Q&A on RHIO Connectivity

Please note, this Q&A was updated on November 20, 2017. Click here to see the most recent version.

Regional Health Information Organization (RHIO) connectivity is a DSRIP requirement for all OneCity Health partners that either provide clinical services and/or have an Electronic Medical Record (EMR).

In the beginning of 2017, OneCity Health conducted a successful pilot with one partner to connect their EMR to the New York Care Information Gateway (NYCIG) RHIO. This pilot has now been expanded to serve a larger wave of partners. For the expanded pilot, our vendor, Digital Edge, is responsible for recruiting partners with an EMR that will receive technical assistance and support from OneCity Health and NYC Health + Hospitals to connect to the NYCIG RHIO.

Digital Edge will or already has sent an email and followed up with a phone call to all OneCity Health partners to schedule an introductory meeting. OneCity Health will help partners establish a site to site Virtual Protected Network connection with the RHIO, and do a test of data exchange. The following Q&A covers additional questions that OneCity Health partners have raised regarding RHIO connection.

Are OneCity Health community-based organization ([CBO], non-Medicaid billing) partners required to connect to a RHIO?
No, these partners are not required to connect to a RHIO. However, if any of these partners are interested in electronic/RHIO connectivity, they should inform OneCity Health so that we can support their electronic/RHIO connectivity efforts.

Are OneCity Health CBO (non-Medicaid billing) partners required to utilize an electronic medical record (EMR)?
No, these partners are not required to utilize an EMR.

Are OneCity Health partners required to connect to the NYCIG RHIO specifically or to any RHIO? If to any RHIO, will Digital Edge provide technical assistance for a partner to connect to a RHIO other than the NYCIG RHIO?
OneCity Health partners can connect to any RHIO. However, we are only offering technical assistance for connection to the NYCIG RHIO.

If my organization is already connected to a different RHIO, is there any advantage to connecting to the NYCIG RHIO as well?
There is no disadvantage to connecting to multiple RHIOs. Connecting to multiple RHIOs can provide access to a wider array of information given that each RHIO collects some information that another RHIO may not. However, sharing or gaining access to your patient’s or client’s information in each RHIO you connect to, is dependent on the patient or client executing a consent for each such RHIO.

Are we offering an Electronic Medical Record (EMR) for Medicaid billing partners? If so, do we have a specific product that we are offering?
Yes. We are still finalizing this process though, and will share details when they are available

What is specifically covered by OneCity Health via technical assistance from New York City Health + Hospitals and Digital Edge?

  • Procurement of an EMR or electronic record? No, procurement of an EMR is not covered. You should inform OneCity Health though if you would like to acquire an EMR. OneCity Health is currently exploring the possibility of offering an EMR option to such partners.
  • Technical assistance to connect an EMR or electronic record to a RHIO? Yes, this is covered but only for connection to the NYCIG RHIO.
  • Technical assistance to install an EMR? No, this is not covered
  • Technical assistance to share information bi-directionally with a RHIO? Yes, this is covered but only for the NYCIG RHIO.
  • Costs that an EMR vendor may charge for connecting to a RHIO? No, we will not cover costs that partners may incur from their own EMR vendor to support connectivity to a RHIO; we will only provide technical assistance to support their connectivity to the NYCIG RHIO. Such technical assistance may include collaborating with your EMR vendor as needed.
  • Ongoing subscription fees? Partners should not be subject to any ongoing subscription fees to a RHIO as the New York State Department of Health is currently subsidizing such fees directly with RHIOs.

Are there any other resources (i.e., state or city funded) that partners can utilize to support their electronic/RHIO connectivity?
We are happy to work with you to identify the electronic connectivity option that works best for your organization, which includes the technical assistance services that we are providing free of charge. However, if you prefer to utilize different resources to pursue electronic/RHIO connectivity, we can recommend New York State Department of Health resources such as the New York eHealth Collaborative which may be able to provide financial assistance

If you continue to have questions about connecting to the RHIO, please reach out to the OneCity Health support desk at ochsupportdesk@nychhc.org or call 646-694-7090 (Monday through Friday, 9-5pm ET).

CBO Listening Sessions: Proving Value is New for Everyone

“The concept of proving value is new for everyone,” explained a participant at our Brooklyn Listening Session, channeling the mood of the room. “We have had limited resources in place…[and] we need a central place to collect the data. Without data, how do we prove the work we have been doing over the years?”

Throughout July 2017, we hosted a series of Listening Sessions to hear from our community-based organization (CBO) partners (our partners that provide social services such as food and legal assistance) about their experiences-to-date, challenges and expectations regarding the changing health care landscape. Specifically, we asked about our partners’ organizational experience in developing and marketing a value proposition for one or more of its services, any preparations they’ve made to succeed in a value-based payment (VBP) environment, and where our partners envision themselves following the Delivery System Reform Incentive Payment (DSRIP) program.

While opinions varied, our partners focused on three important areas where OneCity Health can enable CBOs to better integrate with the evolving health care delivery system and demonstrate improved patient outcomes.

  • First, aligning our network to leverage CBOs’ strengths can improve their sustainability. With the health care system moving toward rewarding outcomes, CBOs want to ensure the services they provide are understood and integrated into OneCity Health’s workflows and referral patterns.

    For example, one attendee from Queens noted, “We often define ourselves based on the population served rather than the services provided.” Participants said that continuing to tailor metrics to CBOs is an important first step.

  • Second, CBOs are eager to implement data systems to facilitate analysis and track patient outcomes, but their resources are limited. The need goes beyond simply identifying or installing a new system; to align with the new health care environment, CBOs need to ensure they are using a common system, and that they know what to measure and how often they should measure.
  • Third, CBOs are seeking additional knowledge and assistance to increase their ability to operate in a value-based payment environment. A common set of definitions, with more thorough explanations around what services improve value, would help, explained an attendee from the Bronx.

    As one Bronx participant explained, “At [our organization] there are many different programs. The question is, how do we equate the service to the value that we really have, which is helping people get better?”

Beyond these three key takeaways, Listening Session participants acknowledged these conversations need to continue. In the near-term, these discussions will help influence the metrics and other parameters of our Phase III contracts. Additionally, as part of the technical assistance we are offering to our CBO partners, Community Service Society of New York (CSSNY) will begin reaching out to our CBO partners over the next few months to have them complete an Organizational Self-Assessment aimed at assessing their VBP readiness. Subsequently, CSSNY will be providing them with technical assistance to develop a value proposition. We hope our partners take advantage of this incredible opportunity to increase the sustainability of their agencies’ services.

Webinar Series: Co-Location of Primary Care and Behavioral Health Services

Throughout August, OneCity Health hosted a series of webinars on the Co-Location of Primary Care and Behavioral Health Services for our ten pilot sites currently planning for co-location. Led by consultants from Grassi & Co., our vendor currently working with our pilot sites, the webinar recordings were posted on this page following each session.

In addition to the webinars posted below, in June we hosted a webinar titled, “Navigating the Regulatory Options for Co-location of Primary Care and Behavioral Health,” which is available to view here.

Webinar Recordings
Implementation of Co-Location of Primary Care and Behavioral Health Services
This webinar covered the key components of implementing co-location of primary care and behavioral health, including needs assessment, regulatory requirements, identification of resources needed (e.g. space, staffing, health information technology systems, etc.), care coordination, as well as monitoring implementation.

Click here to view the slides, or watch the recording below:

Measures and Quality Improvement for the Co-Location of Primary Care and Behavioral Health Services
This webinar covered clinical and operational measures recommended for co-location of primary care and behavioral health services and an overview of strategies for quality improvement.

Click here to view the slides, or watch the recording below:

Billing Considerations for Co-Location of Primary Care and Behavioral Health Services
This webinar reviewed information needed for billing and compliance for co-location of primary care and behavioral health services. The information presented is also helpful to information technology stakeholders who need to support billing, revenue cycle and compliance. Please note this information only addressed billing considerations for sites that have chosen the licensure threshold, DSRIP waiver or Integrated Outpatient Services (IOS) license as the regulatory option for co-location at their site.

Click here to view the slides, or watch the recording below.

In addition to the webinar, click here to download an accompanying handout – Revenue Cycle Changes Checklist

Screening Tools for Co-location of Primary Care and Behavioral Health Services
This topic was addressed in two separate webinars:

  • Screening Approaches for Co-location of Primary Care Services in a Behavioral Health Setting
    This webinar provided an overview of the use of screening approaches for physical health (e.g. chronic disease, pain, etc.) in the behavioral health setting. It included a discussion of the importance of provider involvement in achieving success of co-location. Click here to view the slides.
  • Screening Tools for Co-location of Behavioral Health Services in a Primary Care Setting
    This webinar provided an overview of the use of screening tools for depression, anxiety as well as alcohol and substance abuse in the primary care setting. It included a discussion of the importance of provider involvement in achieving success of co-location. Click here to view the slides.

Both webinars are available to view in one recording. The presentation begins with a focus on behavioral health screening, and then the discussion on physical health screenings commences at the 31:10 mark. Watch the recording here:

Updates from the PAC: Digital Edge IT Assessments and Next Steps for Partners

At our March 8, 2017 Project Advisory Committee (PAC) meeting, our partners offered feedback and follow-up questions on a number of resources and ongoing initiatives that we have introduced to further develop our integrated delivery system (IDS). Specifically, our partners suggested:

Over the coming weeks, we will discuss each of the topics in depth, and also continue to provide updates on our monthly OneCity Health Partner Webinars. Our webinars are also a forum for additional questions and answers with our partners.

Below please find an update on OneCity Health’s support to partners for achieving electronic connectivity, including an infographic explaining the benefits of connecting to a Regional Health Information Organization (RHIO), IT assessments conducted by our IT technical assistance vendor Digital Edge, and next steps for partners.

RHIO Connectivity, IT Assessments and Next Steps

RHIO and Benefits to Partners
To further develop our IDS, OneCity Health will facilitate connectivity of our partners with a RHIO this year to ensure that all of a patient’s providers can securely access his or her data and share information.

Please note that it is also a Delivery System Reform Incentive Payment (DSRIP) program requirement for partners to connect to a RHIO. However, if a partner does NOT provide clinical services (e.g., social services only) or does NOT have an Electronic Medical Record (EMR), they are not required to connect to a RHIO. For these partners, OneCity Health is currently procuring a web-based “EMR-like” solution as an alternative option for connection to a RHIO.

To learn more about a RHIO and how it will benefit both our partners and patients, please view our infographic below. It is also available for download here.

Digital Edge IT Assessments
Throughout 2016, Digital Edge, a OneCity Health IT technical assistance vendor, conducted assessments of our partners’ IT capabilities to help us understand the steps we need to take to electronically connect our partners to a RHIO and securely share patient information across our integrated delivery system. Thank you to our partners who worked with Digital Edge; we now have an overview of the current state of our network’s electronic connectivity and are able to move forward with supporting partners in this regard. Here are some key takeaways:

  • Digital Edge reached out to all partners who have signed a Master Services Agreement (MSA) with OneCity Health, and were able to coordinate an assessment with 153 partners. Of this subset:
    • 133 partners have an Electronic Medical Record (EMR)
    • 36 partners are connected to a RHIO

We have stopped conducting IT assessments, and are now moving forward with supporting all of our partners by initiating or strengthening their electronic connectivity.

Next Steps for Partners
Earlier this year, we conducted a successful pilot with one of our partners to connect their EMR to a RHIO. Next, we will start to connect EMRs to a RHIO for a large wave of partners. To start this process, Digital Edge is again conducting outreach, beginning with an email and following up with a phone call, to OneCity Health partners (including those that did not complete the IT assessment) to schedule an introductory meeting to discuss the connection process. Digital Edge will work directly with partners to enable their connection to a RHIO, and will soon reach out all partners.

If OneCity Health partners would like to request to be in this first wave, they should respond to the initial email from Digital Edge right away or reach out to the OneCity Health support desk. Due to space constraints, these requests will be handled on a first come first served basis.

What will be Required of Partners During the RHIO Connection Process?
Connecting to a RHIO is FREE for OneCity Health partners. This means we will help partners establish a site to site VPN connection with the RHIO, and do a test of data exchange at no cost to partners. However, OneCity Health will not compensate a partner’s current IT vendor that may need to facilitate additional connections to another RHIO(s).

Partners are requested to identify an IT contact who can collaborate with Digital Edge throughout the RHIO connection process, which should take about 3-4 weeks.

Utilizing eConsult to Improve Access to Specialists from Primary Care

An underlying theme of our transformation initiatives is increasing value for patients, and ensuring they receive the right care at the right place at the right time.

In their recent case study, published in the New England Journal of Medicine’s NEJM Catalyst, Hannah Byrnes-Enoch, MPH, Program Manager, Ambulatory Specialty Care, Jesse Singer, DO, MPH, Assistant Vice President, Care Models and Analytics, and Dr. Dave Chokshi, Chief Population Health Officer, all of OneCity Health, addressed one particular aspect – the challenge facing patients and primary care providers in accessing timely, affordable specialty care.

“Improving our ability to deliver specialist expertise in lower-cost settings for more patients is critical to our mission as a safety-net health system,” said the authors. “Changes in the health care landscape, particularly an increase in the number of uninsured patients, will make access to specialist care in the safety net more challenging for patients.”

Focusing on NYC Health + Hospitals, they identified opportunities for change. These include:

  • Identifying instances where a patient’s needs can be met in the primary care setting in conjunction with a specialist’s input and guidance
  • Increasing access to specialty care based on the urgency of the patient’s need

To make progress, our team sought to determine whether the eConsult concept, sometimes termed eReferral or eCR, could be integrated into NYC Health + Hospitals’ Electronic Health Record (EHR) system. Their goal was to improve provider-to-provider communication and make it easier for primary care providers and specialists to communicate about and co-manage patients when appropriate. Through the EHR, a specialist would review all incoming referrals, responding electronically when appropriate and requesting the patient to be scheduled for a face-to-face visit if needed.

While the full case study details how they executed the pilot, initial results are encouraging. Early data and feedback from pilot clinics show that the eConsult workflow is contributing to improved access to specialty care and clinical recommendations for patients. There were over 6,000 referrals placed in an eConsult and triaged to a specialist in the pilot. Among these, 70 percent were deemed appropriate for an in-person visit and triaged by urgency, while the specialist provided immediate guidance to the primary care provider for the remaining 30 percent.

Dr. Chokshi and his team are continuing to refine the eConsult model to further improve patient communication and scheduling processes. Read the full article to see the lessons learned and other next steps.

Updates from the PAC: Enhancements to the Partner Portal

At our March 8, 2017 Project Advisory Committee (PAC) meeting, our partners offered feedback and follow-up questions on a number of resources and ongoing initiatives that we have introduced to further develop our integrated delivery system. Specifically, our partners suggested:

  • A comprehensive update regarding the OneCity Health Partner Portal, including enhancements, partner valuation, notifications and the invoicing process
  • More information regarding IT assessments conducted by Digital Edge and next steps for partners
  • Additional details regarding a partner services directory
  • A recap of our network’s metric submission performance in Phase I

Over the coming weeks, we will discuss each of the topics in depth, and also continue to provide updates on our monthly OneCity Health Partner Webinars. Our webinars are also a forum for additional Q&A with our partners.

First, below please find an update on the OneCity Health Partner Portal, including specific questions our partners raised at the PAC meeting.

OneCity Health Partner Portal

Provide an update on the enhanced Portal for Phase II and when resources will be available
Our team has made several improvements that are now available, or will be soon. Improvements include the following:

  • New interface with ability to access information on one screen
  • Improvement of notifications of pending actions, and visual indication of submission deadlines and progress
  • Ability to submit invoice concurrent to metric submission
  • Ability to download submissions and invoices for records
  • Improved features to give greater guidance for metric submissions and remediation

For more information about the updates to the Portal, please view the slides from our April OneCity Health Partner Webinar here, where we detailed the enhancements that were available as of April 11, 2017. We will discuss the new features that are since live on our May 9, 2017 Partner Webinar.

Make partner valuation something that gets updated or removed
Partner valuation will not be updated in the Phase I version of the OneCity Health Partner Portal, and is not included in the Phase II version of the OneCity Health Partner Portal. We are still deciding how to best display performance data, including partner valuation via the Partner Portal.

Fix the portal notifications window to ensure it is in chronological order
The chronological order of the portal notifications was fixed in the Phase I version of the OneCity Health Partner Portal. In Phase II, there is no longer a notifications window, and partners can see the status of their submissions in their Home Page after they log into the Portal.

Ensure the OneCity Health support desk has a list of invoices awaiting submission to provide to partners when they call
The OneCity Health support desk has the ability to confirm what invoices are currently available for submission, as well as what metrics are pending submission. The support desk has been and will continue to update partners regarding their invoice and submission status upon request by phone and/or email.

Achieving Transformation Through Training and Education

As we progress with our transformation efforts, it is essential for our partners to have a shared understanding of the Performing Provider System’s (PPS) goals and how to reach them. To that end, OneCity Health has undertaken numerous activities to date – and will soon launch many others – to help train and educate our partners.

From instructing Transition Management Teams to coaching our partners to utilize the Patient Activation Measure® (PAM®) survey, each OneCity Health initiative has been rooted in engaging our PPS partners with educational materials and technical assistance, which helps our partners:

These are just a few examples; education supports improved patient and population health across our integrated delivery system and could extend to areas such as care management and information technology (IT), among other topics. OneCity Health is investing $50 million in workforce training for our network over the Delivery System Reform Incentive Payment (DSRIP) program to support these efforts.

As we make educational content available or schedule opportunities for instruction, we will reach out to our partners and ensure they are well-positioned to improve patient health. Simultaneously, we will coordinate with our PPS partners’ many training-related assets to encourage best practices and leverage our greatest strengths.

PCMH Transformation: Update on Achieving Recognition

Helping our community partners achieve Patient-Centered Medical Home (PCMH) recognition is critical to ensuring that New Yorkers have access to high-quality primary care. OneCity Health is initially investing $1.8 million in PCMH transformation for our network through March, 2017, which will improve upon a fragmented delivery system through better coordination and management of care.

After kicking off the initiative last July, OneCity Health technical assistance (TA) vendors completed comprehensive baseline assessments for an initial wave of 44 community-based primary care partner practices, which was a critical step in helping these practices achieve National Committee for Quality Assurance (NCQA) 2014 PCMH Level 3 accreditation.

Baseline assessments help our partners to understand their gaps in achieving PCMH recognition, which can include information technology (IT) gaps, access gaps such as limited operating hours or the need to institute quality improvement processes. They will now work with our TA vendors to implement a work plan to become accredited. An important component of this process is now on the horizon, as they will soon attend their first PCMH transformation learning collaborative. This in-person event will focus on team-based care and enhancing access for our patients. We have reached out directly to our primary care partners who completed a baseline assessment to register for this event.

We will soon begin reaching out to our second wave of community-based primary care partner practices to begin conducting their baseline assessments.

Partner Webinar: Coordinating Patient Care

Thank you to our partners who attended today’s OneCity Health Partner Webinar: Coordinating Patient Care: GSI and the RHIO.

For our partners who were unable to view the webinar, the slides are available to view here.

Please also view the webinar here:

Our partners should keep in mind next steps:

    • Due by October 14, 2016: 13 Comprehensive Schedule B metrics
    • Due by October 15, 2016: Five Patient Engagement metrics
    • Continue to attend monthly OneCity Health Partner Webinars. Our next one will be November 15, 2016
  • Our support desk is also available for questions.

    We look forward to continuing to engage with our partners on future webinars.

    Agenda for October 11 Partner Webinar

    On Tuesday, October 11, we are hosting our third monthly OneCity Health Partner Webinar.

    As a reminder, on these webinars we intend to further assist partners in understanding Comprehensive Schedule B requirements, discuss practical steps for project execution and reporting, and highlight best practices.

    Additionally, attending these webinars will help our partners complete the Comprehensive Schedule B performance metric to “attend 75 percent of monthly webinars hosted by OneCity Health within the Schedule B period”. We detailed the webinar series here.

    The agenda for Tuesday’s webinar is:

    • OneCity Health Partner Webinar series logistics
    • Comprehensive Schedule B deadlines
    • Enrollment in GSI training
    • Background on the Regional Health Information Organization (RHIO) and OneCity Health IT assessments
    • Final reminders
    • Patient Engagement metrics
  • Here is how to join:

    Tuesday, October 11th, from 2:00 p.m. – 3:30 p.m. EST
    WebEx Meeting Link: click here
    Audio Connection: 1-855-282-6330 US TOLL FREE
    Access Code: 730 459 022

    Partner Webinar: Improving Access to Care

    Thank you to our partners who attended today’s OneCity Health Partner Webinar: Improving Access to Care: Documenting Workflows & Cultural Competence.

    For our partners who were unable to view the webinar, the slides are available to view here.

    Please also view the webinar here:

    Our partners should keep in mind next steps:



    • Due by September 30, 2016: 13 Comprehensive Schedule B metrics

    • Due by October 7, 2016: Complete the Excel template to submit a workforce report. Be on the lookout for the template and instructions via email

    • Due by October 15, 2016: five Patient Engagement metrics


  • Our support desk is also available for questions.

    We look forward to continuing to engage with our partners on future webinars.