Commonwealth of VirginiaPuzzle: To clarify or solve (something confusing) by reasoning or study

David E. Mix, PMP, MBAHIT/MITA Program ManagerDepartment of Medical Assistance ServicesCommonwealth of VirginiaDavid.mix@dmas.virginia.gov

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Puzzle Pieces American Recovery and Reinvestment Act (ARRA)

HITECH: Health Information Exchange (HIE), certified Electronic Health Record (EHR), Provider Incentive Program, meaningful use looking for better outcomes and coordination of care

Patient Protection and Affordable Care Act (PPACA) Health Benefit Exchange (HBE/HBX), Eligibility Systems, Medicaid expansion looking for

better user experience and coordination of services DHHS efforts towards simplified enrollment standards and Federal verification service

with IRS, DHS, SSA Enhanced funding for eligibility systems to support HBE/HBX

Other factors X12 5010/NCPDP D.0, ICD10, NCCI, Provider screening regulation State mandates State budget challenges

State assets (as-is) Executive support

Multi-Secretariat collaboration championed by Dr. Bill Hazel, Secretary of Health and Human Services

Secretary of Technology, Jim Duffey and the Virginia IT Agency (VITA) HIT Advisory Commission, Health Reform initiative, and HIT Standards Advisory

Committee Virginia Department of Motor Vehicles technology modernization efforts State Agency legacy system silos

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Puzzle Picture To assemble a complex puzzle, a picture

of the completed puzzle is helpful Medicaid IT Architecture (MITA) V2.0

Concept of Operations (COO) document provides a picture of the assembled puzzle Includes HIE, EHR, and eligibility systems

(basis for HBE/HBX) While focus is on Medicaid/CHIP it does reflect

interoperability with other social service programs

Technology base is program agnostic Business case: one of cost avoidance

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Virginia’s Strategy Leverage MITA as core strategy to address both ARRA and

PPACA requirements Adopt MITA vision (self-directed services) Look at requirements from an enterprise perspective Use MITA State Self Assessment process to align efforts to Federal

direction Maximize Federal funding assistance

Leverage Virginia’s existing assets VITA provides enterprise infrastructure

Governance, standards, competency centers (new), hosting, disaster recovery, strategic planning, help desk, cost allocation/rate setting, IT procurement/project approval, project management

Strategic planning at Secretariat level with State Agency alignment begins to reflect migration path to enterprise interoperability

Legacy systems can interoperate on the enterprise using standards-based services/interfaces

Enterprise technical infrastructure becomes an enabler of business transformation

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Work In ProgressFederal funding approved

Establishing HIT/MITA program office Secretariat level Fund and manage multiple HIT/MITA projects

Data sharing/trust initiative IT strategic planning initiative

Establishing a common physical technical architecture Compliant with MITA Technical Architecture Standard Pay-for-use environment – available to all Federal/State/local

programs Foundation for HIE and HBE/HBX interoperability with State systems Includes a Master Data Management (MDM) product for

person/organization information Targeting significant improvement to Medicaid enrollment accuracy

Establish Service Oriented Architecture (SOA) and MDM competency centers

Establish authentication service Tied to MDM product Used for public facing portals (HIE & HBE/HBX etc) Developed by Virginia Department of Motor Vehicles

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Planning In Progress Federal funding requested for interfacing

Health Department and State Lab systems to the enterprise for access by HIE

Planning for replacement of multiple eligibility systems with an integrated solution Reflected in MITA Transition Plan Meets CMS seven conditions and standards

for funding

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References MITA

http://www.cms.gov/MedicaidInfoTechArch/ Virginia MITA transition plan

http://dmasva.dmas.virginia.gov/Content_pgs/mita.aspx Virginia HIE Strategic and Operations Plan

http://www.hits.virginia.gov/ Virginia State Medicaid HIT Plan

http://dmasva.dmas.virginia.gov/Content_pgs/pr-arra.aspx

Virginia IT Agency (VITA) Enterprise standards http://www.vita.virginia.gov/oversight/dm/

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