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MICROSOFT CONNECTED HEALTH
AND HUMAN SERVICES FRAMEWORK
TRANSFORMINGTHE MANAGEMENT
AND DELIVERY OFHEALTH ANDHUMAN SERVICES
MICROSOFT PUBLIC SECTOR WHITE PAPER
JUNE 2012
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ContentsExecutive summary ................................................................................................................................................................................ 1Welcome to Connected HHS ............................................................................................................................................................. 3
Why service mattersfor IT .......................................................................................................................................................... 4A new model for the business and technology of Connected HHS.................................................................................. 5
Looking at Connected HHS for care coordination ....................................................................................................................... 6Ideas for care coordination ............................................................................................................................................................ 7
Modernizing systems for the HIX era ............................................................................................................................................... 8Ideas for modernizing ...................................................................................................................................................................10
Shared services: an overview of Medicaid today ........................................................................................................................11Ideas for Medicaid systems ..........................................................................................................................................................12
The architecture of coordination .....................................................................................................................................................13Core infrastructure..........................................................................................................................................................................13Connected HHS enterprise service bus ....................................................................................................................................14Shared services layer .....................................................................................................................................................................15Agency applications layer.............................................................................................................................................................15Always-on services in the cloud .................................................................................................................................................15
Getting started: your roadmap forward ........................................................................................................................................16A roadmap for shared services ...................................................................................................................................................16Manage change: the new governance.....................................................................................................................................17
Microsoft and HHS ...............................................................................................................................................................................18Connected HHS technology from Microsoft ..........................................................................................................................19
List of tables
Table 1. SOA at a glance: benefits of a Connected HHS environment ..................................................................................................... 4Table 2. Phased implementation of a Connected HHS environment ........................................................................................................ 5Table 3. Ways to use CRM in a Connected HHS environment ................................................................................................................... 6Table 4. High-level HIX architecture based on a Connected HHS environment .................................................................................... 9Table 5. Microsoft products and solutions ................................................................................................................................................... 19
2012 Microsoft Corporation. All rights reserved. This document is provided "as-is." Information and views expressed in this document, including URL and
other Internet website references, may change without notice. You bear the risk of using it.
This document does not provide you with any legal rights to any intellectual property in any Microsoft product. You may copy and use this document for your
internal, reference purposes.
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EXECUTIVE SUMMARY
From Medicaid to children's services to public safety,
state and local agencies provide vital health and humanservices (HHS), typically each with its own information
technology (IT) systems. With changes in policy and
funding models, your organization has the opportunity
to modernize systems so you can coordinate care and
connect services across programs in ways that produce
better outcomesfor the people you serve and for your
agency.
Government, nongovernment, and nonprofit HHS organizations and theirpartners strive to work together and to deliver exceptional services, despite
the fact that many operate in relative isolation, without the ability to easily
share information and to coordinate services. State and local agencies and
partners often rely on legacy IT systems that arose in isolation over time in
response to program-specific needs, independent funding vehicles, and
different policy drivers. Citizens are now served by multiple agencies
spanning functions such as behavioral health, family services, employment
programs, courts, and education.
Given lean budgets and legacy IT investments, how can your organization
move toward the promise of a simpler, connected future? The past decade
of increasingly connected systems of care points the way to innovation,
while changing requirements, such as health insurance exchanges (HIXs), are
driving rapid change. New models of improved access, quality, and
efficiency support the proactive strategies you need to innovate in HHS
deliveryfor example, the rising use of electronic records, relatively
inexpensive data warehousing options, and the ability to bridge diverse
operating environments. Together, these changes can help you devise more
coordinated, interconnected, and cost-effective systems of care that
enhance outcomes.
Innovators such as The Childrens Trust, Health Choice Network, Miami-
Dade County Public Schools, and Ready Schools Miami demonstrate theleading edge of change.
iTheir information exchange may revolutionize the
delivery of health, education, and social services for children from birth
through entry into the workforce. Called Childrens Health Education and
Economic Resource (CHEER), the exchange will enable programs to
coordinate the delivery of services and benefits to children and measure
their impact.ii
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CHEER is just one example of something we at Microsoft call Connected Health and Human Services, a vision and a
technology framework for making the most of IT in the service of people. Rather than an all-or-nothing approach to IT,
organizations are using the Connected HHS Framework to evolve over time. Without embarking on a costly rip-and-
replace project, your agency can make improvements incrementally and can share business and IT services across
groupsand start benefitting from new avenues of funding.
Through the Connected HHS Framework and platform, your agency or program can begin sharing services and
information with others in a beneficial exchange that helps support coordinated care models, deliver cost savings,
respond to a changing regulatory environment, and can ultimately improve health and services.
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WELCOME TO CONNECTED HHS
New coordinated care models ask HHS agencies to work
together and help connect people to services more
efficiently. Yet many agencies find themselves mired inworkflows that sprang from last-generation software. With
Connected HHS technologies and practices, you can begin
to bridge the gaps and move on.
In the past, federal and state categorical funding requirements effectively
dictated separate infrastructures and organizations. For many years, IT systems
supported only limited, if any, coordination across programs. Dating back to
the 1980s, agencies were tethered to a legacy of large, disconnected transfer
systems that took years to build, were outdated at implementation, and could
not interoperate with one another.
In the past several years, as technology has rapidly evolved, policymakers have
begun to endorse the operating models that support a vision of shared
services. These architectural guidelines recognize the value of a service-
oriented approach to IT, in which technology components can be reused across
organizations and programs that have similar business processes. By sharing
services, agencies can reduce the cost and complexity of both acquiring and
supporting business applications.
Connected HHS is the model and the technology that enable you to shift from
the disconnected systems of care of the past to the coordinated systems of care
needed today and in the future. With this approach, your organization canbegin to:
Connect information. When you bring systems, processes, and peopletogether across public health and social services organizations, partners,
and citizens, you can free the data that is locked in existing systems.
Promote collaboration. When people can work together easilywhetherthrough better program or case management, coordinated workflows, or
information accesseveryone wins.
Support decisions. The right information in the right hands at the right timeunlocks insights. Business intelligence (BI) helps leaders act decisively oncritical issues.
3 steps to Connected HHS
On the road to Connected HHS, you
can start with the systems you already
have. Then, you need a vision of
where you want to go and a list of the
partners to connect to. The journey
takes three steps:
1. Connect. Get systems talking toone another. For that, you need to
connect disparate systems and
integration services that enable
databases to exchange records freely.
That way, you have all the relevant
information you need about a
clientfor example, Samandyouknow you have the right Sam.
2. Analyze. Find the details you needbased on queries of accurate data.
For example, you can find at-risk
populations or see all the services
Sam is receiving.
3. Coordinate care. Collaborate withcaregivers, case workers, care
recipients, and other stakeholders.
With a click, you can be connected
through email, instant messaging
(IM), the phone, a website, or a
common workflow.
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Why service mattersfor ITConnected HHS is a technology and a roadmap for transforming HHS delivery using a service-oriented architecture
(SOA) designed to work whenever possible with familiar Microsoft technologies that many agencies already have. Your
organization has the choice to build, deploy, and manage solutions in the way that works beston your premises, in
the cloud, or in a hybrid approachusing SOA and industry standards.
A Connected HHS approach based on SOA works. For example, in 2004, the Medicaid Information Technology
Architecture (MITA) framework from the Centers for Medicare and Medicaid Services (CMS) advocated a business and
technology architecture in which modular components can be reused efficiently across HHS agencies, and it provided a
path for agencies to modernize their IT systems. The Enterprise Architecture Committee of the National Association of
State Chief Information Officers (NASCIO) endorses MITA-like IT concepts and principles for connecting systems, as
does the Federal Enterprise Architecture (FEA) project sponsored by the Federal Office of Management and Budget
(OMB). Furthermore, to share information among systems, the National Information Exchange Model (NIEM) was
created. Also endorsed by NASCIO,iii NIEM provides a common vocabulary for information-sharing across government
lines of business.
Taken together, these guidelines make it clear why SOA matters and how a Connected HHS platform benefits serviceorganizations. You could say that SOA gives power to the people by giving them access to information that helps them
make decisions about care and services. (See Table 1.)
Table 1. SOA at a glance: benefits of a Connected HHS environmentWho Benefits
Caseworkers
Workflow solutions give case workers relief from the burden of redundant administrative reporting processes and
repetitive intake processes that get in the way of service delivery.
Decision-makers
BI solutions help managers focus on problem-solving based on accurate metrics and enhanced analysis. Results can
be seen quicklyeven within an executives tenure.
AgenciesSolutions for coordination bring agencies and programs together so they can focus on common business processes
and target services to at-risk populations, such as children or the elderly. The right services get delivered at the right
time to the right people, helping to reduce administrative overhead and risk.
Citizens Through web-based solutions and self-help tools, clients become more independent. For example, people can log onto web-based information kiosks or portals and then determine eligibility requirements or review their case status.
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A new model for the business and technology of
Connected HHSHow do you get started? Think sharing. Shared service initiatives drive for
improvements through specific tactics, such as care coordination, case
management, better business analytics, streamlined communications, dataintegration, and relationship management. Connected HHS technology can
help you meet the needs of these new care models, but you must also
consider how shared services affect your business processes.
The Connected HHS architecture is designed for incremental deployment,
enabling your agency to take a three-phased approach to implementation.
(See Table 2.) Whether you implement all three phases together or over
time, the goal is to deliver early successes that galvanize future efforts.
Table 2. Phased implementation of a Connected HHS environmentPhase Goal Description
1 Build thefoundation.
Select and deploy foundation technologies that use SOA,
because they support the standard protocols and
interfaces needed for cross-agency collaboration,
information access, and process orchestration.
2 Connectthe silos.
Connect disparate systems and information silos. The
Connected HHS enterprise service bus is the key to
providing people-centric views of data and to supporting
performance management across agencies.
3 Use sharedservices.
Develop HHS-specific applications for common functions,
such as intake, financial payments, or eligibility.
A solution for service delivery
Nonprofit Aspiranet delivers services
to more than 10,000 California
children and families a year. It is
imperative for them to carefully
coordinate service delivery and to
keep meticulous records to remain
compliant with regulations. They
deployed a solution based on
Microsoft SharePoint technologies to
help meet their need for case worker
collaboration and enhanced
compliance. The solution helped
them streamline business processes
so that they could enhance the
services they deliver to communities.iv
Affordable email for HHS
Since consolidating its HHS agencies,
Texas needed a long-term solution
for also consolidating their
communications. The Texas Health
and Human Services Commission
(HHSC) was finally able to link five
HHS agencies, representing 55,000
state employees, with a single email
system. They chose Microsoft Office
365, a cloud-hosted service.
Office 365 includes around-the-clocksupport and disaster recovery
services, two features HHSC required
in a new email platform.v
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LOOKING AT CONNECTED HHS FOR CARE COORDINATION
What do coordination of care models, e-health initiatives, child welfare services, and
behavioral health programs have in common? People. Coordinated care models ask HHS
organizations to share common data, information, and processes. Connected HHS helpsyou bring people, processes, and systems together.
Organizations are using the new care coordination models to reveal areas where shared services can help them to
streamline and cut costs. The main point of intersection for many agencies, departments, and programs is people: the
citizens, clients, or patients they serve. When health and social services are fragmented, the experience can seem like a
tangle of complex, impersonal, and inefficient interactions between caregivers and recipients. The new coordinated care
models cross traditional organizational boundaries and help caregivers establish ongoing relationships with colleagues,
clients, partners, and patients. For this reason, many are turning to citizen relationship management (CRM) as the
foundation of their Connected HHS environment.
Whether you work in a clinical setting or in a social services organization, CRM is a strategyand technologythat can
help you achieve efficient workflows and improved outcomes of coordinated care. As part of a Connected HHS
platform, CRM gives your organization a way to manage relationships based on the needs of the people you serve. For
example, a social worker can use CRM tools to view all the services being delivered to an individual or familyno
matter who provided those services or when they provided them. From there, it can be much easier to coordinate
benefits, avoid duplication of effort, and get better results. (See Table 3.)
Table 3. Ways to use CRM in a Connected HHS environmentArea Benefits
HEALTH Coordinate care across the continuum of serviceswhether primary care, lab services, vision, dental, or
behavioral health counselingto help improve outcomes.
Manage and schedule ongoing communications for proactive, long-term care and patient follow-up. Analyze and improve processes so you can track complex workflows, become more efficient, and help boost
patient satisfaction.
HUMANSERVICES
Coordinate benefits for a family, and track all the services they receive from different programs. Get up-to-date client information in combination with rich demographic data from multiple sourcesall in
one view.
Manage more tasks across functions, such as intake, eligibility, and enrollment, to maximize your relationshipswith other departments, agencies, and partners.
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Ideas for care coordination
Connected HHS architectures support care coordination solutions, which
might look like a mobile application that a case worker can use while out
of the office, an automated process that replaces tedious manual
procedures, or something else. Consider these ideas for enhancing care
coordination:
Streamline administration. Take key tasks, such as providermanagement or benefits management, or joint workflows, such as
tracking, alerting, and e-forms, and look for ways to implement a
common interface across the groups that use similar processes. Or
integrate common administrative functions, such as scheduling, payments, or claims. For example, to provide
benefits for community college students, Single Stop USA created the Benefits Enrollment Network (BEN) using
Connected HHS technologies. Existing IT silos were connected, enabling information-sharing across multiple systems
with identity security. Thanks to BEN, workers can coordinate benefits and provide critical tax preparation assistance;
benefit screening and eligibility for federal, state, and local programs; and even legal assistance. Preliminary data
from select sites indicates an improvement in semester-to-semester retention rates of students who received Single
Stop services.vi
Ease case management. Look for ways to improve forms and records management so case workers can spend lesstime on data entry and manual reporting and more time helping clients. Help boost workflow, too, by offering
workers smartphone applications or automated workflow tools. For example, employees gain mobility when they
can record data in the field using everyday software, such as Microsoft Outlook.
Enhance communications and public safety. Extend care coordination models to systems for public safety. Forexample, the Wisconsin Health Information Exchange (WHIE) aggregates real-time data across more than
142 hospitals and 120 clinics, plus claims information from the state, primarily for use by participating emergency
departments. However, by depersonalizing the records, they can make that information available to public health
organizations, which use it to help support their public health surveillance activities.vii
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MODERNIZING SYSTEMS FOR THE HIX ERA
HIX requirements are driving IT modernization efforts
for many state officials. The right solution must help
you integrate multiple aspects of health insurancedeliveryincluding plan enrollment, privacy, consumer
portals, eligibility determinations, financial services, and
program administration.
Although a HIX is often compared to an online travel site, with its one-
time purchasing transactions, the comparison is inadequate. States must
now assume significantly more complex, ongoing administrative
workflowsall while managing numerous regulatory changes
throughout the year. To do that, your agency needs flexible IT
components that support interoperable exchanges in addition toapplications that enable enrollment, assess eligibility, deliver business
intelligence, and support case coordination.
An end-to-end HIX solution based on the Connected HHS Framework
can help you achieve compliance and keep costs down while adapting to
changing regulations and technology approaches. For example, one
large, private Medicare insurance exchange is using Connected HHS
technologies to extend its services in support of HIX requirements. They
plan to provide plan-comparison tools and to add enrollment and call
center functionality.viii
With its infrastructure based on SOA components, the Connected HHS
Framework delivers a consistent architecture that connects internal and
external systems so that you can:
Accommodate the many aspects of health insurance delivery. Get the most out of your existing IT systems. Connect existing systems to new technology and data from other
agencies and the private sector.
Combine all of the components into an integrated, end-to-endsolution.
Expand into health areas not traditionally administered by stateagencies, such as comparing health plans or collecting premiums.
HIX in Utah
Utah Health Exchange was one of the first
operational state health insurance exchanges
in the country. To meet the requirements of
their states health system reform legislation,the state Office of Consumer Health Services
created an Internet portal, the Utah Health
Exchange. It connects consumers to the
information they need to make informed
health care choices and, in the case of health
insurance, to execute that choice
electronically.ix
The Utah Health Exchange is administered by
Microsoft partner bswift, which provides
enrollment and administrative services
through Connected HHS technologies,
including Microsoft SQL Server and the
Microsoft .NET Framework. Through this
flexible, familiar platform, state administrators
are freed to focus on helping Utahs citizens
make the best choice in a health plan.x
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With the Connected HHS approach to HIX, state agencies can assess a single offering and a well-known set of
interoperable technology productsa simpler task than evaluating numerous solutions from various firms to find
something that works well with government policies and existing IT infrastructures. In this architecture, back-end
systems help states to handle eligibility and enrollment, while front-end portals provide access to resources for
consumers. In addition, integration with cloud services enables insurers to handle fluctuating volumes of queries,
payment deductions, and processing. (See Table 4.)
Table 4. High-level HIX architecture based on a Connected HHS environmentCONSUMER PORTAL
Eligibility determination
User interfaces
Financial services
Subsidies
Premium pooling
Plan tools:
Presentation Comparison Enrollment
Customer care
Call center
EXCHANGE ADMINISTRATION, OPERATIONS, COMPLIANCE, AND TRANSPARENCY
MICROSOFT CONNECTED HHS FRAMEWORK AND PLATFORM
Another benefit of the Connected HHS approach to HIX is the ease with which business intelligence can be
provided to decision-makers and key stakeholders. By providing healthcare payers with analytics tools to measure
health outcomes, the HIX solution can help reduce costs. For example, state administrators can use the analytics
capabilities to search demographic data so they can research plans for children, senior citizens, or other groups.
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Ideas for modernizing
Connected HHS solutions support IT modernization initiatives and help
bring organizations together with up-to-date capabilities, such asaccess to real-time information and collaboration tools.
Consider the following possibilities for your organization.
Get digital. If electronic case files are not part of your institutionsvocabulary yet, they should be. By digitizing health and human
services data, your organization can begin exchanging electronic
records easily and in a highly secure manner across organizational
boundaries. Your agency can also create business intelligence solutions that give employees access to accurate,
up-to-date information.
Build a bus. Bridge disparate legacy systems with a Connected HHS enterprise service bus, which enables youto connect fragmented parts of your services ecosystem. For example, Arizona Department of Health Services
adopted the Partner Healthcare Electronic Data Exchange (PHEDEX) to meet the federal requirement for state
health departments to support interoperable information exchange between public health partners. PHEDEX
organizes exchanges among diverse applications and data types while ensuring that transactions are audited
and backed up.xi
Put business intelligence to work. Empower decision-makers with analytics tools that provide big picture data.Web dashboards can turn raw data into visually appealing charts and graphs. For example, analysts can
monitor claims data more effectively to prevent fraud, administrators gain insight from financial data that can
help achieve cost savings, and managers can visualize demographic and mapping information that helps them
serve key populations better.
Automate compliance and reporting. Help reduce report-processing time with an automated solution based onyour business intelligence. For example, Boulder County, Colorado, had no way to understand the impact of its
services on the 294,000 individuals it served, and reporting requirements were burdensome and inconsistent
across the more than 100 local agencies and organizations involved. To enhance program efficiency and to
improve cross-agency coordination, the county worked with Microsoft Gold Certified Partner Social Solutions to
deploy Efforts to Outcomes (ETO) software, a community-based, collaborative social services solution. ETO not
only helped the county dramatically reduce wait times for participants but also enabled it to measure services
overlap to help improve efficiency, protect against abuses of the system, measure the impact of its various
agencies, and track participant progress toward self-sufficiency on a benchmarked spectrum.xii
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SHARED SERVICES: AN OVERVIEW OF MEDICAID TODAY
The ripple effect of federal policy reform opens newdoors for state Medicaid programs. Flexible
Connected HHS solutions can help you meet the
latest mandates for program modernization and
interoperable systems of care.
Health reform is in the spotlight, thanks to the Affordable Care Act and
the Health Information Technology for Economic and Clinical Health
Act (HITECH Act). Nearly $25 billion dollars is at stake from various
federal grants, stimulus funds, and incentive payments from the CMS,
Health Resources Services Administration (HRSA), and the Office of the
National Coordinator for Health Information Technology (ONC). Now
its up to state Medicaid programs to try to keep up with increasing
healthcare costs and expanding populations.
Fortunately, technology has become more flexible and mature since the
days of the Medicaid Management Information Systems (MMIS). The
current legacy of Medicaid policies and MMIS are based on the fee-for-
service model, which has been the norm for decades and which was
designed simply to pay claims. Yet as states shift to managed carein
which commercial payers become accountable care organizations forthe Medicaid populationsstates will benefit from pay-for-
performance models, in which providers are held accountable for
improved patient outcomes. For this shift to occur, the payers who
manage the care of their Medicaid members must have robust
information systems capable of integration with health information
exchanges (HIEs). Only then can organizations gain seamless access to
members medical records.
To fulfill the promise of health reform goalsimproved outcomes plus
more efficient, cost-effective service deliveryhealth information must
flow freely. An MMIS solution based on the Connected HHS Frameworkmakes that possible for payers and providers alike by providing the rich
technologies and business services they need to meet the challenges of
modern health IT.
Connected HHS benefits for
Medicaid
Make use of existing infrastructure. Simplify and speed administrative
processes.
Preserve the organizationalintegrity of caregivers and
agencies.
Help enhance service outcomes. Provide security-enhanced, role-
based access to information.
Deliver improvements in accessand efficiencies.
Provide better analytics.
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Ideas for Medicaid systems
MMIS solutions based on Connected HHS components can help you
comply with MITA standards by integrating your existing, agency-shared services with new services.
Consider the following possibilities:
Expedite access to services. Eliminate complex, redundant intakeand eligibility systems, which can discourage individuals and families
from seeking care or finding necessary resources. Portals with web-
based forms offer a simple solution for easing access and reducing
duplication.
Assess where data can be shared. Start streamlining eligibility determination across programs by using asolution that passes client information from one system to anothersuch as Temporary Assistance for NeedyFamilies (TANF) to Supplemental Nutrition Assistance Program (SNAP).
Manage identities. Improve data quality while resolving and correlating common data, such as names andplaces, as information is aggregated from across different data systems. You may be familiar with identity
management by another name: Master Data Management (MDM), Enterprise Master Patient Index (EMPI), or
Common Client ID (CCID). By any name, identity management is essential for shared services and enables the
correct matching of information drawn from disparate systems. For example, the Alabama Medicaid Agency
adopted a solution for identity synchronization and autoprovisioning, which helped saved IT staff valuable
hours. The solution also helped the state enhance the security of its data and its compliance with privacy
regulations, such as those detailed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA).xiii
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THE ARCHITECTURE OF COORDINATION
Today we have the technology to build more holistic, connected, people-centeredHHS systems. Your IT legacy need not become an impediment. The Connected HHS
Framework demonstrates how interoperability and services can be deployed in an IT
architecture.
By adhering to the tenets of service orientation, federated data,
federated security, and trustworthiness, the Connected HHS Framework
can help you:
Create a security-enhanced, connected infrastructure. How can youmake information accessible when and where people need it? Itstarts with a core infrastructure designed for integration and
interoperability.
Connect operational silos. How can government agencies,nongovernment service providers, nonprofit agencies, commercial
partners, and relevant stakeholders work together unless they can
share information easily? An enterprise service bus connects the
dots.
Modernize information and systems. Do you want to enhance andextend existing applications or to develop new solutions that work
with your existing IT investments? To coordinate care, you need an
architectural framework based on shared services.
Connect people. At the applications layer, the Connected HHSarchitecture exemplifies the meaningful use of technologyto
promote coordination and information sharing across programs,
departments, and communities of careand, ultimately, to improve
your ability to deliver services.
Core infrastructure
The core infrastructure of a Connected HHS technology platform
includes enterprise-level communications, collaboration, and other services that provide the stable building blocks
for an agile applications environment. (See Figure 1.)
Success with SOA
Technical solutions based on SOA
achieve limited success when they are
driven from the bottom up without
attention to an organization's larger
mission. And top-down, mega-projectsoften take so long to implement that
they are obsolete before they are
complete.
How is the Connected HHS Framework
and vision different? Its the:
People. A people-first approach toSOA means implementing
technologies that are mapped to
processes and desired outcomes
according to your roadmap and
business processes.
Incremental approach. Technologiesare implemented as incremental,
iterative projects governed by your
strategic vision.
Rapid return. Unlike systems of thepast that took years of planning and
implementation, an architecture
based on Connected HHS principles
enables you to build solutions that
deliver results fastwithin the tenure
of the executives backing the rollout.
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Figure 1. Architectural layers of the Connected HHS Framework rely on a common set of technologies.
Connected HHS enterprise service bus
To join up silos of operations, you need solutions that help you handle diverse systems, platforms, technologies,
access and delivery channels, applications, languages, and credentials. The Connected HHS architecture is
designed to help you support interoperability amidst diversity.
To do this, the architecture uses an enterprise service bus that performs multiple functions. It:
Enables interoperability across programs and systems through web services. Provides the data services used for business performance management tools. Offers a unified view of clients and resources across departments.
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Shared services layer
In a Connected HHS architecture, new applications and functionality can be introduced through the shared
services layer. In this context, shared services refer to extensible applications and loosely coupled web servicesreusable components that you can deploy across agencies to target common areas, such as intake, pre-eligibility,
referrals, business rules engine, case coordination, security, and privacy. These types of shared services help you
implement process, program, or legislative changes fast and flexibly.
At this layer, a security and compliance strategy must be built in with appropriate controls. You must protect
confidential citizen information and support compliance with relevant policies yet retain the flexibility to share data
and application functions across boundaries. The Connected HHS Framework is designed with multiple layers of
security. You can also provide a single, consistent identity credential for many applications, including authentication
and authorization of different kinds of users.
Agency applications layer
With a clear view of common service components needed in your environment, you can then choose the most
suitable application technologies. The agency applications layer of a Connected HHS architecture makes available
to users the information that would have been stored away in legacy systems. Even within single departments,
workers can get more from your existing systems. Business solutions can provide improved access to data and
analytics, offer simplified user interfaces for workflows, or deliver flexible, web-enabled interfacesthus liberating
data and creating a platform for business transformation.
Mobile applications, in particular, can help free workers to spend more time with clients. With a smartphone, tablet
PC, or other mobile device, employees have access to the information they need to stay productivevirtually
anytime and anywhere they have an Internet connection.
Always-on services in the cloud
The freeing power of cloud computing is allowing public and private sector professionals to stay connected to vital
work resources while on the road, with a combination of smart devices, Internet connectivity, and powerful apps.
As a Connected HHS option, cloud computing unlocks access to programs using Internet protocols while also
significantly reducing the high material costs of ITservers, software, and operations by in-house IT staff. Instead,
cloud data centers do the work for you so your IT staff can focus on business solutions for your organizations
users.
For example, the nonprofit Czech Red Cross worked with a partner to create a hosted private cloud infrastructure
built on Windows Hyper-V technology. The solution replaced the inefficient, paper-based communication
processes that volunteers had been using and sped the transmission of information during emergencies. Inaddition, the new IT infrastructure can be easily managed by its volunteer staff.xiv
With a platform based on Connected HHS and shared services, you don't have to choose between cloud services
or on-premises solutions. You can configure a hybrid combination that fits your requirements now and in the
future.
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GETTING STARTED: YOUR ROADMAP
FORWARD
Out with the stove pipes and silos, in with the shared
services. But how do you get there? Your agency
needs a new approach to its business processes to
take full advantage of Connected HHS technology.
Its time to draft your strategy.
The Connected HHS vision encompasses a new approach to business
processes and technology infrastructure. A project-specific roadmap
guides your teams toward the shared services goal by analyzingbusiness needs, identifying gaps, and then aligning technology
initiatives with business goals.
For example, when the State of Alabama began planning its Connected
HHS deployment, key agencies convened, from the Department of
Human Resources to the Medicaid Agency to the Department of
Finance. Commissioners and key staff worked together to review
processes, systems, plans, and performance results alongside the
Information Services Division. Planning paid off in design specifications
tailored for the critical initial components of the states deployment.xv
A roadmap for shared services
Your roadmap should define the approach, timing, and steps that will
take your organization to a shared services environment:
Establish a baseline. Know what you have so you know what successlooks like. Start by listing existing business and technology assets, and then set targets, establish metrics, and
measure progress against your baseline so you can track the return on investment (ROI).
Get strategic. Articulate a front-to-back business strategy, and align it with a comprehensive technologystrategy. Start with your model for delivering collaborative services. Determine the types of data-sharing that
are useful.
Weigh the choices. Which cases need cross-agency collaboration? How will the agencies and programs worktogether? Review relevant experiences, and evaluate approaches that have been successful elsewhere.
Updating your business model
With the new service models, your
agency needs to develop anarchitecture for its business as much as
it needs one for its IT infrastructure. A
business architecture is your roadmap of
enterprise processes and performance
objectives. With the goal of sharing and
connecting services, your business
architecture aligns with your technical
strategy so that you can drive program
and technology departments in the
same direction.
A roadmap guides the process. As you
begin to define your businessrequirements, you can use the
Connected HHS approach for the
delivery of shared services. You start
with two key pieces of information:
Common practices. By identifying thecommon business processes used
across multiple programs, you begin
to see where organizations can share
services.
Points of intersection. Where doprograms and departments cross
paths? Your architecture must
address these points of informationaccess.
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Get funding. Ask how cost will be allocated. Where is the fundingcoming from?
Design for governance.Establish clear parameters for sharinginformation. From a user perspective, clarify accountability. Who
gets to decide the optimal, cross-agency case plan? Who can see
what about whom, when, and where? From a systems perspective,
determine where the integrated system runsand who makes
repairs when necessary.
Invest over time. Don't wait to define perfection on paper beforemoving forward. Instead, plan for incremental changes in alignment
with your roadmaps vision. Grow capabilities over time, build upon
each success, and expectand design forchange.
Prioritize. Let policy set precedence, whether that means providingemergency relief, expanding access to care, becoming more
accountable, improving reporting, or mitigating risk.
Set milestones. Recognize that aspects of the roadmap will probablyshift with time and experience. Adopt regular checkpoints for
roadmap reassessment.
Manage change: the new governance
How agile are you? Youre about to find out. Shared services require a
new approach to governance and change management, and your
roadmap needs to consider this idea. Governanceis the operational
framework you use to determine how existing services are monitored,
defined, and authorizedtasks that often become more complex in
shared services workflows where the number of stakeholders expands.
Therefore, the transition to a more agile and connected business and technology environment requires
organizations to rethink governance. Whether your organization chooses to set up a centralized, distributed, or
outsourced model or to use a hybrid approach, successful governance requires a strong vision and shared goals
across agencies, departments, and programs.
Mind the gap as you go
Your roadmap should include a detailed
gap analysis, which serves as the
blueprint for implementing a Connected
HHS solution. Microsoft Services can
help you assess how closely the
Connected HHS Framework aligns with
your requirements and can help
determine how to tailor the solution to
your needs. Our analysis helps fulfill
your due diligence requirements by:
Identifying gaps before you deploy,which helps reduce risk.
Providing a quick, but thorough,analysis for your decision.
Building confidence that yoursolution will meet expectations.
Reducing the time and effortrequired for implementation.
Contact us for details at:
www.microsoft.com/services
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MICROSOFT AND HHS
The health of our nations HHS systems depends on aservice-oriented business and technology
architecture. Shared services are at the heart of the
Connected HHS Framework and the Microsoft vision
for a holistic, incremental approach to innovation.
Our goal is to help improve access, outcomes, and
efficiency through connected systems of care.
Connected systems of care center on the individual and the family.
Microsoft delivers comprehensive, proven, security-enhancedtechnology and services platform for HHS agencies, departments, and
programs. Through CRM, business intelligence, unified
communications, and other Connected HHS technologies, your agency
can speed response time and deliver greater value to citizens, other
organizations, and the communities you serve.
With more than $10 billion invested annually in research and
development, plus the largest partner ecosystem in the industry,
Microsoft offers wide-ranging choices to public sector organizations
considering business and technology modernization initiatives.
Together with our certified partners, we can help you apply Microsoft
technologies in innovative ways that unite government and IT for
greater impact.
LEARN MORE
Microsoft has a long-term commitment
toand extensive experience inthe
public health and social services sectors.
As a technology leader, we understand
the importance of compliance with
standards and we routinely operate
within open-standard and industry-
standard environments to support your
agencys technology needs.
Contact your Microsoft Account
Manager or partner to learn more about
how Microsoft solutions and Connected
HHS technology can help your
organization.
CONTACT US
www.microsoft.com/hhs
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Connected HHS technology from Microsoft
Much of the technology and resources needed on the road to Connected HHS may already exist in your data
centers and on your computers. Microsoft can show you how other government agencies have embraced theConnected HHS philosophy by leveraging existing IT tools and integrating new technologies. To learn more,
[email protected] take a look at some of our products and solutions, listed below.
Table 5. Microsoft products and solutionsTechnology Description
Businessintelligence
Derive the most value from information with the enterprise-ready data analysis tools inMicrosoft SQL
Server 2012.
Call centersBoost satisfaction for citizens with the latestunified communicationstechnologies which, together withCRM
applications, can help you manage citizen requests and connect callers to the channels they
preferincluding live service representatives or web-enabled self-service portals.
Casemanagement
Give case workers access to up-to-date demographic information, progress notes, and other information
critical to individual or family care.Microsoft Dynamics CRM 2011 delivers connected case coordination
capabilities.
Cloud servicesGain more value from your server infrastructure by turning to the cloud. Acloud-optimized data centercan
help you deploy agency solutions and data to community-based organizations and nonprofit agencies that
do not have dedicated IT staff or data centers.
Collaboration Extend the use of existing Microsoft Office products for communication and collaboration. MicrosoftSharePoint 2010gives teams many ways to share information. For more information, download the whitepaper, Improving health and human services with enterprise content management.
Desktopefficiency Get a streamlined user interface and new features that make everyday tasks easier withWindows 7.
Medicaidmanagement
Get help complying with MITA standards. Microsoftsolutions for Medical management information
systems, based on the Connected HHS Framework, can help you to reduce administrative costs, enhance
delivery of essential services, and implement improved security, privacy, and control.
Systemsintegration Connect disparate systems with the integration server solution,Microsoft BizTalk Server 2010, the hub ofyour Connected HHS architecture.
Web servicesProvide flexible access to servicesfrom mobile service centers to self-help portalsfrom a variety of
devices, including PCs, smartphones, and other mobile devices. Web solutions can also provide acentral
workspacewhere cross-agency teams can log on and share information.
mailto:[email protected]:[email protected]:[email protected]://www.microsoft.com/industry/government/products/SQL_Server_2012/default.aspxhttp://www.microsoft.com/industry/government/products/SQL_Server_2012/default.aspxhttp://www.microsoft.com/industry/government/products/SQL_Server_2012/default.aspxhttp://www.microsoft.com/industry/government/products/SQL_Server_2012/default.aspxhttp://www.microsoft.com/industry/government/solutions/unified_communications/default.aspxhttp://www.microsoft.com/industry/government/solutions/unified_communications/default.aspxhttp://www.microsoft.com/industry/government/solutions/unified_communications/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/health/ww/solutions/Pages/cloud-optimized-datacenter.aspxhttp://www.microsoft.com/health/ww/solutions/Pages/cloud-optimized-datacenter.aspxhttp://www.microsoft.com/health/ww/solutions/Pages/cloud-optimized-datacenter.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://download.microsoft.com/download/2/9/F/29FAF225-FFFC-4D01-8596-C36BB2F067C1/Health_and_Human_Services_ECM_Whitepaper.pdfhttp://download.microsoft.com/download/2/9/F/29FAF225-FFFC-4D01-8596-C36BB2F067C1/Health_and_Human_Services_ECM_Whitepaper.pdfhttp://download.microsoft.com/download/2/9/F/29FAF225-FFFC-4D01-8596-C36BB2F067C1/Health_and_Human_Services_ECM_Whitepaper.pdfhttp://www.microsoft.com/industry/government/products/windows7/default.aspxhttp://www.microsoft.com/industry/government/products/windows7/default.aspxhttp://www.microsoft.com/industry/government/products/windows7/default.aspxhttp://www.microsoft.com/industry/government/solutions/medicaid/default.aspxhttp://www.microsoft.com/industry/government/solutions/medicaid/default.aspxhttp://www.microsoft.com/industry/government/solutions/medicaid/default.aspxhttp://www.microsoft.com/industry/government/solutions/medicaid/default.aspxhttp://www.microsoft.com/industry/government/products/server/biz_talk_2009/default.mspxhttp://www.microsoft.com/industry/government/products/server/biz_talk_2009/default.mspxhttp://www.microsoft.com/industry/government/products/server/biz_talk_2009/default.mspxhttp://www.microsoft.com/industry/government/products/server/biz_talk_2009/default.mspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/server/biz_talk_2009/default.mspxhttp://www.microsoft.com/industry/government/solutions/medicaid/default.aspxhttp://www.microsoft.com/industry/government/solutions/medicaid/default.aspxhttp://www.microsoft.com/industry/government/products/windows7/default.aspxhttp://download.microsoft.com/download/2/9/F/29FAF225-FFFC-4D01-8596-C36BB2F067C1/Health_and_Human_Services_ECM_Whitepaper.pdfhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/industry/government/products/Sharepoint2010/default.aspxhttp://www.microsoft.com/health/ww/solutions/Pages/cloud-optimized-datacenter.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/products/dynamics_crm_4_0/default.aspxhttp://www.microsoft.com/industry/government/solutions/unified_communications/default.aspxhttp://www.microsoft.com/industry/government/products/SQL_Server_2012/default.aspxhttp://www.microsoft.com/industry/government/products/SQL_Server_2012/default.aspxmailto:[email protected]7/27/2019 Microsoft Chh s
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Endnotes
iHersey, Jack. Miami-Dade County makes a connection. Microsoft in Health blog. October 19, 2011.
blogs.msdn.com/b/microsoft_in_health/archive/2011/10/19/miami-dade-county-makes-a-connection.aspxiiIbid.iiiA call to action: Information exchange strategies for effective state government. April 2011.www.nascio.org/publications/ivCooper, Lane F. Aspiranet leverages collaboration platform to deliver better and more accountable services to California
children and families. Aspiranet case study. 2009.
biztechreports.com/yahoo_site_admin/assets/docs/AspiranetCaseStudy.360202244.pdfv Thomas-Flynn, Gail. Office 365 and the cloud make HIPAA easy . Microsoft Government: Bright Side of Government blog.
January 20, 2012.
www.microsoft.com/industry/government/state/brightside/detailBlog.aspx?title=Office_365_and_the_Cloud_Make_HIPAA_EasyviOLeary, William, and Elizabeth Mason. Improving health, human services, and education outcomes and reducing poverty:
Microsoft and Single Stop USA case study. 2011.www.singlestopusa.com/MicrosoftSingleStopUSA.pdfviiThe Wisconsin Health Information Exchange Emergency Department Linking Project. March 2011. Microsoft case study.
download.microsoft.com/download/5/3/F/53F61716-24A3-4EA4-936E-
38F865D546DE/AmalgaWisconsinHealthInformationExchangeCaseStudy.pdfviiiHorowitz, Brian T. Microsoft launches state health insurance exchange platform . eWeek. February 9, 2011.
www.eweek.com/c/a/Health-Care-IT/Microsoft-Launches-State-Health-Insurance-Exchange-Platform-403447/ixUtah Health Exchange website. www.exchange.utah.gov/about-the-exchange/overviewxbswift, Microsoft join forces to provide health insurance exchange solutions. bswift case study. October 25, 2011.
www.bswift.com/index.php?/press-releases/bswift-microsoft-join-forces-to-provide-health-insurance-exchange-solu/xiArizona health agency ups quality and security with interoperable exchange solution. Microsoft case study. August 2009.
www.microsoft.com/casestudies/Case_Study_Detail.aspx?casestudyid=4000005113xiiBoulder County deploys collaborative social services tool, wait times drop from weeks to hours. Microsoft case study. August
16, 2010.www.microsoft.com/casestudies/Case_Study_Detail.aspx?CaseStudyID=4000008098xiiiAlabama Medicaid Agency to cut time spent on identity management by 75 percent. Microsoft case study. February 2010.
www.microsoft.com/canada/casestudies/Case_Study_Detail.aspx?casestudyid=4000006514xivHumanitarian group offers timely emergency relief with scalable, hosted private cloud. November 21, 2011. Microsoft case
study.www.microsoft.com/casestudies/Windows-Server-2008-R2/Czech-Red-Cross/Humanitarian-Group-Offers-Timely-
Emergency-Relief-with-Scalable-Hosted-Private-Cloud/4000011451xv Day, Alan, Lynn Davenport, David Meyers, and William OLeary. "Camellia Project: A Connected Health and Human Services
Framework for Alabama." May 2007.www.camellia.alabama.gov
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