Provider User-Experience Challenge

A Notice by the Health and Human Services Department on 03/03/2016

Action

Notice.

Summary

Like the Consumer Health Data Aggregator Challenge, the Provider User-Experience Challenge incents the development of applications for health care providers that use open, standardized APIs to enable innovative ways for providers to interact with patient health data. This challenge will focus on demonstrating how data made accessible to apps through Application Programming Interfaces (APIs) can positively impact providers' experience with EHRs by making clinical workflows more intuitive, specific to clinical specialty, and actionable. The statutory authority for this challenge competition is Section 105 of the America COMPETES Reauthorization Act of 2010 (Pub. L. 111-358).

DATES:

Phase 1

• Challenge launch: March 1, 2016
• Submissions due: May 30
• Evaluation period: May 31-June 28
• Phase 1 winners announced: June 30

Phase 2

• Submission period begins: May 31
• Submissions due: November 7
• Evaluation period: November 14-December 14
• Phase 2 winners announced: December 15, 2016

FOR FURTHER INFORMATION CONTACT:

Adam Wong, adam.wong@hhs.gov (preferred), 202-720-2866.

SUPPLEMENTARY INFORMATION:

Award Approving Official

Karen DeSalvo, National Coordinator for Health Information Technology.

Subject of Challenge Competition

The Provider User-Experience Challenge is intended to spur development of third-party applications for use by clinicians and use FHIR to pull various patient health data into a dashboard. The challenge has two phases—the first requiring submission of technical and business plans for the application (app), the second a working app that is available for providers. Phase 2 of the competition will not be limited to only those who won Phase 1—all Phase 1 competitors, and those who did not participate in Phase 1, can submit a final app at the end of Phase 2.

The final application must meet the following requirements:

• Uses FHIR Draft Standard for Technical Use 2 (DSTU2)
• Aggregate all data as specified in the 2015 Edition Common Clinical Data Set (Data column in https://www.healthit.gov/sites/default/files/commonclinicaldataset_ml_11-4-15.pdf)
• Verified compatibility with different health IT developer systems implemented in production settings, 1 of which must be from the top 10 systems measured by Meaningful Use attestation per HealthIT.gov. Apps must be integrated with a minimum of 3 unique health IT developer systems in 2 unique provider settings
• Has been tested with patients and used in production settings
• Available to providers through at least one of the following modes: Direct from Web, iOS Store, or Android stores

Phase 1

Participants interested in competing for Phase 1 awards will need to submit an app development plan that must include:

• Mockup/wireframes
• Technical specifications, including but not limited to planned data sources, system architecture
• Business/sustainability plan
• Provider partnership

To augment technical development and enhance the likelihood of a successful app that will continue to exist beyond the end of the challenge, a progress update/matchmaking event will be held that will seek to connect participants with provider partners. Up to five app proposals will be recognized as winners and awarded up to $15,000 each.

Phase 2

The second phase will entail the actual development of the apps, verification of technical capabilities, user testing/piloting, and public release of the apps. This will include remote testing with providers and health IT developers to test the technical abilities of the apps to connect to in-production systems. Participants will submit:

• Working prototype of the app
• Video demonstrating the app (maximum of 5 minutes, on YouTube or Vimeo)
• Slide deck describing app (maximum of 10 slides)

The grand prize winner will receive $50,000 and a second place winner will receive $25,000. There will be an additional $25,000 prize for the app that connects to the greatest number of unique health IT developer systems implemented in production settings, which can be won by the grand or 2nd place winner.

Eligibility Rules for Participating in the Competition: To be eligible to win a prize under this challenge, an individual or entity:

1. Shall have registered to participate in the competition under the rules promulgated by the Office of the National Coordinator for Health Information Technology.

2. Shall have complied with all the requirements under this section.

3. In the case of a private entity, shall be incorporated in and maintain a primary place of business in the United States, and in the case of an individual, whether participating singly or in a group, shall be a citizen or permanent resident of the United States.

4. May not be a Federal entity or Federal employee acting within the scope of their employment.

5. Shall not be an HHS employee working on their applications or submissions during assigned duty hours.

6. Shall not be an employee of the Office of the National Coordinator for Health IT.

7. Federal grantees may not use Federal funds to develop COMPETES Act challenge applications unless consistent with the purpose of their grant award.

8. Federal contractors may not use Federal funds from a contract to develop COMPETES Act challenge applications or to fund efforts in support of a COMPETES Act challenge submission.

An individual or entity shall not be deemed ineligible because the individual or entity used Federal facilities or consulted with Federal employees during a competition if the facilities and employees are made available to all individuals and entities participating in the competition on an equitable basis.

Entrants must agree to assume any and all risks and waive claims against the Federal Government and its related entities, except in the case of willful misconduct, for any injury, death, damage, or loss of property, revenue, or profits, whether direct, indirect, or consequential, arising from my participation in this prize contest, whether the injury, death, damage, or loss arises through negligence or otherwise.

Entrants must also agree to indemnify the Federal Government against third party claims for damages arising from or related to competition activities.

Submission Requirements

In order for a submission to be eligible to win this Challenge, it must meet the following requirements:

1. No HHS or ONC logo—The product must not use HHS' or ONC's logos or official seals and must not claim endorsement.

2. Functionality/Accuracy—A product may be disqualified if it fails to function as expressed in the description provided by the user, or if it provides inaccurate or incomplete information.

3. Security—Submissions must be free of malware. Contestant agrees that ONC may conduct testing on the product to determine whether malware or other security threats may be present. ONC may disqualify the product if, in ONC's judgment, the app may damage government or others' equipment or operating environment.

Registration Process for Participants: To register for this Challenge, participants can access http://www.challenge.gov and search for “Provider User-Experience Challenge.”

Prize

• Phase 1: Up to 5 winners each receive up to $15,000.
• Phase 2: One final winner receives $50,000; 2nd place receives $25,000; and an additional $25,000 connector prize.
• Total: Up to $175,000 in prizes.

Payment of the Prize: Prize will be paid by contractor.

Basis Upon Which Winner Will Be Selected: The review panel will make selections based upon the following criteria:

Phase 1

• Technical feasibility of plan, including number of EHR sources targeted.
• Adherence to data privacy and security best practices.
• Strength of business/sustainability plan.
• Impact potential in clinical setting.
• Provider and/or health IT developer partnerships.

Phase 2

• Number, sources, and types of data aggregation using FHIR.
• Functionality and quality of data aggregation.
• Privacy and security of patient data.
• Impact potential in clinical setting.
• User experience and visual appeal.

Additional Information

General Conditions: ONC reserves the right to cancel, suspend, and/or modify the Contest, or any part of it, for any reason, at ONC's sole discretion.

Intellectual Property: 

Each entrant retains title and full ownership in and to their submission. Entrants expressly reserve all intellectual property rights not expressly granted under the challenge agreement. By participating in the challenge, each entrant hereby irrevocably grants to Sponsor and Administrator a limited, non-exclusive, royalty-free, worldwide license and right to reproduce, publically perform, publically display, and use the Submission to the extent necessary to administer the challenge, and to publically perform and publically display the Submission, including, without limitation, for advertising and promotional purposes relating to the challenge.

Authority:

15 U.S.C. 3719.

Dated: February 23, 2016.

Karen DeSalvo,

National Coordinator for Health Information Technology.

[FR Doc. 2016-04466 Filed 3-1-16; 11:15 am]

BILLING CODE 4150-45-P

The Latest Stage 2 Meaningful Use Attestation Data: Shocking Yet Anticipated

by Naomi Levinthal and Anantachai (Tony) PanjamapiromTuesday, July 29, 2014

TOPIC ALERT:

• Meaningful Use

Click on topic to receive periodic emails.

At the July 10 Health IT Policy Committee meeting, CMS and the Office of the National Coordinator for Health IT reported the latest Stage 2 attestation numbers: 972 eligible professionals (EPs) and 10 eligible hospitals (EHs) through July 1.

Nearly the entire industry is amazed by the paltry attestation volume so far. However, the Stage 2 bar is very challenging to reach, and from our previous research, we anticipated such a dramatically slow attestation trend. Last year, we conducted interviews with more than 100 hospitals in integrated delivery networks across the country to assess their levels of Stage 2 readiness. We evaluated interviewee responses on a four-point scale and converted the values to percentages, with 100% being "Process not yet evaluated for Stage 2," and 0% being "No gaps remaining to remediate." The top-two Stage 2 core objectives for which hospitals were least prepared one year ago was Transition of Care (TOC) and View, Download and Transmit (VDT) (see Figure 1).

 

Preparing for Transitions of Care and View, Download and Transmit

The TOC and VDT objectives have subtle yet important nuances that can prolong planning and incur additional efforts. The TOC objective requires providers to meet three measures that track the transmission of a summary of care record to the next setting of care:

• The first measure allows providers to use any method to deliver the summary of care record (including patient delivery);
• The second measure requires electronic transmission; and
• The third measure is a "yes or no" attestation that a provider has exchanged at least one summary of care record with another user on a different electronic health record system than their own.

In our study, these hospitals had not yet assessed the available, specific transmission options for TOC's Measure 2, in which a summary of care document must be electronically transmitted for more than 10% of the patient transitions or referrals.

VDT has two measures. The first is to make certain required information available on a patient portal or personal health record within four business days for EPs and 36-hours post-discharge for EHs, with a more than 50% performance threshold. The second VDT measure tracks patients' access of the portal or PHR and requires that more than 5% of the patients view, download or transmit their health information. Last year, we found most hospitals had yet to validate whether all required data elements can be made available within 36 hours for VDT Measure 1. Additionally, these hospitals were in the early implementation phases of their portal or PHR rollouts and had yet to develop a patient engagement initiative.

Based on our experiences with multiple hospitals around the country preparing for Stage 2 attestation, TOC and VDT objectives prove to be the most taxing from both technology and workflow perspectives. The trends we identified last year are confirmed within the preliminary attestation data ONC released based on 474 EPs and 8 EHs that attested by the end of May. We analyzed this new data set with a specific focus on these two most challenging objectives.

Transitions of Care Stage 2 Attestation Trends Show High Level of EP Exclusions

The data show that 77% of EPs did not reach sufficient referral volumes and thus met the exclusion criteria for all of the objective's measures. By removing one of the most difficult objectives from these EPs' lists, that likely made Stage 2 much easier to achieve, resulting in the high number of attestations compared with hospitals.

The story is different for hospitals, which do not have any exclusion criteria. It is impossible to derive statistical significance from a pool of only eight EH attestations; however, their data provide some interesting observations. Only two hospitals reported a performance rate greater than or equal to 25% for TOC's Measure 2 (the required threshold for electronic transmission of a summary of care record is more than 10%). However, the reported performance rates are much higher for TOC's Measure 1, which does not require electronic transmission and can rely on patients to deliver the summary of care record. For that measure, six of the hospitals achieved between 75% and 85% performance. We anticipate that EP exclusion rates will continue for 2014 Stage 2 attestations and that EHs will continue to perform at the margin for the TOC's Measure 2.

EPs Fare Better With VDT Than EHs

Eighty-one percent of EPs performed in the highest range (i.e., 90% to 100%) for the first VDT measure (making information available to patients within specified timeframes for greater than 50% of patients), whereas EH data show a more varied performance. More than half of the EPs met the second VDT measure (the percentage of patients who viewed, downloaded or transmitted their information) within the 5% to 30% range. However, for all eight EHs, the performance was right at the margin (5% to 10%).

New portal implementations will affect both EP and EH performance, but we expected EPs to fare better than EHs for the second VDT measure for several reasons. The patient portal implementation continued well into 2014 for the majority of our hospital members. Although we have not tracked portal implementation trends for EPs, we assume many practices are rolling out a tightly-integrated portal also designed by their primary EHR vendor. Those portal set-ups may lend implementation benefits for EPs, as opposed to EHs that may experience integration challenges when they deploy a third party portal (e.g., 37% of our interview chose a third-party portal vendor).

In addition, patient engagement may be easier to realize in a provider's office because of the more frequent patient interaction, compared with the acute care setting. For example, EPs can encourage patients to use the portal pre-encounter by setting up an appointment on the portal, whereas for the inpatient domain, admission is condition-dependent and not usually based on "choice" or a patient's schedule. Furthermore, patients seen in the ambulatory setting are generally more "well" than those admitted to the hospital or seen in the emergency department, and that difference in the patient population condition may also make it easier for the EPs to educate patients on the benefits of the portal and encourage its use.

While CMS acknowledged in its Stage 2 final rule that patient portal use will largely be outside the provider's control, we conclude that patient engagement requirements are harder on EHs than EPs and are likely a significant contributing factor to the early differences in the current Stage 2 attestation volumes.

ONC and CMS' reports to the Policy Committee on Aug. 6 will tell us more about the Stage 2 providers meeting this new bar of meaningful use. Undoubtedly, the attestation volume will increase and with it, perhaps, greater insights into these measures that were the most difficult.

http://www.ihealthbeat.org/perspectives/2014/the-latest-stage-2-meaningful-use-attestation-data-shocking-yet-anticipated

HHS releases new data and tools to increase transparency on hospital utilization and other trends

Data can help improve care coordination and health outcomes for Medicare beneficiaries

With more than 2,000 entrepreneurs, investors, data scientists, researchers, policy experts, government employees and more in attendance, the Department of Health and Human Services (HHS) is releasing new data and launching new initiatives at the annual Health Datapalooza conference in Washington, D.C.

Today, the Centers for Medicare Medicaid Services (CMS) is releasing its first annual update to the Medicare hospital charge data, or information comparing the average amount a hospital bills for services that may be provided in connection with a similar inpatient stay or outpatient visit. CMS is also releasing a suite of other data products and tools aimed to increase transparency about Medicare payments. The data trove on CMS’s website now includes inpatient and outpatient hospital charge data for 2012, and new interactive dashboards for the CMS Chronic Conditions Data Warehouse and geographic variation data. Also today, the Food and Drug Administration (FDA) will launch a new open data initiative. And before the end of the conference, the Office of the National Coordinator for Health Information Technology (ONC) will announce the winners of two data challenges.

“The release of these data sets furthers the administration’s efforts to increase transparency and support data-driven decision making which is essential for health care transformation,” said HHS Secretary Kathleen Sebelius.

“These public data resources provide a better understanding of Medicare utilization, the burden of chronic conditions among beneficiaries and the implications for our health care system and how this varies by where beneficiaries are located,” said Bryan Sivak, HHS chief technology officer. “This information can be used to improve care coordination and health outcomes for Medicare beneficiaries nationwide, and we are looking forward to seeing what the community will do with these releases. Additionally, the openFDA initiative being launched today will for the first time enable a new generation of consumer facing and research applications to embed relevant and timely data in machine-readable, API-based formats."

2012 Inpatient and Outpatient Hospital Charge Data

The data posted today on the CMS website provide the first annual update of the hospital inpatient and outpatient data released by the agency last spring. The data include information comparing the average charges for services that may be provided in connection with the 100 most common Medicare inpatient stays at over 3,000 hospitals in all 50 states and Washington, D.C. Hospitals determine what they will charge for items and services provided to patients and these “charges” are the amount the hospital generally bills for those items or services.

With two years of data now available, researchers can begin to look at trends in hospital charges. For example, average charges for medical back problems increased nine percent from $23,000 to $25,000, but the total number of discharges decreased by nearly 7,000 from 2011 to 2012.

In April, ONC launched a challenge – the Code-a-Palooza challenge – calling on developers to create tools that will help patients use the Medicare data to make health care choices. Fifty-six innovators submitted proposals and 10 finalists are presenting their applications during Datapalooza. The winning products will be announced before the end of the conference.

Chronic Conditions Warehouse and Dashboard

CMS recently released new and updated information on chronic conditions among Medicare fee-for-service beneficiaries, including:

• Geographic data summarized to national, state, county, and hospital referral regions levels for the years 2008-2012;
• Data for examining disparities among specific Medicare populations, such as beneficiaries with disabilities, dual-eligible beneficiaries, and race/ethnic groups;
• Data on prevalence, utilization of select Medicare services, and Medicare spending;
• Interactive dashboards that provide customizable information about Medicare beneficiaries with chronic conditions at state, county, and hospital referral regions levels for 2012; and
• Chartbooks and maps.

These public data resources support the HHS Initiative on Multiple Chronic Conditions by providing researchers and policymakers a better understanding of the burden of chronic conditions among beneficiaries and the implications for our health care system.

Geographic Variation Dashboard

The Geographic Variation Dashboards present Medicare fee-for-service per-capita spending at the state and county levels in interactive formats. CMS calculated the spending figures in these dashboards using standardized dollars that remove the effects of the geographic adjustments that Medicare makes for many of its payment rates. The dashboards include total standardized per capita spending, as well as standardized per capita spending by type of service. Users can select the indicator and year they want to display. Users can also compare data for a given state or county to the national average. All of the information presented in the dashboards is also available for download from the Geographic Variation Public Use File.

Research Cohort Estimate Tool

CMS also released a new tool that will help researchers and other stakeholders estimate the number of Medicare beneficiaries with certain demographic profiles or health conditions. This tool can assist a variety of stakeholders interested in specific figures on Medicare enrollment. Researchers can also use this tool to estimate the size of their proposed research cohort and the cost of requesting CMS data to support their study.

Digital Privacy Notice Challenge

ONC, with the HHS Office of Civil Rights, will be awarding the winner of the Digital Privacy Notice Challenge during the conference. The winning products will help consumers get notices of privacy practices from their health care providers or health plans directly in their personal health records or from their providers’ patient portals.

OpenFDA

The FDA’s new initiative, openFDA, is designed to facilitate easier access to large, important public health datasets collected by the agency. OpenFDA will make FDA’s publicly available data accessible in a structured, computer readable format that will make it possible for technology specialists, such as mobile application creators, web developers, data visualization artists and researchers to quickly search, query, or pull massive amounts of information on an as needed basis. The initiative is the result of extensive research to identify FDA’s publicly available datasets that are often in demand, but traditionally difficult to use. Based on this research, openFDA is beginning with a pilot program involving millions of reports of drug adverse events and medication errors submitted to the FDA from 2004 to 2013. The pilot will later be expanded to include the FDA’s databases on product recalls and product labeling.

For more information about CMS data products, please visit http://www.cms.gov/Research-Statistics-Data-and-Systems/Research-Statistics-Data-and-Systems.html.

For more information about today’s FDA announcement visit:

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM399335 or http://open.fda.gov/

OCR, ONC Release Model Notices for HIPAA Compliance

Tuesday, September 17, 2013

TOPIC ALERT:

• ONC

Click on topic to receive periodic emails.

Two HHS agencies have released model notices that health care providers can use to comply with new HIPAA privacy and security rules that take effect in less than a week, Health Data Managementreports (Goedert, Health Data Management, 9/16).

Background

The final HIPAA omnibus rule -- which includes four final rules that implement tougher privacy and security provisions -- was called for under the 2009 federal economic stimulus package's HITECH Act and the Genetic Information Nondiscrimination Act. The rules:

• Clarify when breaches must be reported to HHS' Office for Civil Rights;
• Establish new standards for the use of patient-identifiable information for fundraising and marketing;
• Expand liability to "business associates" of hospitals and other "HIPAA-covered entities," such as data miners and health IT service providers; and
• Raise the maximum penalty for noncompliance to $1.5 million per violation.

The new federal privacy and security regulations will take effect Sept. 23 (iHealthBeat, 9/10).

Details of Models

The examples were developed by HHS' Office for Civil Rights and the Office of the National Coordinator for Health IT.

OCR and ONC released the model notices in three formats:

• A booklet;
• A layered notice with a summary of the information on the first page and full content on additional pages; and
• A notice with the design elements of a booklet, but formatted for full-page presentation.

Covered entities also can download a text-only version (Miliard, Healthcare IT News, 9/17).