The following are suggested elements for the establishment of a roadmap for HIE:

1. Create Achievable, Actionable and Practical Initiatives

1. Develop and implement short-term, achievable, practical, and measurable initiatives as part of the strategy to show early progress, value, and momentum.
2. Develop mid-term and long-term recommendations that will be prioritized by criteria, such as urgency and feasibility.
3. Provide recommendations that reach across geographical and organizational boundaries.
4. There are federal requirements that SDEs support the needs of providers within their jurisdiction in the attainment of meaningful use, whether via the Medicare or Medicaid programs. HIE initiatives should be aligned with the requirements of the meaningful use of EHR incentive program in order to increase participation in the HIE. See the State HIE Cooperative Agreement FOA and PIN.

2. Ensure that Initiatives are Consumer-Focused

1. Involve consumers from the start in the governance and advisory structure of an interoperable HIT environment as appropriate.
2. Provide recommendations that will enable consumers to make more fully informed choices in their own health care.
3. Ensure that consumer health information security and privacy needs are met. See Privacy and Legal and Information Sharing.

3. Provide Technical Basis for Health Data Exchange

1. Develop and implement a technical infrastructure that will support the federal initiatives of interoperable, real-time electronic health data exchange based on national standards.
2. Ensure health information availability at the point of care for all providers and patients.
3. Ensure that there are both clinical and administrative functions as part of a robust architecture, in order to improve quality and lower costs of care delivery.

4. Promote Sustainability (Organizational and Financial)

1. Engage key stakeholders early. These stakeholders will usually include the major hospital systems, the primary payers including Medicaid, state government, and physician representation.  Once identified, they need to be actively engaged through meetings, conference calls, etc. in the development and design process. See Governance for additional information on stakeholders.
2. Develop early exchange of administrative data and information that may improve payments and assist with financial sustainability, by improving administrative inefficiencies.
3. Develop and maintain a model for sustainability that adapts to continuing change. It should align the costs and incentives with the benefits related to health information technology and health information exchange.
4. Develop a governance structure that attracts and retains participants and defines roles and responsibilities of a public / private collaborative.

5. Increase the Quality and Performance of Healthcare

1. Identify metrics to measure performance from the perspective of patient care, public health, provider and payer value, and overall economic value.
2. Provide clinicians and other authorized health care professionals with clinical decision support to enhance decisions, avoid clinical errors, including medication errors and adverse events, avoid duplicative medical procedures, and assist in following recommended practices throughout the care delivery process.
3. Enhance and facilitate the use of patient care data for appropriate public health disease surveillance, outbreak detection, trending, and health protection efforts. Meaningful Use requirements include a focus on the improvement of public and population health. Therefore, it will be important for the HIE to ensure that the measure of quality performance also enables providers, within their jurisdiction, to transmit and receive data from public health authorities.
4. Collect and use scientifically valid data and information to assess the quality, performance and cost of healthcare

6. Assist in Health Care Research

1. Collect and use data and information for scientifically valid research and public health.

Useful Links:

CORHIO HIE Roadmap

NEHII Table of Contents, Playbook