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Development of Health Information Technology to Impact Urban High Risk Populations

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Title: Development of Health Information Technology to Impact Urban High Risk Populations Subject: AHRQ Annual Meeting Presentation 9/8/2008 Author – PowerPoint PPT presentation

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Title: Development of Health Information Technology to Impact Urban High Risk Populations


1
Development of Health Information Technology to
Impact Urban High Risk Populations
  • LaRah Payne, ScD, MPH, CIPP/G
  • Senior Policy Analyst/Privacy Officer
  • DC, Department of Health/MAA
  • Washington, D.C

2
Not a place you would want to be . . .
  • Not a place where you would want to be . . .

3

4
DC Healthcare System Challenges
  • High incidence of chronic disease
  • High mortality rates for selected diseases
  • Distribution of health care resources
  • Variations in the utilization of services

5
Health Insurance Coverage
  • DC has a very high coverage rate
  • Medicaid covers 1 out of 4 residents
  • Local Only Funding XIX gt 1 out of 3

6
Medicaid Transformation Grant Project Purpose
  • Interface currently separate patient data on IT
    systems across MAA, DOH, six local health
    centers and three local hospitals
  • The interface will be accomplished through the
    development and implementation of a Medicaid
    Patient Hub which will include
  • linkages to the providers EHR and EMR products
  • a master client index
  • a physical repository for population-based data
  • a record locator component
  • an analytical component for data analysis by MAA
  • user access control and audit component

7
Medicaid Transformation Grant Project Goals
  • Data Integration Integrate patient data so DOH
    can expand its ability to perform analysis on
    Medicaid populations and individuals served by
    the Department and those who are served by other
    organizations participating in this effort (6
    neighborhood health centers, 3 hospitals, and DOH
    programs).
  • Coordinate Health Services Delivery Enable
    community health centers to coordinate health
    services delivery with other participating
    clinics and hospitals.
  • Medical Decision Making Improve the quality of
    medical decision making through secure exchange
    of accurate and comprehensive patient health
    information and through patient-centered and
    outcome driven analytical capabilities.

8
MTG Project Goals (cont.)
  • DC-wide Clinical Informatics and Analysis
    Capabilities Available at the point of care for
    providers with individual level access, and on
    the desktop for aggregate analyses by program
    level analysts and administrators in MAA and DOH.
  • Patient Care Medicaid patients medical
    information (in linked systems) will be
    accessible at the point of care including
    clinics, hospitals, DOH facilities, Medicaid care
    managers, etc.
  • Cost Savings by Management of Care, Outcomes
    Costs Patient and provider data will be analyzed
    to identify cost savings through the reduction of
    duplicate services and better coordination of
    care among the provider participants.
  • Potential NHIN-type Linkages Provide connecting
    link to larger, regional HIE and RHIO efforts in
    the NCA

9
MTG Project Organization
MTG Steering Committee (Chair John McCarthy)
Medicaid Representatives DC Dept. of Health
Representatives Office of the Chief Technology
Officer Representatives
Executive Sponsor Robert Maruca Sr. Deputy
Director, Medical Assistance Administration
Subject Matter Experts Medicaid
Administration Medicaid Operations HIT Standards
Interfaces Health Information Exchange
Privacy/Security/Confidentiality Local/State
Legislation Variation Policy and Procedure
Development EHR and EMR Interfaces MITA Standards
Requirements Health Care Costs and
Outcomes Business Processing Re-engineering
MAA Senior Policy Director John McCarthy
Program Manager TBD
Patient Hub Contractor/ Systems Integrator Vendor
- TBD

GWU MTG Facilitator
Data Analysis
Record Locator
Physical Repository
Master Client Index
Links to EHRs and EMRs
User Access Control and Audit
10
MTG Project Components
INTEGRATION
REPOSITORY
LOCATOR
ANALYSIS
MASTER INDEX

Data Mining Analysis
Patient Data Linkages
Identity Reconciliation
Population-based Data
Secure Data Exchange
  • Providers can receive basic patient record
    summary data from MMIS
  • Providers access patient data through patient hub
  • User access control and audit enforces HIPAA
    compliance
  • Master Client Index provides for accurate
    identification of patients across MAA, DOH,
    health centers and hospitals
  • Reduces medical record errors and duplication
  • Physical data repository for population-based
    data from public health programs
  • Public Health data can be pushed to remote
    providers
  • Informs clinical decision-making at the provider
    site
  • Patient Record Locator for remote access and
    exchange of necessary medical record data
  • Provides for future access to larger NHIN
    exchange efforts
  • Analytical component to determine true costs of
    care
  • Ability to check for duplication of services
    across provider sites

11
Transformation Grant Project Period
Medicaid MMIS
Separately funded
CMS
MDS OASIS

Data Flows Both Ways Through Record Locators
Completed - Black In process - Grey
Corrections

Clearing House
IMA
Record Locator
TG Patient Data Hub Enable Access Aggregator

CFSA
Clinics

6 Clinics
Record Locator
DYRS
Other Clinics
Metadata Repository
Record Locator
DMH
Hospitals

3 Hospitals
Record Locator
  • Analytics Reporting
  • Predictive Modeling
  • Adm. Decision Support Tool

DCPS

Other Hospitals
DOH
Record Locator
  • APRA
  • MAA
  • SHPA
  • EPSDT
  • MPCA
  • WIC
  • IR
  • Lead
  • Cancer
  • HAA
  • AIDS
  • HEPRA
  • Public Labs
  • HCRLA

Labs


Private Labs
Master Patient Index
Record Locator
Providers

Other Providers
Safe Passage Portal (Limited Data
Set) OPERATIONAL DATA REPOSITORY
Medicaid Data Never Rolls Off Real time record
locator Analytical repository
- Scope

- Fully Funded

- Not funded
- Vision
12
Post Transformation Grant Vision
Medicaid MMIS
CMS
MDS OASIS
Data Flows Both Ways Through Record Locators
Corrections
IMA
TG Patient Data Hub Enable Access Aggregator
CFSA
Record Locator
Clinics
DYRS
All Clinics
Metadata Repository
Record Locator
DMH
Hospitals
All Hospitals
DCPS
Record Locator
  • Analytics Reporting
  • Predictive Modeling
  • Adm. Decision Support Tool

Labs
DOH
Private Labs
Record Locator
  • APRA
  • MAA
  • SHPA
  • EPSDT
  • MPCA
  • WIC
  • IR
  • Lead
  • Cancer
  • HAA
  • AIDS
  • HEPRA
  • Public Labs
  • HCRLA

Providers
Other Providers
Master Patient Index
Safe Passage Portal (Limited Data
Set) OPERATIONAL DATA REPOSITORY
Medicaid Data Never Rolls Off Real time record
locator Analytical repository
13
Relationship MTG to Medical Home-EMR
Phase HUB HUB EMR
Phase Internal Interface EMR
I (MTG) Architecture Design Build infrastructure Create Master Patient Index Architecture Design Build API Establish EMR base in clinics
II (MTG) Fix Defects Provide Reporting Enhance Capability Connect to 6 Clinics Connect to 3 Hospitals Connect to HUB
III (Post MTG) Fix Defects Enhance Capability Connect to Labs Connect to Other Clinics Connect to Other Hospitals
IV (Post MTG) Connect to All Providers
14
MTG Project Chronology
  • CMS Approval Letter February 2007
  • Project Award
  • First Year funds 5,459,000
  • Second Year funds 4,405,000
  • Executive Steering Committee formed March 2007
  • Joined Medicaid Transformation Grant
    Collaborative (13 states)
  • Retained GWU Contractor to Support Use Case
    development, Outline Evaluation Framework, and
    Draft Scope of Work for RFP
  • Finalized Draft RFP but procurement process has
    been slower than originally anticipated

15
Where We Want to Be
  • A full and active participant in developing
    statewide HIE efforts
  • A key facilitator of providers participation,
    especially for vulnerable populations, and
  • An effective user of Health IT to improve the
    quality and health outcomes of Medicaid
    recipients

16
Thanks for Listening
  • Contact Information
  • LaRah Payne, ScD, MPH, CIPP/G
  • Senior Policy Analyst / MAA Privacy Officer
  • D.C. Dept. of Health/MAA
  • 825 N. Capitol St. NE, Suite 5200
  • Washington, DC 20002-4210
  • Tel 202.442.9116
  • E-mail LaRah.Payne_at_dc.gov
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