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080723 NC HIE Council Policy Development Committee Minutes by WqO2CZ6


                         NC Health Information Exchange Council
                             Policy Development Committee
                                       July 23, 2008

Meeting Participants
See end of minutes.

Welcome and Introductions
Holt Anderson welcomed the group and asked participants to introduce themselves.

Approve Minutes
The minutes from the June 25, 2008 Policy Development Committee meeting were approved.

Review Online Policy Discussions
The committee utilized the UNC-Greensboro online collaboration space to facilitate discussion
about policy issues related to HIE in an open forum. Lakshmi Iyer provided an update on recent

HISPC Project
A list of states participating in each collaborative in Phase 3 of the HISPC Project was
presented. The project includes 42 states and territories.

Consent Collaborations
A discussion of the consumer’s role in providing health information and disclosing their health
record information took place. The HISPC Collaboratives include the Consent Policy
Collaborative which is one of the two Collaboratives NC is participating in.

The Collaborative, and NC in particular will explore the questions around the level of specificity
consumers should have. Additionally, the Collaborative will assess the obligations and rights of
providers and service organizations to populate HIOs with information on specific consumers.
It is expected that laws, regulations and policies will govern these determinations.

Deliverables for this Collaborative will include:

      Process for determining state by state intrastate and interstate consent issues;
      Central library of consent documents;
      Matrix of international and national consent approaches;
      Summary of risks and benefits associated with specific intrastate consent approaches;
      Recommended legal mechanisms to address interstate consent solutions.
It was suggested that patients have the ability to choose information to disclose. However, this
led to some concerns about liability from health care providers. In addition, the break the glass
scenario in which health care providers would be able to access all medical information in an
emergency situation was emphasized.

There was also discussion about the intrastate and interstate implications of a NC HIE. For
conflicts in state laws, a legal methodology for the situation could be instituted.

In preparation for working on these deliverables between now and November, the Policy
Development Committee will be conduct several work sessions to examine specific risks,
benefits (pros and cons) of consent options for several ambulatory scenarios. NCHICA, using
the services of the various workgroups including the Policy Development Committee and the
legal expertise of Trish Markus and Linda Attarian, will compile the NC recommendations for NC
action as well as incorporation into the Collaborative wide results with California, Illinois and

Interorganizational Agreement and DURSA
A request for additional participation or references for attorneys to participate in the
interorganizational agreement project was made. Please provide Roy Wyman names of any
attorneys with expertise in the healthcare law field.

The Data Use and Reciprocal Support Agreement (DURSA) being developed as part of the
NHIN project continues to make its way through the internal review of the federal agencies
participating in the NHIN project. It is expected that the production data DURSA to arrive at the
Policy Development Committee this fall, for NC review and input.

Meeting adjourned at 12:50

Upcoming Meetings
• August 27    11:00 a.m.          NCHICA Offices
• September 24 11:00 a.m.          NCHICA Offices
• October 22   11:00 a.m.          NCHICA Offices
• November 26? 11:00 a.m.          NCHICA Offices

        Attendees        Company Name
Lakshmi Iyer             UNC Greensboro
Mark Dunnagan            Terida, LLC
David Dillehunt          FirstHealth of the Carolinas
Joy Hardee               ECU Brody School of Medicine
Patricia Markus          Smith Moore Leatherwood LLP
Marie Moseley            ECU Brody School of Medicine
Derek W. H. Kung         Williams Mullen
Janis Moysey             Beacon Partners, Inc.
                         Wake Forest University Baptist Medical
Chris Safley             Center
Colleen Shannon          Duke University Health System
Vera Bullard             Southeastern Regional Medical Center
Mary Thompson            ECU Brody School of Medicine
Linda Attarian           NC DHHS Division of Medical Assistance
Ginny Wagner       IBM Corporation
                   North Carolina Healthcare Information and
Andrew Weniger     Communications Alliance, Inc.
Roy Wyman          Williams Mullen
Larry LaBanc       Novant Health System
Dennis Severt      IBM Corporation
James Murphy       NC Office of MMIS Services
Lois Holmes        CTG HealthCare Solutions
                   Carolinas Center for Medical Excellence
Mark Massing       (formerly MRNC)

                   North Carolina Healthcare Information and
W. Holt Anderson   Communications Alliance, Inc.
John Watson        NC Association of Pharmacists

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