Marrying Your Medicaid Management Information System (MMIS) and Your Health Information Exchange (HIE)

Transcription

1 Marrying Your Medicaid Management Information System (MMIS) and Your Health Information Exchange (HIE) Presentation to: CMS Region 4 & 6 Meeting Presented by: Stacey Harris, Director of Health IT Innovation Division of Health IT Date: September 16,

2 Mission The Georgia Department of Community Health (DCH) We will provide Georgians with access to affordable, quality health care through effective planning, purchasing and oversight. We are dedicated to A Healthy Georgia. 1

3 DCH Division of Health IT The Division facilitates various aspects of the Health IT infrastructure throughout Georgia, including: Strategic planning for health IT adoption by providers and patients Technology and policy development of the Georgia statewide health information exchange network and connection to the nationwide network Promotion of the overall statewide health IT infrastructure in Georgia Administration of the Medicaid EHR Incentive Program Our Mission is to advance healthcare quality while reducing costs Improving access to information to support coordination of care and among hospitals, labs, and healthcare organizations to better manage patient care Promoting the early detection, prevention, and management of chronic illness through use of health information technology Achieving improvements in care efficiency and population health 2

4 What is Health Information Technology? Set of technologies that makes it possible for providers and patients/consumers to better manage one s care through secure use and exchange of health information. Electronic Health Records (EHR) Health Information Exchanges Personal Health Records (PHR) Mobile health apps, smart tech eprescribing TeleHealth Digital health devices Health informatics, and more What is the purpose of Health Information Exchange? To close the patient information gap across care settings by electronically connecting disparate systems and data sources to support improved quality of care, better health outcomes, and reductions in cost. 3

5 Georgia s Health IT Continuum Electronic Health Records eprescribing Digital health tools Widespread provider connectivity Patient Engagement Population Health Management Strengthen privacy and data protections Support public-private health IT collaborations Evaluate effectiveness of health IT initiatives 4

6 Georgia Health Information Exchange Network DCH has facilitated the development and implementation of Georgia s statewide health information exchange network. DCH collaborated with the Georgia Health Information Network, Inc. (GaHIN), a non-profit organization, to establish the statewide HIE GaHIN is a Network of Networks Model. Health systems and regional HIEs connect hospitals, physician practices and other providers to GaHIN Not a central repository of clinical data. Information remains with the treating provider and only flows when there is authorization Established governance and policy framework to support Network DCH transitioned the HIE operations and technology to GaHIN June

7 Current GaHIN Members/Connections State Agencies: Georgia Medicaid Department of Public Health Department of Juvenile Justice Department of Family and Children Services Amerigroup (CMO) Emory Healthcare (Cerner) Grady Health System (Epic) ArchHIE (Siemens) Q Children s Healthcare of Atlanta (Epic) Q

8 Title or Chapter Slide (use as needed; feel free to delete) Leveraging existing technologies and infrastructure 7

9 GAMMIS Web Portal 8

10 GAMMIS Web Portal 37 Public Pages Available Search for Providers with a Direct Exchange Address Ability for members to self-register for secure access Ability for providers to self-register for secure access 41 Secure Pages Available Level of access determined by user role/delegations Ability to register for a Direct Exchange Address Ability to access the Georgia Health Information Network (GaHIN) Patient Profile site Ability to submit/view applications for the EHR Incentive Program (MAPIR) 9

11 Georgia Medicaid Management Information System (GAMMIS) HP interchange system went live 11/2010 Medicaid Provider Secured Web Portal Georgia Medicaid Provider Web Portal has been operating since 4/2003 Medicaid Provider use the web to Enroll in Medicaid, submit/resubmit Claims, Prior Authorizations, and Referrals, verify Member Eligibility, view Remittance Advices 10

12 Georgia Medicaid Management Information System (GAMMIS) Both Medicaid Providers and Medicaid Members use the Web Portal They are familiar with the technology We are able to do mass communications in the form of banner messages, provider and member notices, and messages to their secured web portal inbox 11

13 Medicaid Providers Medicaid Providers are able to register for Georgia Direct via the GAMMIS Web Portal. Secured Direct Messaging is available to Georgia provider at no cost Medicaid Providers can access the GaHIN Clinical Viewer/Patient Profile via GAMMIS Web Portal Gives Medicaid providers a longitudinal look a the Medicaid member including lab results, pharmacy, and encounters from all providers including non-medicaid providers. 12

14 Direct Exchange Address Registration/View Registration and request status is available to all Georgia Medicaid Providers and the delegates to whom they grant access to on the secure GAMMIS. A weekly extract file submits new requests to the Direct Exchange vendor and all Direct Exchange request status responses are loaded to the Georgia MMIS. 13

15 GaHIN Patient Profile Access - Providers All registered Georgia Medicaid Providers and the delegates to whom they grant access to have access to the GaHIN Patient Profile link on the secure GAMMIS by means of a single sign-on solution. Multiple extracts from the Georgia Medicaid MMIS are provided to the GaHIN Patient Profile vendor, including claims, member data, provider data and so on. Provider and user information is securely passed to the GaHIN Patient Profile site when navigating from the GAMMIS. As of July 24, 2014, over 157,000 Georgia Medicaid Providers have registered for secure access to the GAMMIS. 14

16 Access to the GaHIN 15

17 A view to more patient information 16

18 A view to more patient information 17

19 Georgia Medicaid Management Information System (GAMMIS) Medicaid Member Secured Web Portal Member Web Portal has been operating since 4/2003 Medicaid Members use the portal to view their Medicaid eligibility, request replacement Medicaid card, view claims and prior authorizations, search for Medicaid Providers 18

20 A view to more patient information 19

21 Medicaid Member Member Engagement and Outreach Enhancements to Medicaid Member Portal to include: More interactive and consumer focused view of their information Aligning the Medicaid member web experience with that of our State Health Benefit Plan-BeWell SHBP to support health and wellness Personal Health Record 20

22 GaHIN Patient Profile Access - Members As of July 24, 2014, over 51,000 Georgia Medicaid Members have registered for secure access to the GAMMIS. The Georgia Department of Community Health and HP Enterprise Services are collaborating on solutions for easy access and management of personal health information by Georgia Medicaid members. 21

23 Title or Chapter Slide (use as needed; feel free to delete) Future Innovations 22

24 Future Innovations Enhancements to allow linking of claims and clinical data for better analytical. Bi-directional sharing of information between the data sources and the MMIS. XDR connection between MMIS and GeorgiaDirect 23

25 Thank You. Questions and Answers 24

26 Stacey Harris, Director of Health IT Innovation Georgia Department of Community Health 25