MITA Compliant?

Is there truly such a thing as “MITA Compliant” solutions or components? Can an existing architecture be “MITA-sized” with the addition of drop in “MITA-compliant components? Can a vendor today deliver a “MITA-Compliant” MMIS?

Well....no.

If one Googles the term “MITA compliant”, the search engine returns over 100 listings of web entries that contain this term; a fascinating number, really, considering there is currently no such thing (Although if you Google “Sasquatch” you get almost two million hits so I guess we aren’t doing all THAT bad…yet).

Most of the sites that reference “MITA Compliance” are related to vendors that appear to have little or no understanding of MITA or MITA concepts; these vendors pepper their sites and their site’s meta-data with the terms “MITA” and “compliance” in the hope that search engines will direct people seeking information on MITA to their site. One particular gem that I happened upon stated that “MITA compliant MMIS systems will enable real-time HIPAA processing” and that this new and amazing capability, “will give healthcare providers to [sic] significantly increase the productivity of systems and staff.” Now this might be amusing except…there are actually real people working for real State governments in the area of Medicaid information systems who have been charged with determining the impact of MITA on their State Medicaid business and these good folks have to navigate the gauntlet of false claims and misinterpretations being offered by many of these self-proclaimed experts (present company excluded of course).

This raises an interesting question – will there be such a thing as a MITA-compliant solution at some point in the future? To answer this question, it helps to take a closer look at what MITA is and what MITA is not.

Simply put, MITA will provide standards around which technical and information solutions will be built and/or provided to advance the maturity of State Medicaid business processes. More specifically, MITA will stipulate standard formats for business process inputs and outputs and for the shared data that are used in the performance of these processes – MITA is a framework, not a solution.

In its simplest of form, a “framework” is a structure supporting or containing something or an organizing structure for the essential knowledge and skills in a program area. Some common industry definitions for the word “framework” include, “an extensible structure for describing a set of concepts, methods, technologies, and cultural changes necessary for a complete product design” and, “a systematic format and technical structure that supports metadata concepts, contents, and controlled vocabularies.”

MITA is today, a set of defined business processes that will provide significant help to States as they complete the business process re-engineering phase of systems development with the goal of maturing these processes toward the long term aspirations of utilizing clinical data to improve the quality of beneficiary care and the enabling the interoperability that will support the quality goals.

MITA today contains the basic elements needed to introduce States to the tenets of service-oriented architecture (SOA) and lays the foundations for the technical functions that need to be implemented to allow this architecture to support the maturing business processes.

MITA today explains the need for a standardized information architecture and reliance on data standards to support maturing business processes.

MITA today is not complete and does not contain the components needed for anyone to offer a “MITA compliant” solution. Noticeably missing are the definitions of the formats for the standard WSDL inputs, outputs, and data standards for various levels of business process maturity along with common conceptual and logical data models. Both of these areas are currently being addressed by CMS and various workgroups but are at best works-in-progress.

Until the MITA framework is more complete, claims of MITA compliant solutions should be viewed through the prism of caveat emptor. If someone approaches you claiming the ability to deliver a MITA compliant solution, I would simply ask, based on what?