THERE’S ALSO THAT CONNECTION BETWEEN THE OHA STAFF, IT SOUNDS
LIKE THAT IS HAPPENING. I APPRECIATE THAT.
IT’S BEEN A WHILE SINCE I’VE BEEN ABLE TO ATTEND ONE OF THE
HEALTH EQUITY COMMITTEE MEETINGS, BECAUSE OF MY
SCHEDULING CONFLICTS. SO I — I’M GLAD THAT’S
HAPPENING, AND I WOULD ADVOCATE THAT THAT IS HAPPENING TO MAKE
SURE THAT THERE’S PROGRESS THAT’S BEING MOVED AND THAT IT’S
NOT JUST ON THE OEI SIDE, BUT IT’S CONNECTED
BACK TO THE OHA SIDE.>>MAYBE THAT’S — THIS IS PAT. I THINK OF OEI STAFF AS OHA
STAFF. IF I COULD REPHRASE WHAT I THINK
YOU’RE SAYING, IN ADDITION TO OHA, OEI
STAFF, YOU’D LIKE OHA POLICY STAFF INVOLVED?
>>YES. YEAH. I DO THINK THAT — I MEAN, I
KNOW OEI STAFF IS OHA STAFF, BUT IT DOES FEEL THERE’S — THERE’S
A FEELING IT’S A LITTLE BIT SEPARATED. I REALLY WANT TO MAKE SURE
THERE’S THAT INTEGRATION BETWEEN BOTH DIVISIONS.
>>THAT WOULD BE REALLY HELPFUL FOR US. WHAT I HEARD WAS, KRISTIN WOULD
CONSIDER THE HITOC THING AFTER DOING MORE
EXPLORATION, BUT THERE’S NO COMMITMENT.
SHE’S NODDING HER HEAD YES.>>[INDISCERNIBLE]
>>I WOULD BE HAPPY TO RESPOND BACK TO KARLA.
>>OKAY. SOUNDS GOOD.>>I’M WILLING TO HELP OUT IF
YOU CAN’T MAKE IT. I DO THINK I HAVE A CONFLICT. [INDISCERNIBLE]
>>I TRIED.>>WE’LL WORK WITH THE CHAIR AND
VICE CHAIR AND THE FOLKS WHO HAVE IDENTIFIED THEMSELVES AS
INTERESTED IN LEARNING MORE INFORMATION.
AND THANKS SO MUCH FOR YOUR TIME TO TALK ABOUT THIS TODAY.
>>THANK YOU.>>THANKS.
>>WE HAVE ABOUT THREE MORE MINUTES LEFT FOR ANY LAST THOUGHTS OR
COMMENTS. [INDISCERNIBLE]
>>NO ONE HAS RAISED THEIR HANDS.
>>MARCH 5th [INDISCERNIBLE] HOPEFULLY WITHOUT THE SNOW AND
ICE. FOR EVERYBODY WHO IS TRAVELING
TODAY FROM THE MEETING, PLEASE BE SAFE.