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Health IT Policy Reports Archives

The Maryland Health Care Commission's (MHCC) Center for Health Information Technology and Innovative Care Delivery (Center) publishes various documents relating to advancing the adoption and use of health information technology (health IT).  Listed below are archived reports, organized by topic. 

Adoption of Electronic Health Records among Long Term Care Facilities in Maryland

The MHCC conducted an environmental scan (scan) to assess EHR adoption among independent LTC facilities in the State.  LTC facilities provide health care services for residents who often transition between acute, post-acute, and LTC settings.  This flyer provides the findings of the scan and explains EHR adoption challenges.

2015; 2013 

Comprehensive Care Facilities:  Adoption of Health Information Technology (2016)

Comprehensive Care Facilities (CCFs) provide medical and nursing services for residents over an extended period of time due to age, disability and disease.  Information from MHCC's Annual Long Term Care Survey was used in assessing health IT adoption among 230 CCFs in Maryland.  This brief highlights CCFs adoption of EHRs, basic EHR use, and adoption of HIE and telehealth, including plans for adoption and reported adoption challenges.  

Electronic Health Records

Accelerating Meaningful Use in Maryland:  Strategies Aimed at Eligible Providers (2013)

In an effort to advance the Meaningful Use (MU) of electronic health records (EHRs), the American Recovery and Reinvestment Act of 2009 established incentives for Medicare and Medicaid eligible professionals (EPs) who adopt certified EHR systems and meaningfully use them to improve patient care quality and satisfaction, increase population health, and reduce health care costs.  In the spring of 2013, MHCC collaborated with Maryland stakeholders to assess the challenges experienced by EPs as they worked toward practice transformation and to develop strategies contained in this report to accelerate the achievement of MU.

Electronic Health Records:  An Environmental Scan of Local Health Departments and State Hospitals (2015)

This information brief presents findings from an EHR Environmental Scan (scan) on EHR adoption in local health departments (LHDs) and State hospitals.  The scan assessed EHR technology in place today, identified LHD EHR implementation challenges, and explored opportunities where collaboration could enhance user capabilities among LHDs. 

Electronic Health Records:  Incentives and Program Progress (2015)   

The Maryland General Assembly passed a law in 2009 that requires certain State-regulated payors (payors) to offer incentives for providers to adopt electronic health records.  The MHCC worked with the six largest payors and provider representatives in the State to establish an incentive program, which requires payors to provide incentives to primary care practices (family, general, geriatric, internal medicine, pediatric, or gynecologic practices), including nurse practitioner-led practices.  This information brief provides an update on the impact of the State incentive program and the initiatives aimed at encouraging program participation among eligible practices.

Electronic Health Records:  State Incentive and Usability Across Hospital Settings (2013)

At the request of leadership from the General Assembly’s Maryland House Health and Government Operations (HGO) Committee, MHCC evaluated the State-regulated payor EHR Adoption Incentive program (State incentive program) to determine if changes were necessary to ensure that the intent of the law was met. In collaboration with the State incentive program workgroup (workgroup), this report includes the recommended program enhancements. The MHCC was also asked by the HGO Committee leadership to explore provider challenges involving the usability of EHR systems across hospital settings and provide recommendations contained in this report that mitigate these challenges.

HB 706:  Electronic Health Records - Regulations and Reimbursement (2012)

The Maryland General Assembly passed House Bill 706, Electronic Health Records - Regulation and Reimbursement, (HB 706) during the 2009 legislative session with the purpose of advancing health IT adoption and use among Maryland providers. The law required MHCC to report to the Governor and General Assembly periodically on implementation of the law.

HB 706:  Electronic Health Records - Regulations and Reimbursement (2010)

HB 706:  Electronic Health Records - Regulations and Reimbursement (2009) 

The Maryland General Assembly passed House Bill 706, Electronic Health Records - Regulation and Reimbursement, (HB 706) during the 2009 legislative session with the purpose of advancing health IT adoption and use among Maryland providers.  The law required MHCC to report to the Governor and General Assembly periodically on implementation of the law.

HB 736:  Electronic Health Records - Incentives for Health Care Providers - Regulations (2013)

House Bill 736, Electronic Health Records – Incentives for Health Care Providers – Regulations, amended the law, Md. Code Ann., Health-Gen. § 19-143 requiring Maryland payors to pay cash incentives to certain providers for the adoption and use of EHRs. The amendments also required MHCC to study and submit recommendations to the Senate Finance Committee and the House Health and Government Operations Committee as to whether the scope of health care providers that may receive the incentives from payors should be expanded beyond primary care practices.

Health Information Technology Survey Reports

Health Information Technology:  An Assessment of Freestanding Ambulatory Surgical Centers in Maryland (2012)

The MHCC conducts an annual Freestanding Ambulatory Surgical Center (Centers) Health Information Technology Survey to Assess the Current Health IT Adoption planning efforts among Centers in Maryland.  The Centers are asked to report about their use of or plans to implement certain health IT functions including:  EHRs; infection surveillance software (ISS); electronic prescribing (e-Prescribing); and electronic HIE, laboratories, diagnostic centers and outpatient physicians.

Health Information Technology:  An Assessment of Freestanding Ambulatory Surgical Centers in Maryland (2011)

Health Information Technology:  An Assessment of Freestanding Ambulatory Surgical Centers in Maryland (2010)

The MHCC conducted an annual Freestanding Ambulatory Surgical Center (Center) Health Information Technology Survey to assess the current health IT adoption planning efforts among Centers in Maryland.

Health Information Exchange

A Consumer-Centric Health Information Exchange for Maryland - Staff Recommendations (2009)

The MHCC staff recommendations for advancing the health and wellness of Marylanders by implementing a clinical data sharing utility that ensures that consumers have access to the highest quality, most efficient, and safest care by giving providers access to the right information at the right time through the Chesapeake Regional Information System for our Patients (CRISP), the statewide health information exchange, (HIE).

Building of a Statewide HIE: Implementation Effort Working Papers 

The MHCC and Health Services Cost Review Commission worked collaboratively to implement an interoperable statewide HIE. These working papers laid the foundation for the plan that was used to build the HIE.

Health Information Exchange Challenge Program - Funding Opportunity Announcement Response (2011)

The MHCC proposed to address Challenge Theme Two, under the HIE Challenge Program and pilot the electronic exchange of clinical documents between pairs of long term care (LTC) centers and proximate hospital emergency departments. The pilot centered on six large LTC facilities across Maryland, with some services being offered to every facility in the State; the duration of the project was about 36 months. The project aims to improve long term and post-acute care transitions by leveraging Maryland’s operational HIE to electronically share clinical information in real-time, including information on advance directives, where they exist.

Maryland HIE Evaluation Results Report (2014)

The MHCC compiled this report for Maryland under the State HIE Cooperative Agreement Program to meet the requirements in the program information notice issued by the Office of the National Coordinator (ONC) for Health Information Technology; the plan was approved by ONC.  The report describes the approaches and strategies used by the State-Designated HIE to facilitate and expand HIE in priority areas; identifies conditions influencing implementation of program strategies; assesses how HIE performance has progressed in key program priority areas; as well as how key approaches and strategies implemented by the State-Designated HIE contributed to progress.

The Statewide Health Information Exchange:  Technology to Support a Prescription Drug Monitoring Program (2009)

In June 2008, the Advisory Council (council) on prescription drug monitoring was authorized by Maryland law to study the establishment of a prescription drug monitoring program (PDMP) that electronically collects and stores data concerning monitored prescription drugs. The council proposed an efficient approach to deploying a PDMP in Maryland as a service of the statewide HIE.

Service Area Health Information Exchange:  A Hospital Data Sharing Community Resource Guide (2009)

Service area health information exchanges (SAHIEs) are comprised of providers in a select geographic area that share the same patients across practices and settings. The MHCC convened a workgroup to develop a resource guide for providers in the planning stages of a SAHIE.  The resource guide includes the policies relating to patient rights to their health information and control of this information; range of business practices for access, authentication, authorization, and audit; technical requirements for standards and process workflows; communication mechanisms and outreach initiatives; key community-level financial, organizational, and policy challenges; and alternate community data uses. 

CRISP Plan for a Citizen-Centric Statewide HIE in Maryland (2009)

A comprehensive planning report that highlights strategies for implementing a statewide HIE.  The CRISP planning report outlines a detailed approach to building the HIE infrastructure, data management, use case deployment, engaging stakeholders in the decision-making process, developing HIE policies, governance, finance and sustainability, and community outreach and education.

CRISP Response to the Request for Application for a Consumer-Centric Health Information Exchange for Maryland (2009)

CRISP presents a response to MHCC's request for application (RFA) to build and implement a statewide HIE.  The document details CRISP’s approach, principles, organizational infrastructure and plan for policy development. 

MCHIE Strategies for a Person-Centric, Inclusive Maryland HIE (2009) 

One of two comprehensive statewide HIE planning reports submitted at the request of MHCC. The Montgomery County Health Information Exchange Collaborative (MCHIE) findings were consistent with CRISP's planning report, and focused on community hospitals and low income uninsured, rather than the urban, large hospital system representation in the CRISP planning report.  The report recommendations address key decision elements for governance, financing, privacy and security, technical architecture, and community engagement with the ultimate goal of interconnectivity of improved health care outcomes for all in Maryland. 

Health Information Technology Consumer Awareness & Education Brief (2012)  

Effective consumer awareness and education programs related to health IT are expected to bolster public trust and confidence with the goal of empowering patients to manage their health care by increasing patient access to their health information. This report presents findings from seven consumer focus groups convened by MHCC to assess consumer awareness and trust in health IT. Consistent themes that emerged from the focus group discussions include:  consumers prefer to control who has access to their electronic health information; community based organizations are concerned about the risk of electronic health information being lost or stolen; and concern regarding the lack of health IT awareness and education activities in the State.

State Health Information Exchange Cooperative Agreement Program:  Funding Response (2009)

Outlines the strategic approach to implementing a private and secure statewide HIE by building trust and engaging numerous stakeholders to address fundamental policy issues and a planned course of action. The funding response outlines a four-year plan to advance the necessary governance, policies, technical services, business operations and financing mechanisms for HIE.  This document was submitted to the ONC in response to State Cooperative Agreements to Promote Health Information Technology:  Planning and Implementation Projects funding announcement.

Health Information Technology:  An Assessment of Maryland Hospitals

The MHCC conducts an annual Hospital Health IT Survey that provides information regarding current trends and the future direction of health IT adoption among all acute care hospitals in Maryland. Listed below are links to these reports based on the survey year.

2015;  2014;  2013201220112010;  2009;  2008 

Summaries of the findings are by survey year. 

2015;  2014;  20132012

Privacy and Security

Health Information Security and Privacy Collaboration Consumer and Provider Education “Challenge” Report (2009)

Health Information Security and Privacy Collaboration (HISPC), established in 2006 through a contract with the U.S. Department of Health and Human Services, comprised of 42 states and territories, collaboratively aimed to effectively address privacy and security issues pertinent to electronic health information through a multi-state collaboration. A project extension began in 2009 and focused on consumer and provider outreach and education.

Privacy and Security:  Solutions and Implementation Activities for a Statewide Health Information Exchange (2008)

The MHCC convened a Solutions and Implementation Workgroup (workgroup) to formulate solutions, guiding principles, and implementation activities that address organizational-level business practices affecting statewide privacy and security policies in order to support interoperable HIE.  The implementation activities proposed by the workgroup included, making electronic health information accessible to all stakeholders when appropriate, ensuring that consumers control the flow of their information, embracing governance that is inclusive and transparent, and developing exchange standards.

An Assessment of Privacy and Security Policies and Business Practices (2007) 

A workgroup that consisted of eight health care sector groups was convened by MHCC to assess business policies and practices in general, and security policies and practices in particular that could impede the development of an effective statewide HIE.  This assessment included an examination of each sector group’s perception of HIE; concerns regarding the benefits, risks, and challenges impacting each group; and various alternatives to address these issues. 

Other Health Information Technology Reports, Briefs and Flyers

Advancing Telehealth in Maryland

Maryland is developing strategies to expand the use of telehealth to increase access to care, improve patient outcomes and generate cost savings.  This flyer details Maryland telehealth legislation, and defines the role and progress of the Telemedicine Task Force. The Task Force explored strategies that facilitated increased use of telehealth to more effectively deliver health care services in Maryland.

American Recovery and Reinvestment Act of 2009 Updates to HIPAA

The American Recovery and Reinvestment Act of 2009 (ARRA) signed into law on February 17, 2009 by President Barack Obama, is an economic stimulus bill.  This flyer lists the key privacy and security changes to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as a result of ARRA.

Breaches of Unsecure Protected Health Information

A breach is an impermissible use or disclosure of protected health information (PHI) under the HIPAA Privacy Rule.  This flyer outlines breach notification requirements, security measures to protect PHI, and summarizes the Health and Human Services’ annual report on breaches.

Changes to the Medicare Electronic Prescribing Incentive Program

The Centers for Medicare and Medicaid Services issued a final rule, Changes to the Electronic Prescribing (eRx) Incentive Program, effective on October 6, 2011 that modifies the eRx quality measure to address uncertainties related to the technological requirements of the Medicare eRx Incentive Program and adopts significant hardship exemption categories for the 2012 eRx payment adjustment.  This flyer provides details regarding a qualified eRx system, payment adjustments, and how to apply for significant hardship exemptions.

Electronic Data Interchange Transaction Annual Reports and Information Briefs (2000-2012)

This is a listing of the archived annual Electronic Data Interchange (EDI) Administrative Transaction Reports and the list of reporting payors by year.  Maryland law requires payors operating in Maryland with an annual premium volume exceeding $1 million to report census information to MHCC regarding electronic administrative transitions.  Each year, MHCC examines the information from payors and develops an industry brief.  Payors and providers use this information to monitor and enhance their use of administrative technology.

Health Information Technology and Meaningful Use for Providers (2010)

Provides an overview on meaningful use for eligible professionals.

Health Information Technology State Plan

Describes a strategic and operational plan that includes the efforts to implement a private and secure consumer centric statewide HIE in Maryland.  Topic areas include plans for policy development; governance; finance and sustainability; technical infrastructure; business and technical operation; coordination with Medicaid; Medicare and federally funded State programs; among others.  The Health IT State Plan is updated annually.  The initial four-year plan for 2010-2013 and the plan for 2011-2014 are included below.

Health IT State Plan (2011-2014)

Health IT State Plan, (2010-2013)      Appendices

Describes the implementation of Maryland’s private and secure statewide HIE for advancing health IT and balancing the need for information sharing with the need for strong privacy and security policies while maintaining a judicious approach to funding the HIE. The technical infrastructure outlined in the plan ensures that the Federal government and general public have strong roles in the development of fundamental policies governing information exchange, as well as protecting the interests of the general public and consumers.  The plan also details how HIE allows providers to maximize funding incentives under the American Recovery and Reinvestment Act (ARRA) of 2009.

HIPAA Privacy Rule Accounting of Disclosures under the Health Information Technology for Economic and Clinical Health Act

As required under the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), the U.S. Department of Health and Human Services Office for Civil Rights published a Notice of Proposed Rulemaking that modifies the accounting of disclosures requirement under the HIPAA Privacy Rule.  This flyer provides a summary of the proposed privacy rule changes.

Implementation of Preauthorization Phase 1 & 2 Benchmarks

Maryland law requires payors, pharmacy benefit managers (PBMs), and providers to attain benchmarks for standardizing and automating preauthorization of medical and pharmacy services through a phased approach.  Phase 1 required payors and PBMs by October 1, 2012 to include lists on their website of medical and pharmaceutical services requiring preauthorization and key criteria for making a determination on a preauthorization request.  Phase 2 required payors and PBMs to accept medical and pharmaceutical service preauthorization requests electronically and assign a unique identification number to each request for tracking purposes by March 1, 2013.  This flyer includes a current list of payors and PBMs and addresses to their webpage(s) that contain Phase 1 and Phase 2 benchmark information.

Key Provisions from the ARRA of (2009)

Summarizes key provisions of the ARRA, including topics related to the following:  codification and expansion of the Office of the National Coordinator for Health Information Technology (ONC); national health IT policy and standards; health IT privacy leadership; support for health IT adoption; state grants to promote health IT; support for the development of health care IT professionals; Medicare and Medicaid incentives for electronic health record (EHR) adoption; and the expansion of privacy and security protections for personal health information (PHI).

Leading Requirements of SB 776:  Telemedicine Task Force – Maryland Health Care Commission

Signed into law on May 2, 2013 by Governor Martin O’Malley and effective on July 1, 2013, this law required MHCC, in conjunction with the Maryland Health Quality and Cost Council, to reconvene the 2010 Telemedicine Task Force (Task Force) to study the use of telehealth throughout the State.  This flyer summarizes the requirements of Senate Bill 776.

Leading Requirements of SB 781:  Health Insurance – Coverage for Services Delivered through Telemedicine

Signed into law on May 22, 2012 by Governor Martin O’Malley and effective October 1, 2012, this law required health insurers and managed care organizations to provide coverage for health care services delivered appropriately using telemedicine technology.  This flyer summarizes the requirements of the law and details the additional components of the bill.

Maryland Medical Assistance Program Health Information Technology Planning Advanced Planning Document (2010)

Describes how the Maryland Medical Assistance Program developed a high-level management statement of Maryland’s vision, needs, objectives, plans, and estimated costs that resulted in a State Medicaid Health IT Plan. 

Management Service Organizations – A Vision of State Designated Organizations for Physician Practices (2009)

Management Service Organizations (MSOs) have emerged as a way to address the critical challenges of widespread use of EHRs. This report identifies the critical infrastructure requirements for MSOs that seek State Designation.  For a presentation summary of the MSO State Designation Program year one accomplishments (May 2010 – May 2011), click here.

MCHIE Strategies for a Person-Centric, Inclusive Maryland HIE (2009)

One of two comprehensive statewide HIE planning reports submitted at the request of MHCC. The Montgomery County Health Information Exchange Collaborative (MCHIE) findings were consistent with the CRISP planning report, and focused on community hospitals and the low income uninsured rather than the urban, large hospital system representation in the CRISP planning report.  The report recommendations address key decision elements regarding governance, financing, privacy and security, technical architecture, and community engagement with the ultimate goal of interconnectivity of improved health care outcomes for all those in Maryland.

Overview of the 2012 Legislative Report - House Bill 706 – Electronic Health Records – Regulations and Reimbursement

Signed into law on May 19, 2009 by Governor Martin O’Malley, House Bill 706 aims to advance health IT adoption and use among Maryland providers and required MHCC to, among other things:  designate a statewide HIE, identify EHR adoption incentives from certain payers, designate one or more MSOs, and make certain recommendations to the General Assembly. This flyer details the recommendations for changes in State laws to achieve optimal EHR adoption and use.

Physician Adoption of Health Information Technology - An Information Brief (2016)

Physicians are required to renew their license every two years and MHCC uses information from the license survey to assess the adoption of health IT among active Maryland Physicians.  This brief focuses on the adoption and use of EHRs, HIE, and telehealth. This brief also details how Maryland compares to the nation in terms of health IT adoption.

Recommendations for Implementing Electronic Prior Authorizations (2011)

In July 2011, the Maryland General Assembly Joint Committee on Health Care Delivery and Financing requested MHCC to develop recommendations around best practices for prior authorization of prescription medications and medical services. This report details the recommendations of a multi-stakeholder workgroup convened by MHCC.  The recommendations focused on short-term solutions that incrementally reduce the burden on providers, payors and third-party administrators, and require minimal rework once national standards are adopted.

State-Regulated Payor and Pharmacy Benefit Manager Preauthorization Benchmark Attainment (October 2016)

Health General Article 19-108.2 established four benchmarks with the aim of creating administrative efficiencies in the preauthorization process.  The MHCC was required to report annually to the Governor and General Assembly through 2016 on State-regulated payors (payors) and pharmacy benefits managers (PBM) implementation of the benchmarks.

State-Regulated Payor and Pharmacy Benefit Manager Preauthorization Benchmark Attainment (October 2015)

State-Regulated Payor and Pharmacy Benefit Manager Preauthorization Benchmark Attainment (November 2014)

Health General Article 19-108.2 established four benchmarks with the aim of creating administrative efficiencies in the preauthorization process.  The MHCC was required to report annually to the Governor and General Assembly through 2016 on State-regulated payors (payors) and pharmacy benefits managers (PBM) implementation of the benchmarks.

State-Regulated Payor and Pharmacy Benefit Manager Preauthorization Benchmark Attainment (October 2013)

The MHCC was required to report to the Governor and General Assembly by December 31, 2013 on the progress made by State-Regulated payor (payor) and pharmacy benefit managers (PBMs) in implementing electronic preauthorization.  Automating the preauthorization process for medical and pharmaceutical services (health care services) is intended to streamline the preauthorization request and approval process and minimize administrative burdens on providers.  Payors and PBMs reported to MHCC on their attainment of the three Phases; all payers and PBMs are in compliance with the law.  The law required that providers use an electronic method to submit all preauthorization requests unless granted a waiver by July 1, 2015.  The MHCC worked with payors and PBMs to raise awareness among providers regarding their electronic preauthorization systems. 

State-Regulated Payor and Pharmacy Benefit Manager Preauthorization Benchmark Attainment (March 2013)

The Maryland General Assembly passed House Bill 470, Maryland Health Care Commission - Preauthorization of Health Care Services - Benchmarks during the 2012 legislative session, and was signed into law by Governor Martin O'Malley on May 22, 2012. The purpose of the law is to require State-regulated payors (payors) and pharmacy benefit managers (PBMs) to standardize and automate the preauthorization process, in three phases, and report on their progress. The MHCC reported to the Governor and General Assembly on March 31, 2013 and reported again on December 31, 2013 on the progress made by payors and PBMs with implementation of electronic preauthorization.

Task Force to Study Electronic Health Records:  Review of the 2007 Final Report Recommendations (2009)

The MHCC reconvened the Task Force to Study Electronic Health Records (task force) on April 2009 to reevaluate the 13 recommendations presented in the task force’s final report submitted to the Governor and the Maryland General Assembly on December 31, 2007.  The report detailed the landscape surrounding the adoption of EHRs, and also represented recommendations pertaining to EHRs and expansion of EHR utilization in the State (that included:  electronic transfer, e-prescribing, computerized physician order entry, implementation costs of these items in the State, the impact on school health records, and the impact on patient safety and privacy).

Telemedicine Information Brief

The MHCC conducted an environmental scan (scan) to assess the Maryland telemedicine landscape to inform the Task Force.  This flyer details how the telemedicine landscape has changed as telemedicine adoption has increased; it includes a literature review of the financial impacts of telemedicine, an overview of telemedicine initiatives among office-based physicians, as well as acute care hospitals, and a review of various telemedicine products.

Telemedicine Recommendations:  A Report Prepared for the Maryland Quality and Cost Council (2011)

The Maryland Telemedicine Task Force (Task Force) was convened to address challenges to widespread adoption of a comprehensive statewide telemedicine system of care. Recommendations were identified by the Task Force to promote telemedicine in Maryland, which include:  reimbursement for telemedicine from State-regulated payors, establishment of a centralized telemedicine network built on existing industry standards and implementation of changes in licensure and privileging of providers to facilitate the adoption of telemedicine.

Telemedicine Task Force - Final Report (2014)

This report presents the Task Force recommendations for expanding telehealth adoption Maryland.  The Task Force consisted of three advisory groups:  Clinical Advisory Group (CAG), Finance and Business Model Advisory Group, and Technology Solutions and Standards Advisory Group.  The CAG recommended 10 use cases for implementation in pilot projects to accelerate the use of telehealth.  These uses cases are intended to have an impact on vulnerable populations; be consistent with the goals of healthcare reform; and be implementable, testable, and cost-effective.

Telemedicine Task Force - Interim Report (2013)

State law required MHCC to reconvene the Task Force to identify opportunities for expanding telehealth to improve health status and care delivery.  The law also required MHCC to update the Governor, Senate Finance Committee, and the House Health and Government Operations Committee on the work (interim report) of the Task Force by the end of 2013.  The final report was due December 1, 2014 and included recommendations aimed at increasing the use of telehealth.

Telemedicine Task Force

The effective use of telemedicine can increase access to health care, reduce health disparities, and create efficiencies in health care delivery.  This flyer details the role of the Task Force in addressing challenges to the widespread adoption of a comprehensive statewide telemedicine system of care.  An overview of recommendations from the Task Force is provided.

Telehealth Update

This flyer provides an update on telehealth coverage in Maryland and includes an overview of the work of the Telemedicine Task Force in 2013 and 2014, including recommendations for expanding telehealth adoption in the State. 


Last Updated: 8/25/2020