36C77619R0006-0002005.docx

Department of Veterans Affairs VA Veterans Health Information Exchange (VHIE) Exchange Business Readiness Questionnaire for FAST TRACK PARTNERS ONLY

Department of Veterans Affairs Health Informatics VHA Office of Informatics and Information Governance (OIIG) VHIE Health Program Team

May, 2018 Version 1.7

Table of Contents

Introduction This questionnaire is intended for Healthcare organizations interested in exchanging health data with the Department of Veterans Affairs (VA) via the eHealth Exchange. The intent of this questionnaire is to open a dialog between your organization and the VA and to identify and address barriers to successful implementation early on in the process. The questions asked here have been compiled based on the lessons learned by VA as it has implemented eHealth Exchange with its pilot communities. It is not required that all questions be answered prior to engaging in a dialog with VA, however, answering the questions will provide a better basis of discussion to help with future planning efforts. This questionnaire will be followed by a discussion of the questionnaire with members of the Veterans Health Information Exchange (VHIE) Team. This will provide opportunity for clarification of answers and further elaboration, where necessary.

Instructions Please answer the questions to the best of your ability. The VA answers to these questions are also provided and can be used as both examples for the kind of information being requested and to inform you about current VA eHealth Exchange efforts. VA answers are indicated in blue italics. All questions refer to health data exchange for the purpose of treatment or emergency unless otherwise stated.

Name of Organization:

Physical Address of Organization:

Primary POC:

Telephone:

Scope of Partner Organization

VA currently sends the following traits to its partners to be used in identity matching:

SSN, Name (first, middle, last) ,Gender, Date of Birth, Address (Street, City, State, Zip), Phone Number, Middle Name, Mother’s Maiden Name, Place of Birth VA has found that organizations sending the full SSN in the PD message increase the patient matching probability significantly.

|_| Yes |_| No If yes, will you send it in:

|_| Patient Discovery Initiated |_| Patient Discovery Response

If yes, do you have prospective authorization in place?

VA requires a patient authorization to release information to a non-VA partner; all Veterans are required to sign an authorization to participate in the exchange of eHealth Exchange data. VA authorization covers a 10 year period.

|_| Yes |_| No |_| Other, please explain:

Prospective Authorization:

|_| Yes |_| No If yes, and VA purchased this care from your organization do you still require patient consent before VA can retrieve the results thru exchange?

|_| Yes |_| No

VA requires a patient authorization to release information to a non-VA partner; all Veterans are required to sign an authorization to participate in the exchange of eHealth Exchange data. VA authorization covers a 10 year period.

|_| Yes |_| No If Yes, please describe how a patient’s health records would be obtained from these restricted departments or ‘VIPs’.

If Yes, please provide a list of restricted departments and a definition for ‘VIPs’.

What time (CST) does your auto-query run nightly?

How is your auto-query configured?

Will you include the VA?

For VA, planned for calendar year 2018.

|_| Yes |_| No

Time (CST):

|_| Always send to the VA |_| Only send within a certain radius

|_| Yes |_| No

VA provides both inpatient and outpatient data.

|_| Inpatient data |_| Outpatient data

The VA is a nationwide hospital network with over 140 Medical Centers and hundreds of community based outreach clinics, nursing homes and domiciliaries. VA has 130 unique databases containing Veteran Health Care data. Data from all locations will be available to our eHealth Exchange partners for all shared patients who have opted in to the eHealth Exchange

in HIO

Hospitals

Clinics

Federal Qualified Health Centers (FQHC)

Laboratories

Pharmacies

Nursing homes

Other

VA utilizes the partner TINs to assist in identifying shared patients.

If you are a health care organization and have a link to all your facilities that will be exchanging with the VA, please provide the link. Otherwise, please complete the attached excel spreadsheet listing your facilities that will be exchanging with the VA

If you have Community Connect partners, please list their website if all of their facilities will be available for exchange or provide an excel spreadsheet as noted above.

The VA is a nationwide hospital network with over 140 Medical Centers. Data from all locations will be available to our eHealth Exchange partners for all shared patients who have opted in to the exchange eHealth Exchange Environments Production Environments

VA is using the 4.2.2.2 Connect Gateway product.

Vendor:

Product Name:

Version:

VA’s production certificate expires on 11/15/2018 eHealth Exchange Production certificate expiration date:

VA has fifteen test patients that have been configured in our production environment that can be utilized for production validation activities. We are unable to load additional test patients into our production environment.

Initial production validation:

|_| Yes |_| No On-going system validation activities:

|_| Yes |_| No

ICNs from VA test and production environments:

1012638925V204624 (NWHINONE)

1012581676V377802 (CHDRONE)

Home Community OID:

· OID: 2.16.840.1.113883.4.349

· Name: Production Assigning Authority OID:

· 2.16.840.1.113883.4.349

Home Community OID:

IF the answer is 4437 or 14430, please provide your domain name and IP address for your production servers, so VA can create a firewall exception to allow communications.

If your endpoints use port 443 then VA does not require a firewall exception.

VA receives communications on port 443 and sends outbound communications on port 443, 4437 or 14430. If outbound communication is on 4437 or 14430, a VA firewall exception is required and may extend the on-boarding timeline.

|_| 443 |_| 4437 |_| 14430 If you communicate on 4437 or 14430, please provide the domain name and IP address for your production servers that will receive VA queries.

Domain name:________________________ IP address: __________________________

VA’s identity management systems require that a correlation be stored in our Master Patient Index (MPI) to be able to release data to a partner. If your system does not provide a patient unique ID and assigning authority in your LivingSubjectID field when sending a patient discovery message to VA, your subsequent document query and document retrieve requests would fail our policy check.

|_|Yes, our patient discovery includes a LivingSubjectID with unique patient ID and assigning authority |_| No, we would have to modify our system to support this request

The use of the MatchCriterion tag causes patient discoveries to fail. Therefore, please do not use any MatchCriterion tags for any request or response.

|_| Yes |_| No

Note: Completion of the remaining sections is NOT REQUIRED to submit your questionnaire, but is needed prior to your go-live date.

Test Environments Note: As a Fast Track partner, there is no testing required to on-board with VA Exchange. This information is used for any testing that may take place after you are in production

Test certificate expire?

VA’s test certificate expires on 10/2017 Test certificate expiration date:

Home Community OID:

· OID: 2.16.840.1.113883.4.349.1

· Name: SQA1 Assigning Authority OID:

· 2.16.840.1.113883.4.349 Home Community OID:

Contact Information Please complete the attached list of contacts.

Questionnaire Complete – Thank You Thank you for taking the time to complete this questionnaire. The VA VHIE Health Team looks forward to partnering with your organization.

VA VHIE eHealth Exchange Business Readiness Questionnaire

VA VHIE eHealth Exchange Business Readiness Questionnaire 8 image1.png image2.emf

Template Partner Facilities List for HIE.xlsx Sheet2

Type Facility City State Zip code Tax ID used to bill the VA for referred care Does this participant contribute data? If participant contributes data, in what format will that data be availabile to the VA ? (ie: C32, C-CDA CCD, Encounters)

Sheet1

Hospitals

Clinics

Federal Qualified Health Centers (FQHC)

Practices (health system-owned practices)

Laboratories

Pharmacies

Nursing homes image3.emf

Template Partner Facilities List.xlsx Sheet2

Type Facility City State Zip code Tax ID used to bill the VA for referred care

Sheet1

Hospitals

Clinics

Federal Qualified Health Centers (FQHC)

Practices (health system-owned practices)

Laboratories

Pharmacies

Nursing homes image4.emf

PoC for Sustainment&Support.docx Background of Community Health Partner Organization

Contact information for ongoing sustainment and support activities

Readiness Questionnaire Question

Partner Answer

1.

Please provide the training point of contact for eHealth Exchange:

Name:

Title:

Email:

Phone:

The VLER Health Community Coordinator(s) will serve as liaisons to the local VA Medical Centers to coordinate training.

Name:

Title:

The person who coordinates the training of clinicians (and/or their support staff) to access VA eHealth Exchange data.

2.

Please provide the Clinical Champion point of contact for eHealth Exchange:

The VLER Health Community Coordinator(s) will work with the local VA Medical Centers to identify a clinical champion.

Clinician early adopters and leaders serve as champions for the adoption of VLER Health Exchange at the facility. They will provide feedback to and from providers regarding usability, data quality and desired enhancements. Clinician Leaders / Champions are encouraged to:

Name:

A clinician leader at your facility serves as champion for the adoption of VLER Health Exchange. This clinician will be involved more closely with the local VLER Health implementation plan than the larger end-user community. They will provide feedback to and from providers regarding usability, data quality and desired enhancements.

3.

Please provide the testing point of contact for eHealth Exchange:

Name: Kevin Via

Title: VHIE Health Partner Integration Manager

Email: kevin.via@va.gov

Phone: (202) 568-1214

Name:

4..

Please provide the test outage alerts point of contact for eHealth Exchange:

Primary eHealthExchangePartnerIntegration@va.gov

Secondary

Name: Kevin Via

Title: IT Project Manager

Email: Kevin.Via@va.gov

Phone: (336) 682-9585

Primary

5.

Please provide the production outage alerts point of contact for eHealth Exchange:

Primary eHealthExchangePartnerIntegration@va.gov

Name: David Seitz

Title: VHIE Health Partner Integration Project Manager

Email: david.seitz@va.gov

Phone: (205) 830-5900

Primary

6.

Please provide clinical data (CCD content) point of contact:

Name: Omar Bouhaddou

Title: VHIE Health Business Analyst

Email: omar.bouhaddou@va.gov

Phone: 858-832-1310

Name:

7.

Please provide identity management and patient matching point of contact:

Name: Kimberly Womack

Email: Kimberly.womack@va.gov

Phone: 205-9943-2387

Name: Angela Huss

Email: angela.huss@va.gov

Phone: 205-943-2385

Name: Rush Elliott

Email: rush.elliott@va.gov

Phone: 205-943-2384

Name: Andrea Hill

Email: andrea.hill@va.gov

Phone: 205-943-2333

Name: Teshekia Malone

Email: Teshekia.malone@va.gov

Phone: 205-943-2328

8.

Please provide your Adapter and Gateway system point of contact:

Name: Rob Hassinger

Title: VHIE Health IT Project Manager

Email: Robert.Hassinger@va.gov

Phone: (518) 449-0663

Name:

9.

Please provide your business sponsor of eHealth Exchange point of contact:

Name: Dr.Margaret Donahue

Title: Director VA VHIE Health

Email: margaret.donahue@va.gov

Phone: 585-208-4660

Name:

10.

Please provide your marketing point of contact:

Name: Sabrina Jacobs

Title: Communications Manager VA VHIE Health

Email: sabrina.jacobs@va.gov

Phone: (202) 834-0090

Name:

Please provide your Epic TS contact:

Name: