Medicaid/SCHIP Technical Medicaid/SCHIP Technical Assistance for Health IT/HIEAssistance for Health IT/HIE
2008 AHRQ Annual Conference2008 AHRQ Annual Conference
Presented by:Presented by:Linda Dimitropoulos, RTI InternationalLinda Dimitropoulos, RTI International
Why Medicaid and SCHIP?Why Medicaid and SCHIP?Medicaid and the State Children’s Health Medicaid and the State Children’s Health Insurance Program (SCHIP) serve the Insurance Program (SCHIP) serve the most medically and financially vulnerable most medically and financially vulnerable populationspopulationsLargest payer and insurer in the nationLargest payer and insurer in the nationCan influence the adoption of Health IT Can influence the adoption of Health IT and HIE by providers that serve vulnerable and HIE by providers that serve vulnerable populationspopulationsAgencies face considerable challengesAgencies face considerable challenges
Project Purpose and FocusProject Purpose and Focus
Purpose:Purpose: To support Medicaid and SCHIP program To support Medicaid and SCHIP program efforts to identify and adopt effective health IT and to efforts to identify and adopt effective health IT and to participate in electronic data exchange to improve the participate in electronic data exchange to improve the quality and safety of their programs for the people who quality and safety of their programs for the people who rely on them.rely on them.
Focus:Focus: To develop a program of technical assistance To develop a program of technical assistance that helps agencies tothat helps agencies to identify and prioritize goalsidentify and prioritize goals, to, to overcome barriers to adoption and implementationovercome barriers to adoption and implementation, , and to and to evaluate outcomesevaluate outcomes..
Overview of Project ActivitiesOverview of Project Activities
Conduct a Nationwide Needs Assessment Conduct a Nationwide Needs Assessment Develop a Program of AssistanceDevelop a Program of Assistance– General Technical AssistanceGeneral Technical Assistance– Targeted Technical AssistanceTargeted Technical Assistance– Access to Repository of Resources specific to Access to Repository of Resources specific to
Medicaid and SCHIPMedicaid and SCHIP– Communities of practice and opportunities for Communities of practice and opportunities for
peer-to-peer learning peer-to-peer learning
Current StatusCurrent Status
Completed pilot needs assessmentCompleted pilot needs assessmentNationwide needs assessment is going on Nationwide needs assessment is going on now through mid-November.now through mid-November.Results will inform program plans for 2009Results will inform program plans for 2009Ongoing program evaluation will inform Ongoing program evaluation will inform program changesprogram changesProducts, best practices and lessons learned Products, best practices and lessons learned will be disseminated following each eventwill be disseminated following each eventReassessment will be done in year 2—Reassessment will be done in year 2—June/July 2009June/July 2009
Pilot Needs AssessmentPilot Needs Assessment7 agencies participated7 agencies participatedSelection based onSelection based on– Demographics, Size of Medicaid/SCHIP Demographics, Size of Medicaid/SCHIP
program, Medicaid/SCHIP affiliation, Extent program, Medicaid/SCHIP affiliation, Extent of Health IT/HIE Activityof Health IT/HIE Activity
Structured question guide provided in Structured question guide provided in advanceadvanceState ProfilesState ProfilesIn-person and web conferenceIn-person and web conference
Identification of Health IT ProjectsIdentification of Health IT Projects
Agencies plans change frequently and several Agencies plans change frequently and several agencies had modified/updated their state’s agencies had modified/updated their state’s health IT project plans in the past 12 monthshealth IT project plans in the past 12 monthsFor most agencies, their MMIS/Medicaid For most agencies, their MMIS/Medicaid Information Technology Architecture (MITA) was Information Technology Architecture (MITA) was their main health IT projecttheir main health IT projectMedicaid/SCHIP participation is largely limited to Medicaid/SCHIP participation is largely limited to a role within a statewide health IT project or a role within a statewide health IT project or within a project implemented by another entity. within a project implemented by another entity.
Pilot Needs AssessmentPilot Needs Assessment
Summary FindingsSummary Findings– Majority of Health IT projects are in early Majority of Health IT projects are in early
planning stages.planning stages.– Plans for formal evaluation components Plans for formal evaluation components
specific to Medicaid/SCHIP are limited.specific to Medicaid/SCHIP are limited.– Sustainability was noted as the primary Sustainability was noted as the primary
challenge to implementation. Also,challenge to implementation. Also,Provider participationProvider participationPrivacy and Security IssuesPrivacy and Security IssuesTransitioning between MMIS systemsTransitioning between MMIS systems
Goals and OutcomesGoals and OutcomesGeneralGeneral– Improve care to Medicaid population.Improve care to Medicaid population.– Improve efficiency of business processes with providers.Improve efficiency of business processes with providers.
Project-specificProject-specific– Prevent drug-related adverse events, fraud, and abuse (e-Prescribing).Prevent drug-related adverse events, fraud, and abuse (e-Prescribing).– Make more clinically related data available electronically to providers Make more clinically related data available electronically to providers
(electronic health records [EHRs] built from Medicaid’s administrative (electronic health records [EHRs] built from Medicaid’s administrative data).data).
– Share aggregate health information with provider at point of care (Health Share aggregate health information with provider at point of care (Health Record Bank).Record Bank).
– Allow consumers access to their health information (Health Record Allow consumers access to their health information (Health Record Bank).Bank).
– Afford providers better/more timely access to Medicaid administrative Afford providers better/more timely access to Medicaid administrative data.data.
– Improve overall efficiency of administrative systems (MMIS projects).Improve overall efficiency of administrative systems (MMIS projects).
Challenges to Implementing InitiativesChallenges to Implementing Initiatives
Sustainability/funding of projectSustainability/funding of projectMaintaining participation from providers in the Maintaining participation from providers in the project project Privacy and security issues Privacy and security issues Implementing new MMIS systems (while Implementing new MMIS systems (while continuing to perform and operate concurrently continuing to perform and operate concurrently under the old, legacy systems)under the old, legacy systems)Aligning the goals/interests of multiple Aligning the goals/interests of multiple partners/participants in project; andpartners/participants in project; andSeeking and securing legislative approval for Seeking and securing legislative approval for participationparticipation
TA Topic AreasTA Topic AreasOverall health IT/HIE policy issuesOverall health IT/HIE policy issuesHealth IT/HIE privacy and security issues for Health IT/HIE privacy and security issues for Medicaid/SCHIPMedicaid/SCHIPAdoption and use of data and technical standardsAdoption and use of data and technical standardsMedicaid/SCHIP health IT project initiatives—general Medicaid/SCHIP health IT project initiatives—general topicstopicsMedicaid/SCHIP and EHRsMedicaid/SCHIP and EHRsMedicaid/SCHIP and PHRsMedicaid/SCHIP and PHRsMedicaid/SCHIP and medication management/e-Medicaid/SCHIP and medication management/e-PrescribingPrescribingMedicaid/SCHIP and HIEsMedicaid/SCHIP and HIEsRole of health IT and HIE in quality improvement and Role of health IT and HIE in quality improvement and business process improvementbusiness process improvement
Reported Priority Areas for TAReported Priority Areas for TA
Role of health IT/HIE in quality Role of health IT/HIE in quality improvement and business process improvement and business process improvement.improvement.Adoption and use of data and technical Adoption and use of data and technical standards.standards.Health IT/HIE privacy and security issues Health IT/HIE privacy and security issues for Medicaid/SCHIP.for Medicaid/SCHIP.Overall health IT/HIE policy issues.Overall health IT/HIE policy issues.
Priority Sub-Topics Priority Sub-Topics • Federal and state regulations/laws/guidance that impact
Medicaid/SCHIP plans for health IT and HIE initiatives
• Business process analysis for the implementation of health IT projects in Medicaid/SCHIP agencies
• Cost/benefit analysis to support the implementation of health IT projects by Medicaid/SCHIP agencies (assessing resource requirements and cost/value to agency)
• Integration of e-Prescribing and medication management with MMIS, MITA, and other internal Medicaid/SCHIP systems
General TA: Year 1 WebinarsGeneral TA: Year 1 Webinars
Unraveling privacy and security in HIEs: An overview of Unraveling privacy and security in HIEs: An overview of requirements and options for Medicaid/SCHIP requirements and options for Medicaid/SCHIP programsprograms – March 20, 2008 – March 20, 2008
Identity ManagementIdentity Management for Interoperable Health for Interoperable Health Information ExchangesInformation Exchanges – March 26, 2008 – March 26, 2008
Overview of Technical and Data Standards for Health Overview of Technical and Data Standards for Health IT and HIEIT and HIE – April 3, 2008 – April 3, 2008
Evaluating Health IT Projects: A Primer for Medicaid Evaluating Health IT Projects: A Primer for Medicaid and SCHIPand SCHIP – May 1, 2008 – May 1, 2008
Year 1 Webinars Year 1 Webinars (continued)(continued)
Understanding EHRs: Common features and strategic approaches for Understanding EHRs: Common features and strategic approaches for Medicaid/SCHIPMedicaid/SCHIP – June 5, 2008 – June 5, 2008
HIEs for Medicaid and SCHIP Agencies: An Overview of Core HIEs for Medicaid and SCHIP Agencies: An Overview of Core Characteristics, Components and ApproachesCharacteristics, Components and Approaches – June 19, 2008 – June 19, 2008
Evaluating Health IT Projects: A State PerspectiveEvaluating Health IT Projects: A State Perspective – July 10, 2008 – July 10, 2008
Clinical Decision Support Systems – Critical Health IT Tools for Clinical Decision Support Systems – Critical Health IT Tools for Interoperable Health Information – Interoperable Health Information – August 14, 2008August 14, 2008
Electronic Standards for Consent DirectivesElectronic Standards for Consent Directives –– August 27, 2008 August 27, 2008
Transcripts and Slides for all webinars can be found at: Transcripts and Slides for all webinars can be found at: http://healthit.ahrq.gov/Medicaid-SCHIPhttp://healthit.ahrq.gov/Medicaid-SCHIP
Targeted TA: WorkshopsTargeted TA: Workshops
Strategic Planning work shopStrategic Planning work shop– Identify goalsIdentify goals– Develop RoadmapDevelop Roadmap
Follow-up trackingFollow-up trackingTool kit (development) or product or planTool kit (development) or product or planEvaluation Evaluation
Access to ResourcesAccess to Resources
Develop and maintain Medicaid/SCHIP-specific Develop and maintain Medicaid/SCHIP-specific section on AHRQ National Resource Center section on AHRQ National Resource Center website including: website including: – a repository of information and tools specifically a repository of information and tools specifically
related to Medicaid and SCHIPrelated to Medicaid and SCHIP– a web-based learning community for Medicaid and a web-based learning community for Medicaid and
SCHIP representatives to share experiences and SCHIP representatives to share experiences and lessons learnedlessons learned
Establish and support on-going learning Establish and support on-going learning communitycommunity
AHRQ MEDICAID and SCHIP AHRQ MEDICAID and SCHIP Website and RepositoryWebsite and Repository
Additional Technical Assistance and Support Additional Technical Assistance and Support ActivitiesActivities
Other planned activities include: Other planned activities include: – Facilitated peer-to-peer learning sessionsFacilitated peer-to-peer learning sessions– In-person educational meetingsIn-person educational meetings– Tool kitsTool kits– Issue BriefsIssue Briefs– Highlighted lessons learnedHighlighted lessons learned
How to Keep InformedHow to Keep Informed
Visit the website often!Visit the website often!http://healthit.ahrq.gov/Medicaid-SCHIPhttp://healthit.ahrq.gov/Medicaid-SCHIP
Email ideas and comments to:Email ideas and comments to:[email protected]@ahrq.hhs.gov
Register for the listserv so you can keep informed Register for the listserv so you can keep informed about project events!about project events!– Send an E-mail message to: Send an E-mail message to: [email protected]@list.ahrq.gov. . – In the subject line, type: In the subject line, type: SubscribeSubscribe– In the body of the message type: In the body of the message type: sub Medicaid-SCHIP-HITsub Medicaid-SCHIP-HIT and and your your
full namefull name. . – You will receive a message asking you to confirm your intent to sign You will receive a message asking you to confirm your intent to sign
up. You must respond to the message to complete your registration.up. You must respond to the message to complete your registration.
