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MINUTES State Consumer Health Information and Policy Advisory Council Meeting Date: September 13, 2012 Time: 10:00am 2:00pm Location: Agency for Health Care Administration - Conference Room A Members Present: James Bracher, Chair; Diane Godfrey, Vice Chair; Curtis Jenkins (for Susan Douglas); Jeff Gregg (for Secretary Liz Dudek); Tom Herring (for Meade Grigg); Nikole Helvey; Danielle Scoggins (for Jane Johnson); Kim Streit; Michael Wasylik, MD; Sally West; and Tom Zutell Members Absent: Laura Cantwell, Chanta Combs, and Michael Epstein, MD Staff Present: Beth Eastman, Cheryl Barfield, Cruz Conrad, Heidi Fox, Patrick Kennedy, Carolyn Turner, Cindy Kucheman, James McLemore, Dylan Dunlap, Liz Jenkins, Adrienne Henderson, and Marsha Webb Interested Parties Present: Stan Whittaker, Florida Council of Advanced Practice Nurses PAC; Steve Mindlin, Sundstrom, Friedman & Fumero, LLP; Holly Miller, Florida Medical Association; and Ellen Anderson, Florida Hospital Association. Call to Order, Welcome and Roll Call: Mr. Bracher, Chair, requested that in light of his laryngitis, Diane Godfrey, Vice Chair, call the meeting to order and welcomed the members and interested parties. Ms. Godfrey then called the roll. Review and Approval of Minutes: The Chair called for a review and approval of the June 21, 2012 draft minutes. A motion to approve was made by Dr. Wasylik and seconded by Nikole Helvey. The Council voted to accept minutes as printed with no opposition. Agency Updates: Jeff Gregg, Director of Florida Center for Health Information and Policy Analysis, provided the Agency update. He noted that Secretary Dudek regrets being unable to attend the meeting. Mr. Gregg then provided the Agency s update, stating that the Agency was currently focusing on the transition to Medicaid managed care. He stated that the Medicaid County billing issues were drawing to a close and should be wrapped up fairly soon. He also noted that the Assisted Living Workgroup was continuing with its meetings, noting that a three day summit was being planned for October at the Agency offices to continue their work on legislative proposals. Health Information Exchange Coordinating Committee (HIECC) Update: Ms. Helvey updated the members on the meeting that was held August 17, 2012. She noted that Representative Gayle Harrell attended the meeting as a special guest speaker who spoke about the importance of health information exchange for achieving the meaningful use of electronic health records. Representative Harrell is a member of the federal Health IT Policy Committee that advises the Office of the National Coordinator for Heath IT. The next meeting is tentatively scheduled for November 15, 2012.

Certificate of Need Process: Mr. Gregg introduced James McLemore who provided a summary of the Certificate of Need (CON) process for the members. Although members are not involved in the CON process or decisions, he felt the information could be useful to members as CON is now a part of the Florida Center. After his presentation, Mr. McLemore encouraged the members to visit the CON website for more information. Membership Update: Beth Eastman notified the members that fellow Council member, Dr. Ebe Randeree of Florida State University, had submitted his resignation to the Council effective immediately due to changes in his workplace. Ms. Eastman noted that the Agency will work on filling this vacancy Long Range Plan Goals and Objectives Update: Patrick Kennedy reviewed the status of the Data Collection goals stating that all of the goals were on target, and stated that he was currently working with leadership to approve the in-person meetings. He stated that he was also working with FHA to facilitate the in person workshop on best practices for data submitters and once approved, will continue to move forward. Mr. Kennedy also informed the members that he was in the process of creating an online video webinar with voice over explaining the process, and including answers to frequently asked questions. There was discussion among the members about the type of meeting and location that would best benefit the data submitters. It was determined that the meeting will most likely take place in Orlando. It was also suggested that Mr. Kennedy research the development of an online training tool with certification that could be accessed by new trainees since the rate of turnover can be high in these positions. Kim Streit suggested that this online tool would help maintain the data integrity, accuracy and quality. Mr. Kennedy agreed to follow up on this line of thinking and report back to the members at the next meeting. ACTION ITEM: Research and report back to the members on the feasibility and potential ability to provide an online training tool with certification. Beth Eastman updated the Council on the goals for improving and promoting FloridaHealthFinder (FHF). She stated that almost all goals were completed or on target. She noted that there were several health fairs and benefit fairs approaching that would be attended by the Florida Center staff in efforts to continue outreach efforts. She also mentioned that there had been several mail outs recently. Ms. Eastman also reviewed the actions taken since the last meeting, stating that the Nursing home watch list had been added to the site, and that stars had been used where applicable. She also noted that there had been enhancements made to the Facility Locator (addition of emergency actions) and Symptom Navigator. She informed the members that she was working closely with the vendor to add wellness tools the website as well. Heidi Fox reviewed the status of the HIE goals and objectives and noted that all were on track. She stated that the Strategic Operation Plan had been approved by ONC on September 7 th, and was available on the FHIN website. She noted that the CHIPRA grant has provided additional funding to expand Direct Secure Messaging (DSM). Ms. Fox then showed a map of the coverage areas for

onboarding, noting that everything was progressing in a timely manner. Mr. Gregg noted that he was anticipating the upcoming retirement of the primary outreach person for the FloridaHealthFinder website and discussed the new options to replace this person with regards to looking at someone with the ability to develop an online structure to do outreach and to be able to extend that outreach beyond the current methods. Ms. Streit responded that this would be a good opportunity for the Florida Hospital Association to partner with the agency in working on developing outreach and other online tools. She urged the Council to look into working with FHA on looking into educational and educational support being offered online through FHF as well as researching grant funding or other funding opportunities to help fund the initiative. ACTION ITEM: Ms. Streit offered to send the link to the FHA initiative for the members review. She also agreed that she will assist in looking into grant funding and other opportunities that may be available. Ms. Eastman informed the Council members that she had recently reached out to the AARP and the local health councils to partner in providing webinars on FHF. She noted that she would be contacting both organizations to develop dates and options in the next few months. Diane Godfrey, Vice Chair, expressed her appreciation that they were looking at training options due to the frequency of staff turnovers. However, she noted that there are still errors due to programming issues and expressed that she felt bringing the audit process to the reporting program would be a huge help. Ms. Godfrey also suggested that revamping the data reporting programs should be included in future long range planning goals. Mr. Gregg responded that staff is currently looking at commercial software available and being used internally to assist navigating XML editor. He stated that they are looking at this as a way to assist facilities review files and correct errors. ACTION ITEM: Add to the goals for the Long Range Plan to include updating/revamping the data reporting program. Environmental Scan: Responding to an Action Item from the June meeting, Heidi Fox provided the members with a review of the environmental scan of data available at other state agencies. She noted that the A-Z Directory of Resources on the Department of Agriculture and Consumer Services was a comprehensive listing of resources and recommended that this link be included on the Agency s FHF site. Beth Eastman stated that she would be working to verify links from other agencies, and reach out to the other agencies to discuss linking back to the FHF site. ACTION ITEM: Add link to the A-Z Directory of Resources on the Department of Agriculture and Consumer Services website. Beth Eastman continued by reviewing the current resources now on FHF. It was suggested that the page listing of the State Health Data Directory be reconfigured to show more information in a more logical order. For instance, it was suggested that Types of Date Collected be featured first, followed by Reporting Entities and Database Purpose. Ms. Eastman assured members that she would work with Ms. Fox to update the pages as requested.

ACTION ITEM: Reconfigure layout of pages in State Health Data Directory as suggested. Ms. Fox continued with her review of the Environmental Scan, concluding that the exercise affirmed that FHF was very comprehensive and offered the most current links to consumer health information. Ms. Eastman noted that she would be following up with MyFLorida to ensure links to FHF on their consumer pages, as well as seeing if the Department of Agriculture directory would provide a more direct link to the facility/provider locator where appropriate, and the Agency for Persons with Disabilities emergency information to include link to the PHR disaster preparedness information. ACTION ITEM: Verify links to other agencies are also linking back to FHF and add the A-Z Directory and other resources to FHF resource directories. Additional Council Activities: Jeff Gregg began his review of potential ad hoc projects as explained to the members at the last meeting. He reminded members that this was simply an exercise in thinking out loud, and that there was no obligation to act at this time he simply wanted to put some ideas out there that could lead to the discussion of other ideas. His first example of ways to improve the use of information in the regulation of licensed inpatient adult cardiovascular systems listed operational and policy goals that the members could tackle. The second example dealt with improving emergency care with better information about specialist backup. Mr. Gregg noted that if the members were interested in pursuing either of these options, or any others, it would require several meetings to vet and discuss the issues and make a recommendation. After discussion of both examples, Ms. Streit suggested that it would be a good opportunity to reconvene earlier workgroups. Ms. Godfrey agreed, stating that it would be helpful for the ad hoc group to help make these types of recommendations. Mr. Gregg stated that he would be open to gathering suggestions and discussing the issues further. The Chair questioned if the level of expertise was sufficient to address the issues, or would there be a need to bring others on board? Mr. Gregg responded that he felt it could be a short process to develop a plan that led up to proposed legislation to make clinical information understandable to the non-clinical user. After further discussion of the two examples provided, Ms. Streit suggested that FHF be expanded to include more information by developing an information guide that provided clinical information for consumers. Mr. Gregg posed the question to the members is there a way to initiate a project of designing an information system that could report publically current rich data collected. He challenged the members to review what had been discussed so far, and come back with a recommendation at the next meeting. He added that he felt it would be best to choose one particular project rather than attempt to deal with both at one time. Kim Streit suggested that the non-medical early elective deliveries where they could look at the data to address key policy areas. After further discussion by the members, Mr. Gregg reminded them that this would be at a very high level with no preconceived idea of where it can go. The Chair asked for a consensus on one project that the Council could begin working on. It was determined that the two examples given earlier would be difficult given the sensitive nature on cardio reporting as would the ER specialist backup issue. It was decided that the group would look at the deliveries issue, noting that the issue would be to determine the effect of the trend of non-medically necessary deliveries before 39 weeks and tie in to the NICU admissions. It was noted that CMS wants to address the issue because there is the potential for a negative effect on the newborn. Rates are high and of concern to many.

ACTION ITEM: Ms. Streit informed the members that she was aware of a study currently being done by USF with the March of Dimes. She agreed to provide staff with information regarding this study and will arrange for a presentation of the framework currently being used. Public Comments and Meeting Summary: Ms. Eastman called for public comments. There being none, she then summarized the meeting and noted the following: The date for the next Council meeting will be November 29th. Mr. Kennedy and Ms. Eastman will continue looking at webinars and training data for users and consumers. They will continue to work closely with FHA and local health councils to assist with training sessions for those outside of Tallahassee. Mr. Kennedy will research and report back to the members on the feasibility and potential ability to provide an online training tool with certification. Ms. Streit offered to send the link to the FHA initiative for the members review. She also agreed that she will assist in looking into grant funding and other opportunities that may be available for outreach efforts. Future long range planning goals and objectives will include education on programming errors, edits, thresholds, etc. (Improving and Streamlining Data Collection). Ms. Eastman will review the environmental scan to find sites for opportunities to promote FHF and add a link to the A-Z Directory of Resources on the Department of Agriculture and Consumer Services website and reconfigure layout of pages in State Health Data Directory as suggested. Ms. Eastman will work with Ms. Streit to develop a report and or presentation on nonmedical early elective deliveries for the November meeting. Ms. Eastman reminded members that there will be elections at the November meeting for the upcoming year s officers, and they will be discussing the Long Range Plan for 2013. Adjournment: The meeting adjourned at 1:40 pm.