Keeping Pace with the Interoperability Landscape TEFCA, What It Is and How It Will Work
The Trusted Exchange Framework and Common Agreement (TEFCA) will define standards for interoperability as required by the 21 st Century Cures Act signed into law in December 2016. The 21 st Century Cures Act contains a number of interoperability requirements, including the creation of a Trusted Exchange Framework being built through TEFCA with oversight by the Office of the National Coordinator (ONC).

Following a comment period, the final version of TEFCA will be published in the Federal Register later this year. The draft TEFCA guidance contains policies, procedures, and technical standards that the government views as an on-ramp to interoperability. This coordination is expected to bridge the gap between providers’ and patients’ information systems and enable interoperability across disparate Health Information Networks. 

TEFCA is meant to establish a single way for Health Information Exchanges (HIEs), enabling providers, hospitals and other health care stakeholders to join any health information network (HIN) and automatically connect and participate in nationwide health information exchange.
TEFCA also creates “Qualified” HINs as a vehicle to facilitate a standardized methodology for HIE interconnectivity, along with a new administrative organization, the Recognized Coordinating Entity (RCE). The concept is to create a network of networks and connect authorized participants or end users, including payers, vendor networks, government agencies, individuals, and the nation’s 100-or-so HIEs such as Health e Paradigm, the physician-led HIE created in partnership with the Medical Association of Georgia. 
Promoting Interoperability
CMS recently restated its commitment to improving interoperability and patients’ access to health information. To reflect this focus, CMS renamed the EHR Incentive Programs to the Promoting Interoperability (PI) Programs. CMS also plans to streamline the programs to reduce the time and cost required of providers to participate.

This is exciting news for physicians and their patients, and great news for Health e Paradigm participants who have access to all of the tools required to align CMS’s aim to become patient centric. To learn more about how this rule-making affects Medicare eligible clinicians participating in the Promoting Interoperability (formerly Advancing Care Information) performance category of the Merit-based Incentive Payment System (MIPS), visit the Quality Payment Program website, and stay tuned for more information.

To become a Health e Paradigm participant, visit or contact Susan W. Moore at 678.303.9275
Health e Paradigm and the Medical Association of Georgia (MAG) - A Partnership on Health Care Transformation
The escalating importance and availability of health care analytics deliver providers a means to successfully transition to the new Quality Payment Program (QPP) models. Providers are expected to manage diverse data sets, to face increased competition, to answer growing regulatory complexity and to deliver value-based care to their patients. 

How can providers harness this new opportunity? Robust data and analytics. Meaningful analytics hold the power to transform patient care, reveal new sources of value and differentiate competitors. 

Physicians and hospitals are undergoing a major transformation in how they are paid and how they are expected to deliver care. As payment models evolve, margins shrink, budgets tighten, and health care data analytics opens a door. Financial, operational, clinical, and other data impact the goals of improving care, providing access, and controlling cost.

James Walton, DO, MBA, FACP and President and CEO of Genesis Physicians Group, Dallas, reminds physicians that health care organizations need to utilize resources and produce value quickly. 

In a webinar focused on MACRA, he said, “Number 1, doctors and practice managers need to get ready to use data and move into the data-driven atmosphere. We can expect this trend around data collection and utilization to increase. And Number 2, the pressure is on health care and is going to continue to increase—patients are expecting more service while living longer with more chronic conditions, just as payors and regulators are increasing expectations on documenting quality and efficiency across the care continuum.” 

Business intelligence and analytics such as those generated by Health e Paradigm detect information patterns and present unseen alternatives. Analytics-driven acumen helps providers identify and treat at-risk populations, proactively engage patients sooner, understand the performance of health interventions on health outcomes, and improve costs.

Meaningful analytics includes using data for quality reporting, population health management, risk management, clinical effectiveness, cost and more—analyzing the entire patient history across all points of care. Georgia physicians can access powerful performance data through Health e Paradigm, a new MAG-endorsed, physician-led health information network. Analytics tools of the past often failed to provide effective integration of all a patient’s data. Today, organizations with a data analytics strategy built upon participation in a successful HIE will be well positioned to meet the new MACRA and QPP requirements.

Web-based dashboard visualization tools offer more than just an increase in data comprehension; dashboards reveal data trends and patterns, making the information more accessible and actionable. 

Can You Meet the New Reporting Requirements? 
Health e Paradigm analytics dashboards can ease the transition to QPP reporting by providing physicians access to patients’ aggregated data from the HIE presented through meaningful analysis. 

Analytics Reports Include: Quality Metrics analysis of preventive care procedures commonly required and approved for reporting programs; And High Risk patient analysis for those considered most at risk for poor health outcomes, high resource utilization and in need of care coordination. Six additional trend analysis dashboards are available for Readmissions, Disease Registries, Population Health, Behavioral Health, Patient Attribution and Utilization.
Quality Metrics Dashboard
Come and See Us!
June 1 - 3, 2018
Georgia Society of Rheumatology
2018 Annual Meeting
The Ritz Carlton - Amelia Island
Amelia Island, FL.
June 5 - 6, 2018
Georgia Department of Public Health
2018 Health System Symposium
Crowne Plaza Atlanta SW
Peachtree City, GA.
June 14 - 16, 2018
Georgia Academy of Family Physicians
2018 Summer CME Meeting
Omni Amelia Island Resort
Amelia Island, FL.

Susan W. Moore
Medical Association of Georgia
Director, Strategic Programs and Initiatives