We'll be reviewing this presentation which includes a review of the HIE work done to date, the proposed State Medicaid Health Plan, and the national standards work ahead.
The key initiatives of the State Medicaid Health Plan (SMHP) include:
EHR Program – Administer the Incentive Payment program enabling payments through the state’s MMIS (Medicaid) system
Direct Project - Promote the adoption of the Point-to-Point Push capability by providing increased level of documentation, training and a common HIE interface. Extend use case to include some EOHHS Department of Public Health services
Record Locator Service – Enabling a citizen record locator service. Infrastructure could be leveraged for statewide use.
Provider Directory Interface – Create/establish a statewide Provider Directory
Public Key Infrastructure (PKI)/Certificate Management - To support HIE and Medicaid security infrastructure.
Health Information Service Provider – To make HIE services available to providers that meet certain economic and technical qualifications. This is especially targeted to HIE actors not affiliated with larger organizations and networks. Including in this consideration is consumer education and involvement.
Massachusetts Virtual Gateway (VG) upgrade – VG is the front door for many of the Health and Human state services Enhance this critical service by further increasing support for standards-based interfaces including Direct.
Clinical Database – Enabling a data-marts in support of Meaningful Use measures.
Connection to Quality Data Center – Establish Medicaid performance measure infrastructure leveraging standards-based Quality Data Center service providers.
Formulary/Medication Management - Reducing errors in drug identification by enabling global access to accurate medication data for improving prescription practices and patient compliance using NCPDP 8.1 for Medication History and HL7 for Medication Reconciliation. Electronic Prior Authorization is another area of opportunity.
Re-architecting and Enabling Payment Methodologies – With the advent of payment reform, flexible IT claim processing systems shall be needed to quickly adapt to the evolving ACO (and other) programs and reforms.
Claims Relay Service Analysis and Design Project – Similar to the HL7 and HIPAA Hub concept, this project shall provide a single gateway for the submission of claims for MassHealth (regardless of medical, pharmacy, Dental or Health Safety Net Claims)
Public Health Interfaces (labs, immunizations, syndromic surveillance) – Targeting an EOHHS MA Single End Point (XML Gateway) for a variety of “services” including both HL7 transactions and HIPAA transactions. This includes bi-directional sync and async support.
Statewide HIE Solution Integration Services – Systems Integrator services supporting above project and aggressively advancing the adoption of statewide HIE services.
Our first task will be reconcile health information exchange planning done to date with the state medicaid health plan and evolving meaningful use stage 2 requirements.
I look forward to the discussion!