CommunityNetwork

What is SMRTNET for Community Networks?

SMRTNET has been recognized by AHRQ as one of its eight success stories and by the National eHealth Collaborate as one of twelve national HIE leaders. 

The Secure Medical Records Transfer Network is an “HIE utility company” that focuses on the planning and implementation of many self governed health information exchanges that can share data with one another.

To date SMRTNET has planned eleven networks, eight are operational and several in construction.

One network has been funded by ONC to a Beacon Project. Another has been funded by ONC as a Challenge grant. All network consensus based planning projects have developed 100% consensus between participants around issues of governance, legal, privacy, clinical, quality, technology (vendor neutral), and sustainability issues in under 90 days with a commitment of no more than two three-hour meetings by participants.

SMRTNET is a public non-profit developed as an outgrowth of a five year, $ 5 million effort supported by AHRQ and many other sources through a wide variety of providers including hospitals, state agencies, universities, Native American tribes, public health, mental health, private providers, community health centers, and other provider types. To date over 500 experts have participated in SMRTNET planning sessions.

A table of eleven network planning projects is attached at the end of this document. This includes the network, description, approximate number of staff involved including CEOs, attorneys, clinicians, privacy officers, quality officers, financial/budgeting and marketing staff.

Objectives

• Improve planning time from 12-18 months to under 3 months
• Reduce upfront costs from (range of $1.5 million – $100,000) to $30,000 – $ 50,000
• Increase success rate from 40% to 90%
• Framework is inclusive of wide variety of partners
• Totally consensus based
• Commitment of six hours per person (maximum)
• Vendor neutral

Planning Services

• Planning service format utilizes a step-by-step series of consensus driven decisions involving all network organizations.
• Utilizes a planning committee to oversee and coordinate all reports (this can also be the governance board).
• Utilizes SMRTNET expertise to lead the groups, answer common questions and explain different options available. The shape of the network is driven by the answers and choices that the members make. Therefore each network is configured to meet the needs of the members.
• Utilizes the internal expertise of participants administrative, legal, privacy, quality, financial and technology experts.
• No more than two meetings of three hours each per person.

Governance

• Mission
• Members
• Legal
• Privacy policy
• Sustainability
• Products
• Developmental plan
• Special voting processes for HIOs
• Legal formats
• Data reports policy and controls
• Intersection to state plan
• Utilization review
• Training
• Patient communications

Clinical

• Identification of use cases
• Identification of provider types
• Meaningful use
• Specification of data to be shared
• Utilization
• Common concerns of providers
• Speed of data transfer
• Training of providers
• Policy formation

Quality Improvement

• Identification of key quality indicators by facility types
• Development of measurement systems
• Measuring meaningful use
• Identification of shared quality measures
• Development of measurement systems
• Review of new quality improvement uses

Legal

• Exchange under HIPAA and HiTech
• Other issues of state law and special circumstances
• Technology based security protections
• Issues concerning documents and CCDs
• Sensitive information
• Opt-in, opt-out and hybrids
• EMPI procedures
• Issues of liability
• Role access
• Twenty-seven privacy policies to protect data and consumers
• Fourteen legal documents that are needed
• Use of trusted sources
• Beaches
• DURSA issues
• Consumer information
• Privacy implications of Direct Secure messaging
• Additions of NHIN Requirements for common member exchange agreement

Sustainability and Return on Investment

• Identification of key cost saving factors
• Hard cost reduction
• Savings in personnel time
• Opportunity costs
• Measurement of legal risk
• Coordinate to pricing and value

Technology

• Assessment of current systems
• Interoperability strategies
• Identification of standards
• Data security
• Data storage
• Data transfer
• Transfer speed issues
• RFIs
• Auditing
• Dashboards
• NHIN readiness