Date : February 17, 2011 Time : 12:00 pm – 2:30 pm Conference Call ONLY Dial in : 1-866-922-3257 Participant Co

1. Date: February 17, 2011 Time: 12:00 pm – 2:30 pm Conference Call ONLY Dial in: 1-866-922-3257 Participant Code: 654 032 36#

2. Agenda

3. CEO Report

4. CEO Report • NC HIE’s “State Designated Entity” Status • Communications RFP • CEO Search Update • Executive Committee Membership • Board Membership / Legal-Policy Workgroup Co-Chair • Board Bylaws • Beacon Community Request

5. NC HIE Workgroups: Process, Progress and Next Steps

6. Collaborative Infrastructure: Decisions are the Direct Result of Stakeholder Input NCHIE Board of Directors Governance Work Group Tech/Clin Ops Work Group Finance Work Group Legal/Policy Work Group Executive Committee NC HIE Operations/ Staff POLICY RECOMMENDATIONS • Develop financing model • Finalize initial payment methodology/mechanics • Develop sustainability plan • Review bylaws • Define the parameters of Qualified Organizations and develop QO criteria • Define oversight and enforcement mechanisms • Proposed legislation to facilitate opt-out • Propose legislation to harmonize state medical record law • Draft set of detailed privacy & security policies and procedures • Hire RFP consultant • Define HIE RFP review process • Develop detailed consensus specifications • Draft and issue RFP 6

7. Governance 7

8. Statewide HIE Governance: Timeline and Tasks Develop Qualified Organization Criteria Define Oversight Roles and Enforcement Mechanisms Develop Participation Agreements • Define parameters of Qualified Organizations in the HIE participation model • Develop written criteria for Qualified Organization designation Executive Committee Recommendation: NC HIE should reach out to organizations that may be planning to serve as Qualified Organizations to determine how their needs can best be met. 8

9. Key Questions for Qualified Organizations & Participants • What is a Qualified Organization? • What are the value and benefits of the Qualified Organization approach? 3a. What are the criteria for being a Qualified Organization? 3b. Should each Qualified Organization be required to meet all criteria? 4a. How do Qualified Organizations participate in statewide HIE? 4b. How do providers or organizations unaffiliated with a Qualified Organization participate in statewide HIE? 5. What are a Qualified Organization and/or Participant’s responsibilities as a participant in statewide HIE? 6. How much does it cost to participate in statewide HIE? • What happens if a Qualified Organization or participant withdraws from participation in statewide HIE? 9

10. Immediate Next Steps: What are the criteria for being a Qualified Org? 10

11. Legal and Policy 11

12. Legal & Policy: Timeline and Tasks Finalize Draft Legislation Develop and Finalize Privacy and Security Policy and Procedures • Legislation -implementation subcommittee finalizing 2 draft bills: • HIE-specific bill to facilitate opt-out model • Bill to harmonize various state laws related to medical records Key Considerations • Proposed legislation has been agreed upon, pending finalization of provision for the protection of providers in cases where information accessed via the HIE is incorrect or incomplete. • The proposed legislation allows, but does not require, provider-level opt out; the Board has flexibility to determine the most appropriate Opt-Out Policy. 12

13. Legal & Policy: Development of Privacy & Security Policies Initial Set of Policies • Defining Eligible Participants • Purposes for Access by Covered Entities • Compliance With Minimum Necessary Requirement • Break the Glass • Access to Data by HIE Staff Additional Policies to Be Defined • Scope of Rules • Patient Opt Out Rights • Defining Eligible Participants • Access to Data by Researchers • Access to Data by Government Agencies • Access to De-identified Data • Access by Patients • Responding to Subpoenas and Discovery Requests • Security Policies • Sanctions 13

14. Clinical and Technical Operations 14

15. Clinical/Tech Operations: Timeline and Tasks Develop HIE RFP Review Proposals, Negotiate, Award Contract for HIE Services Develop, Deploy, Test, and Accept HIE Services and Connect to Qualified Organizations • Secure RFP consultant • Define HIE RFP review process and recruit evaluators • Develop detailed specifications • Draft RFP 15

16. Clinical/Tech Operations: RFP for Process Management Consultants • RFP released on Jan 21, 2011 • Responses due Feb 11, 2011 • Eight proposals received and currently under review • NC HIE staff to make selection recommendation to Executive Committee • Negotiate and award contract in mid-March 16

17. Clinical/Tech Operations: Vendor Selection Process The process by which a vendor is selected should: • be fully transparent • respond to input from and the needs of all constituents • take into account all available information • be approved by the Board 17

18. Clinical/Tech Operations: Progress and Next Steps 18

19. Financing 19

20. Financing: Timeline and Tasks Develop Financing Model Finalize initial payment methodology / mechanics Finalize participation agreements and payments • Refine approach through Finance Work Group • Outreach to stakeholders for feedback and input 20

21. Financing: Accomplishments and Key Considerations 21

22. Financing: Next Steps 22

23. Open Public Comment and Closing Comments

24. Open Public Comment & Closing Comments Next Steps Upcoming Meetings Governance, Finance and Technical/Clinical Operations Work Groups – March 3 Legal/Policy and Technical/Clinical Operations – March 18 Board Meeting – March 24

25. Upcoming Work Group Meetings

26. ATTACHMENTS

27. Mission Statement of the NC HIE As included in its Operational Plan, the mission of the NC HIE is: • To provide a secure, sustainable technology infrastructure to support the real time exchange of health information to improve medical decision-making and the coordination of care.

28. Expectations of the NC HIE Work Groups • Participants have been nominated and invited to participate by the NC HIE governing board co-chaired by Secretary Lanier Cansler and Mr. Charlie Sanders for your expertise in your field and your commitment to improving health care quality, access, and affordability for all North Carolinians. • Workgroup members are asked to draw on their expertise and perspective from across industries sectors with an eye toward supporting the greater goal of a statewide resource for North Carolina. • Workgroups are expected to be multi-stakeholder, nonpartisan and all discussions, meetings and decision-making processes to be fully transparent. • Workgroups are asked to consider multiple stakeholder group perspectives when working toward solutions. • Workgroups will be asked to make consensus-based recommendations to the NC HIE governing board. In cases where consensus is not reached, the workgroup is expected to put forth a balanced, fair consideration of the pros and cons of an issue. • Workgroup members are expected to respect the opinions and input of others and to engage in fair meeting conduct to work toward consensus recommendations. • Workgroup members are strongly encouraged to attend meetings in person whenever possible. • Public stakeholder input is encouraged.

29. Governance Work Group Co-Chairs • Ben Money, NC Community Health Association • Tom Bacon, UNC School of Medicine, AHEC Members* • Connie Bishop, MSN RN, NC Nurses Association • Jacquelyn Boyden, Boyden Healthcare Consulting • Janis Curtis, Duke Health System • Craigan Gray, DHHS DMA • Mark Gregory, Kerr Drugs • Don Horton, LabCorp • Steve Keene, NC Medical Society • Harry Reynolds, IBM • Craig Richardville, Carolinas Healthcare System • Pam Silberman, NC Institute of Medicine • Craig Souza, NC Healthcare Facilities Association • Sam Spicer, New Hanover Regional Medical Center * NC HIE is currently evaluating the potential inclusion of a representative from a local HIE due to the departure of representative from WNC DataLink,

30. Clinical/Technical Operations Work Group Co-Chairs • Allen Dobson, CCNC • J.P. Kichak, UNC Hospital Members • Ben Alexander, WakeMed • Cynthia Cox, Raleigh Medical Group • Sam Cykert, AHEC, Moses Cone • Michael Fenton, NC CIO Office • John Graham, UNC Institute for Public Health • Susan Helm-Murtagh, BCBSNC • Arlo Jennings, Mission Hospitals • Yan Wang Kolbas, NC Nurses Association • Bill Leister, LabCorp • Keith McNeice, Carolinas Healthcare System • John A. (Sandy) McNeill, NC Health Care Facilities Association • Don Spencer, UNC Health Care • Angela Taylor, NC DHHS • James Tcheng, Duke University • John Torontow, Piedmont Health

31. Finance Work Group Co-Chairs • Maureen O’Connor, BCBSNC • Dr. Dave Tayloe, Goldsboro Pediatrics Members • Mark Bell, NC Hospital Association • Brian Harris, Rural Health Group, Inc. • Yvonne Hughes, Coastal Connect HIE • Mark Miller, Novant Health • John Minnich, CSC • Steve Owen, NC Medicaid • Phred Pilkington, Cabarrus County Health Dept. • Devdutta Sangvai, MD, Duke University Medical Center

32. Legal/Policy Work Group – Legislation and Implementation Subcommittee Co-Chairs • Senator Josh Stein • Representative Thom Tillis Members • Linda Attarian, NC DHHS (Vice-Chair) • Judith Beach, Quintiles • Mark Botts, UNC School of Government • Chris Collins, NC Office of Rural Health and Community Care • Brian Forrest, Access Healthcare • Chris Hoke, NC Department of Health & Human Services • Linwood Jones, North Carolina Hospital Association • Trish Markus, Smith Moore Leatherwood • Barbara Morales-Burke, Blue Cross Blue Shield of North Carolina • Melanie Phelps, North Carolina Medical Society • Troy Trygstad, Community Care of North Carolina • Robin Wright, NCHICA Consumer Advisory Council • Bill Wilson, AARP