Section D. From Business Processes to Systems Requirements
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2 Section D From Business Processes to Systems Requirements
3 From Business Processes to Systems Requirements Defining system requirements is the most important step in developing or acquiring any information system. A well-conceived and planned health information system can help organizations understand the need to adjust tasks or processes to be more effective or proactive in protecting community health Source: URL: 3
4 Health Department: Organizational Chart 4
5 EHR-S: Public Health (PH) IS Features 5
6 EHR-S: Public Health (PH) IS Features 6
7 EHR-S: Public Health (PH) IS Features 7
8 EHR-S: Public Health (PH) IS Features 8
9 Common Grounds Project: Cabbarus Health Alliance Use case scenarios were developed to guide vendors in demonstrating their products to ensure the most important features and functionality were viewed by the project team - Use Case: Child Health - Use Case: Family Planning - Use Case: Maternal Care Coordination - Use Case: Maternal Health - Use Case: Sexually Transmitted Disease - Use Case: Tuberculosis Source: 9
10 AHIC National Use Cases:
11 Meaningful Use of Health IT Use Cases: Future CMS rule Future CMS rule Current CMS NPRM Source: W. Suarez, et al. Review of CMS Meaningful Use NPRM and ONC Standards and Certification IFR: Implications for Public Health. Presentation at JPHIT-PHDSC Webinar, February 4, Public Domain. 11
12 Public Health and Clinical Information Exchanges Developer View = Transactions Syste m System Syste m System Syste m System Syste m System Source: (2009). HITSP. Public Domain. 12
13 Building a Consensus Building a Consensus on Public Health High-Level Business Areas 13
14 Learning from CMS MITA Medicaid Information Technology Architecture (MITA) CMS believed that the majority of business processes in Medicaid were similar i.e., paying claims was universal Business processes are intended to be processes and are not represented by programs or organizational structure Focus groups with multiple states developed eight common business areas and 79 common business processes If business processes are similar, then standard modules could be developed and implemented in each state and from state to state Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 14
15 Learning from CMS MITA A modular approach could allow states to upgrade incrementally and move away from the big black box approach to the Medicaid Management Information System (MMIS) A business process should describe most of the commonality among states, but states may have some modifications State modifications to each module would generally not be extensive All new requests for federal funding must demonstrate that it will improve the maturity, or capabilities, of these business processes Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 15
16 MITA Business Areas Member management 8 BPs Provider management 7 BPs Contractor management 9 BPs Program integrity management 2 BPs Operations management 26 BPs Care management 4 BPs Program management 19 BPs Business relationship management 4 BPs Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 16
17 MITA Business Areas Member management 8 BPs Provider management 7 BPs Contractor management 9 BPs Program integrity management 2 BPs Operations management 26 BPs Care management 4 BPs Program management 19 BPs Business relationship management 4 BPs Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 17
18 Member Management: Tasks Determine eligibility Enroll member Disenroll member Manage applicant and member communication Manage member grievance and appeal Manage member information Perform population and member outreach Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 18
19 Learning from CMS MITA The MITA concept is included in HITECH Meaningful Use rules and is a focus for HHS Facilitates interoperability of information systems within the agency and with other health care systems Standardized data can be accumulated and analyzed more quickly to speed CMS activities Facilitates cross state communications Reduces silos; systems are expensive and resources are limited Standardized applications can be implemented more quickly, inexpensively, and in more locations Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 19
20 MITA Concepts and Public Health What large business areas are universal across local and state public health agencies and across public health programs? What smaller business processes would also be similar across such agencies and programs? Could enough commonality be found or agreed upon that would enable modular system components that could proceed toward meaningful use requirements? What would it take to get public health agencies to participate to create such a concept? Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 20
21 Learning from CMS MITA It is difficult to arrive at a consensus among 50+ states/ territories and about 3,000 local agencies Implementation of such processes can take years Categorical funding is still a major challenge It has to be done well to be effective and enable creation of applications or modules CDC and other funders need to get behind the process and provide leadership But we have always done it this way and But we re different are probably the largest roadblocks Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 21
22 Resources for MITA Information %20Health-MITA.asp Source: Klein S. and Hohner V. (Nov.4, 2010.) MITA Lessons. Presentation PHDSC Annual Business Meeting, Hyattsville MD. 22
23 A New Project Building a Consensus on Public Health High-Level Business Areas A New Project 23
24 Health Department: Organizational Chart 24
25 EHR-S: Public Health (PH) IS Features 25
26 Working with Vendors: a New Project Public health case reporting integration profile - A new profile at the Integrating the Healthcare Enterprise (IHE) to standardize information exchanges between clinical and public health information systems, and public health information systems within and across public health agencies to support public health business processes 26
27 Working with Vendors: a New Project Public health high-level business areas 1. Enable vital registration (births and deaths) in the jurisdiction to know population to serve 2. Enable licensure of health care providers in the jurisdiction to know health care capacities to serve the population 3. Enable protection of the public in the jurisdiction from diseases/conditions and from exposure to biohazards, environmental agents, and natural disasters to prevent and control possible public health threat exposure to the served population 4. Promote wellness of the population in the jurisdiction 5. Enable access to care for underserved population and people with special needs to assure health care delivery for the population in need 6. Agency operation 27
28 Working with Vendors: a New Project Public health high-level business areas 1. Enable vital registration (births and deaths) in the jurisdiction to know population to serve 2. Enable licensure of health care providers in the jurisdiction to know health care capacities to serve the population 3. Enable protection of the public in the jurisdiction from diseases/conditions and from exposure to biohazards, environmental agents, and natural disasters to prevent and control possible public health threat exposure to the served population 4. Promote wellness of the population in the jurisdiction 5. Enable access to care for underserved population and people with special needs to assure health care delivery for the population in need 6. Agency operation 28
29 Working with Vendors: a New Project Selected public health high-level business areas 3. Enable protection of the public in the jurisdiction from diseases/conditions and from exposure to biohazards, environmental agents, and natural disasters to prevent and control possible public health threat exposure to the served population Program operation Program integrity management Contractor management 5. Enable access to care for underserved population and people with special needs to assure health care delivery for the population in need Care delivery Care management Care coordination 29
30 Working with Vendors: a New Project Selected public health high-level business areas 3. Enable protection of the public in the jurisdiction from diseases/conditions and from exposure to biohazards, environmental agents, and natural disasters to prevent and control possible public health threat exposure to the served population Program operation Program integrity management Contractor management 5. Enable access to care for underserved population and people with special needs to assure health care delivery for the population in need Care delivery Care management Care coordination 30
31 Working with Vendors: a New Project Selected public health high-level business areas Program operation - Case identification - Case management/care coordination/patient-based assessment - Outbreak management/population-based assessment - Case management/outbreak management evaluation quality measures - Prevention/mitigation 31
32 Working with Vendors: a New Project Selected public health high-level business areas Program operation - Case identification - Case management/care coordination/patient-based assessment - Outbreak management/population-based assessment - Case management/outbreak management evaluation quality measures - Prevention/mitigation 32
33 Working with Vendors: a New Project Selected public health high-level business areas Program operation - Case identification Surveillance aimed to case identification (syndromic surveillance, risk factor surveillance, biosurveillance, case reporting) Screening aimed to case identification (e.g., hearing screening, blood lead screening, TB screening, cancer screening, and others) Diagnostic testing aimed to confirm suspected diagnosis and to establish the case 33
34 Public Health Case Reporting Integration Profile Project timeline - May 2011: profile development - July 2011: public review - August 2011: profile completion - September 2011: vendors recruitment for profile testing - January 2012: profile testing at IHE connect-a-thon
35 Connecting Processes, Requirements, and Solutions Connecting Business Processes, Functional Requirements, and IT Solutions 35
36 Connecting Processes, Requirements, and Solutions
37 Connecting Processes, Requirements, and Solutions
38 Connecting Processes, Requirements, and Solutions
39 Connecting Processes, Requirements, and Solutions
40 Connecting Processes, Requirements, and Solutions
41 Connecting Processes, Requirements, and Solutions
42 Public Health and Clinical Information Exchanges Developer View = Transactions Syste m System Syste m System Syste m System Syste m System Source: (2009). HITSP. Public Domain. 42
43 Connecting Processes, Requirements, and Solutions 43
44 Connecting Processes, Requirements, and Solutions 44
45 Service-Oriented Architecture (SOA) Service-oriented architecture (SOA): a building block approach to systems design that allows discreet functions to be accessed by any authorized system 45
46 Service-Oriented Architecture (SOA) 46
47 Example of Service Layers/Integration Profile Mapping GetPatientLHR Task services Identity Document Entity services PIX Mgr PDQ Mgr Registry Repository Audit Utility services / IHE integration profiles 47
48 Connecting Processes, Requirements, and Solutions 48
49 Connecting Processes, Requirements, and Solutions 49
50 EHR-S: Public Health (PH) IS Features 50
51 EHR-S: Public Health (PH) IS Features 51
52 Defining Systems Requirements Defining system requirements is the most important step in developing or acquiring any information system. A well-conceived and planned health information system can help organizations understand the need to adjust tasks or processes to be more effective or proactive in protecting community health Source: Public Health Informatics Institute (PHII). 52
53 Standardizing Business Processes: Resources OASIS WS-BPEL Standard - A Service-Oriented Architecture (SOA) View of IHE Profiles White Paper at the Integrating the Healthcare Enterprise (IHE) - IHE_ITI_TF_WhitePaper_A-Service-Oriented- Architecture_SOA_ pdf 53
54 Coming up Next Coming up Next 54
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