The ICD-10 code set has 200,000 codes, almost 10 times the 24,000 codes in the ICD-9 code set. Providers and payers will need to completely redesign their business processes and systems to handle these hundreds of thousands of new codes. Before the transition to ICD-10 can begin, industry must move to the next generation of HIPAA transactions (version 5010) because the current version (4010) will not work with ICD-10. Version 5010 is a major re-write of the HIPAA transaction standards, with more than 850 individual changes.
The Department of Health and Human Services recently proposed rules to implement 5010 by April 2010 and ICD-10 by October 2011. This may appear to be a staggered implementation of these daunting initiatives but in reality, it is not quite that easy. There is no debate as to whether or not 5010 must be implemented prior to conversion to ICD-10 as the expanded diagnosis codes cannot be worked into the standard HIPAA transactions until the appropriate fields have been expanded. The question becomes, is 18 months enough time to have the standard transactions modified, tested, and implemented prior to moving to the enhanced code set? Many think that the timeline is not realistic.
Preparing for 5010 and ICD-10 can hardly be classified under regular system maintenance and operations. Carrying the hefty estimated price tag of $10-20 million, preparing for these changes really falls into to the category of major system modification. As such, many States will be asking for contracted help to perform this work. The feds have hinted that they will pay enhanced (90%) funding for the 5010/ICD-10 work; qualifying for this funding will require an APD and then either a contract modification or an RFP. If a State were to begin today by writing and submitting a planning APD to explain to the feds their approach and plans for 5010/ICD-10 compliance, it would likely be a full year before the final implementation APD and contract mod were approved. If an RFP is involved, add 6-8 months for the award process. On this schedule, work would not even begin until late 2009/early 2010, hardly in time to meet the first deadline of April 2010.
The National Committee for Vital and Health Statistics--an advisory body to HHS—made a recommendation to implement HIPAA 5010 first followed by ICD-10. If the NCVHS process were followed and started now, the soonest ICD-10 could be completed is late 2013, this seems like a more realistic timeframe.
Another consideration is the provider side of the equation. A key lesson learned from HIPAA is that provider education and outreach is critical to ensure providers are aware of the changes that must be made and adequate time is given to make those changes. Providers are looking at a vastly expanded set of options for assigning diagnosis codes. This means that they all must be trained in the awareness and use of the codes and many practice management systems will need to be enhanced, or likely replaced in order to comply with use of the expanded codes. Will this occur on schedule currently presented for payer system compliance? Probably not. The enhancements for 5010 and ICD-10 are not “backward compatible” and so we are looking at the potential for crippling claims backlogs, inaccurate and delayed payments, and an inability to detect fraud and abuse. Is the accelerated timeline worth all of this?
The MITA community needs to give some serious thought into how MITA fits with these two initiatives. How can resources be integrated in such a way that states are moving toward both HIPAA II and MITA compliance in a combined effort? Can MITA business services at level three maturity be built as 5010/ICD-10 compliant? It doesn’t seem practical to keep MITA and HIPAA II as separate activities; there must be a way to kill two birds with one stone here.
Thoughts?
Monday, October 6, 2008
Friday, October 3, 2008
HL7 MITA Project Pics Added
Click on the slide show at the top of the MITA Matters homepage to see a few pictures of the HL7 MITA Project group during a meeting at MMIS 2008 in Nashville. Sent by a friend of the blog, thanks!
Thursday, October 2, 2008
MITA Governance Update
I have it on good authority that Chairpersons have been selected for both the MITA Technical Architecture Review Boards (TARB) and MITA Information Architecture Review Board (IARB). This is good news because these boards are one the critical path to establishing a fully-fledged MITA repository, populated with approved artifacts from each of the three architectures.
Among the TARB’s initial tasks will be a review of the Technical Function Templates that are being completed by the MITA Technical Architecture Committee (TAC). The IARB first official act is likely to be a review of the HL7 MITA Project’s MITA Development Methodology document. It will be interesting to see where these documents are posted once they are approved. I have not heard anything regarding an update to CMS plans for a new repository site. Currently, approved MITA Business Architecture documents can be found here: http://hl7projects.hl7.nscee.edu/docman/?group_id=40.
Among the TARB’s initial tasks will be a review of the Technical Function Templates that are being completed by the MITA Technical Architecture Committee (TAC). The IARB first official act is likely to be a review of the HL7 MITA Project’s MITA Development Methodology document. It will be interesting to see where these documents are posted once they are approved. I have not heard anything regarding an update to CMS plans for a new repository site. Currently, approved MITA Business Architecture documents can be found here: http://hl7projects.hl7.nscee.edu/docman/?group_id=40.
Wednesday, October 1, 2008
HL7 MITA Project Meeting Announcement
The HL7 MITA Project will be holding a teleconference meeting tomorrow aftern0on from 2:30 pm - 4:00 pm EDT. Anyone with an interest in the MITA Information Architecture is welcome to attend the meeting. This group meets every Thursday afternoon.
Meeting Title: HL7 MITA Project
Date & Time: Weekly, Thursday
11:30 PT, 12:30 Mtn, 1:30 CT, 2:30 ET
Join Link: https://ahcccs.ilinc.com/join/kfrxpt
Dial In Number: 770-657-9270
Participant PIN: 451256
Meeting Agenda:
1. Call to order
2. Establish/determine minute taker
3. Review Agenda
4. Approve call minutes for 09/04/2008
5. Working Group Updates/Changes
Ø Introduce Roger Todd, our MITA Project, Project Manager
Ø Discuss sub-workgroups
6. HL7 V3 Ballot Reconciliation
http://www.hl7.org/v3ballot/html/welcome/environment/index.htm
See screen print following agenda for additional reference
6. Review Deliverables for next call
Internal Updates and Com
Respond to Provider
Circle back, final check on all sub-phases
7. Agenda for next call, October 09, 2008
Meeting Title: HL7 MITA Project
Date & Time: Weekly, Thursday
11:30 PT, 12:30 Mtn, 1:30 CT, 2:30 ET
Join Link: https://ahcccs.ilinc.com/join/kfrxpt
Dial In Number: 770-657-9270
Participant PIN: 451256
Meeting Agenda:
1. Call to order
2. Establish/determine minute taker
3. Review Agenda
4. Approve call minutes for 09/04/2008
5. Working Group Updates/Changes
Ø Introduce Roger Todd, our MITA Project, Project Manager
Ø Discuss sub-workgroups
6. HL7 V3 Ballot Reconciliation
http://www.hl7.org/v3ballot/html/welcome/environment/index.htm
See screen print following agenda for additional reference
6. Review Deliverables for next call
Internal Updates and Com
Respond to Provider
Circle back, final check on all sub-phases
7. Agenda for next call, October 09, 2008
Tuesday, September 30, 2008
NHIN Goes Live, Sort Of
The emerging Nationwide Health Information Network (NHIN) was put through its paces today as live operations were demonstrated before a large audience at the Health and Human Services Department and via a Webcast.
The demonstration involved records created for the test but stored in actual health systems. The exercise showed that a health care provider could easily use a Web browser to obtain basic records on a patient stored by another health care system.
“I think you have to admit that this is really cool,” said one of the participants, Dr. Robert White of the New Mexico Health Information Collaborative. “This is kind of like having a magic decoder ring in health care.” …
... Using a variety of Web interfaces and authentication schemes, representatives of more than a dozen health care organizations showed how they could locate a record, retrieve it, and view important information such as the patient’s medications, diagnoses, allergies, laboratory test results and recent treatments.
Find the full article here: http://www.govhealthit.com/online/news/350589-1.html?GHITNL=yes
The demonstration involved records created for the test but stored in actual health systems. The exercise showed that a health care provider could easily use a Web browser to obtain basic records on a patient stored by another health care system.
“I think you have to admit that this is really cool,” said one of the participants, Dr. Robert White of the New Mexico Health Information Collaborative. “This is kind of like having a magic decoder ring in health care.” …
... Using a variety of Web interfaces and authentication schemes, representatives of more than a dozen health care organizations showed how they could locate a record, retrieve it, and view important information such as the patient’s medications, diagnoses, allergies, laboratory test results and recent treatments.
Find the full article here: http://www.govhealthit.com/online/news/350589-1.html?GHITNL=yes
Creationism and Coffee
In the beginning God created coffee,
And God tasted the coffee, and it was good.
Thus began the second day…
And God tasted the coffee, and it was good.
Thus began the second day…
Okay, perhaps not exactly Biblical in proportion, but a damned necessary evil in my book. I stayed up waaaay past my bed time last night to watch my beloved Ravens lose to their arch-rivals, the Steelers, 23-20 in an overtime nail biter. Now, I am left to pick up the pieces of my shattered dreams and this steaming hot cup of Columbian black gold, my Medellin Mistress, is the only comfort I have. As I ponder the thought of work today on the morning after the night before, I am convinced that God did indeed create coffee. There is no way that the Supreme Being toiled endlessly and creatively for six days without a few cups of joe.
If there was no coffee, the World would have never been created; it’s as simple as that. In fact, Pope Clement VIII officially baptized coffee in the late 1500's in recognition of its divine powers. The centuries that followed this frequently overlooked event have brought us wonderful discoveries and technological advances. The same human race that needed thousands of years to invent the wheel has laid the foundation for all the modern sciences in a matter of a few hundred years. Isaac Newton developed the basis of modern Calculus and the Law of Gravity in the 1660's - exactly around the time coffee became widespread in England - coincidence my friends? I think not!
And so it is back to the arms my Caffeine Countess I go and then on to face the big scary world of Medicaid IT!
If there was no coffee, the World would have never been created; it’s as simple as that. In fact, Pope Clement VIII officially baptized coffee in the late 1500's in recognition of its divine powers. The centuries that followed this frequently overlooked event have brought us wonderful discoveries and technological advances. The same human race that needed thousands of years to invent the wheel has laid the foundation for all the modern sciences in a matter of a few hundred years. Isaac Newton developed the basis of modern Calculus and the Law of Gravity in the 1660's - exactly around the time coffee became widespread in England - coincidence my friends? I think not!
And so it is back to the arms my Caffeine Countess I go and then on to face the big scary world of Medicaid IT!
Monday, September 29, 2008
One Stop Provider Enrollment
Received word that the PECOS One-Stop-Shop Medicare & Medicaid Provider Enrollment Discussion Board is being shut down effective 9/29/2008.
It sounds like the concept of the One Stop Shop is being revisited and perhaps even re-designed. I do not have stats on how many states were participating in the discussion board but I know that there was limited interest in participating in the solution as it was presented at the two workshops earlier this year. It would be great if MITA could be more of a consideration in the solution going forward. Anyone with more information on where OSS is headed please feel free to comment.
It sounds like the concept of the One Stop Shop is being revisited and perhaps even re-designed. I do not have stats on how many states were participating in the discussion board but I know that there was limited interest in participating in the solution as it was presented at the two workshops earlier this year. It would be great if MITA could be more of a consideration in the solution going forward. Anyone with more information on where OSS is headed please feel free to comment.
Friday, September 26, 2008
State Alliance for eHealth
The State Alliance for eHealth, co-chaired by the governors of Tennessee and Vermont and sponsored by the National Governor’s Association (NGA), has released their first annual report and recommendations on Medicaid and e-Health. The State Alliance is supported by an advisory committee composed of representatives from both the public and private sectors who provide technical expertise on critical issues related to electronic HIE.
The report is broken down into 4 sections: An Executive Summary, Challenges to the Exchange of Electronic Health Information, Recommendations from the Alliance, and a Conclusion. Here are the six recommendations found in the report to help States further the adoption and use of HIT and electronic HIE:
1. Provide leadership and support for e-health efforts in each state;
2. Address privacy and security;
3. Promote the use of standards-based, interoperable technology; (MITA)
4. Streamline the licensure process to enable cross-state e-health;
5. Engage consumers to use HIT in managing their health and health care; and
6. Develop workforce capacity to support electronic HIE efforts.
On page 42 of the report, The Alliance recommends that states (governors) provide Medicaid with the technical resources necessary to implement MITA and related HIT/HIE activities. This report is a good read if you have 20 minutes or so. The full report can be found here:
http://www.nga.org/Files/pdf/0809EHEALTHREPORT.PDF
The report is broken down into 4 sections: An Executive Summary, Challenges to the Exchange of Electronic Health Information, Recommendations from the Alliance, and a Conclusion. Here are the six recommendations found in the report to help States further the adoption and use of HIT and electronic HIE:
1. Provide leadership and support for e-health efforts in each state;
2. Address privacy and security;
3. Promote the use of standards-based, interoperable technology; (MITA)
4. Streamline the licensure process to enable cross-state e-health;
5. Engage consumers to use HIT in managing their health and health care; and
6. Develop workforce capacity to support electronic HIE efforts.
On page 42 of the report, The Alliance recommends that states (governors) provide Medicaid with the technical resources necessary to implement MITA and related HIT/HIE activities. This report is a good read if you have 20 minutes or so. The full report can be found here:
http://www.nga.org/Files/pdf/0809EHEALTHREPORT.PDF
Thursday, September 25, 2008
Reflections on 2008 MMIS
Hats off to NESCO and the group of MMIS 2008 Conference volunteers - (the “blue shirts”) that acted as registrars, porters, tour guides, nurses, dance instructors, and presentation aides-de-camp - these good folks put on an excellent MMIS conference in Nashville this year!Over 870 people attended the conference this year, which took place at the Gaylord Opryland Resort just outside of the city of Nashville. The facility was cavernous, covering something along the lines of 90 acres, much of that enclosed under a big glass bubble. The resort itself was a bit eclectic in its design, looking and feeling as if Salvador Dali had taken the Jungle Cruise from Disney World, Bourbon Street from New Orleans, and the set of Gone with the Wind and connected them all together (sort of) with winding and distorted passageways. It was actually a nice location, just a bit difficult to navigate at times. After saying farewell to the sun before descending below 10,000 feet on Sunday afternoon on the approach to Nashville, I did not see the big orange ball again until sometime on Tuesday evening. I overheard one of the Gaylord employees making reference to someone as a “bubble rat”; by Thursday afternoon, I felt that I fit the bill.
Back to the conference – it was terrific! There were over 40 breakout sessions, excluding the vendor tracks, that spanned MITA, new technologies, MMIS operations and HIT/HIE plus a couple of good plenary sessions. I found the MITA sessions that I attended to be relatively superficial but helpful just the same. I also “hopped” (new conference term) a few of the new technology and HIE sessions; these I found to be very informative and very interesting. **Mikey Tip: One should not attend these conferences with the primary intent of getting information from the breakouts sessions; the breakout sessions are good, but not really the major reason for attending in my opinion. Rather, attend the MMIS conference to meet and network with others in our industry - so many smart people in one place at the same time, you need to take advantage of that opportunity!
Some highlights for me included the PSTG TAC session (as I was not aware of just how much progress is being made on the MITA Technical Architecture), the panel of States that related their MITA SS-A experiences, hearing about the progress that is being made by the HL7 MITA project team, and the demos of various HIE and EHR products being either under development or available for use.
I thought that the meals were good and discovered again that breakfast and lunch provide great opportunities to meet and chat with others. This was probably when I spent the most time talking with folks from State Medicaid Agencies. Again, smart and competent – having the opportunity to share experiences and information with folks in similar situations across the fruited plain is one of the biggest benefits to attending this event.
I thought that the vendor area was well organized and the participating vendors were, for the most part, professional and courteous. This is the first year that I managed to visit every vendor booth and I can say that it was well worth the time. It occurred to me that for years I have viewed vendors as either cunning competitors or shady salespersons, never stopping to think that they could actually be real people with real families, interesting backgrounds and yes, feelings! I think I made a few new friends this year by shedding the burden of that stereotype and actually engaging in some real conversations. Perhaps another tip for attendees next year, don’t be afraid to dig a little below the surface, you will probably be pleasantly surprised.
With each succeeding year that I attend this conference, I get more of a feeling that although we come from private sector, state government, federal government, wherever – we are more of a community than exists in most other industries; I was actually a little sad boarding the bus on Thursday afternoon and leaving my Medicaid family. Thanks again to Nancy and her crew and to all of the vendors and presenters, this conference was well worth the price of admission.
Okay, enough of the gushy stuff – I’m going to watch a Chuck Norris movie now and crush a few beer cans on my head…Egad man, I’m going softy in my old age…
Tuesday, September 23, 2008
Well, Maybe This Time....
We're back....again Rusty, dusty, out of blogging practice but willing to try once again to open up a dialogue within the MITA community.
Last year at this time, the MITA Matters blog was averaging around 100 visitors per day but only one or two comments a week = lame. There is lots of good MITA stuff happening about which to blog, but Mikey needs to feel the love :-)
Open for business - ideas for post topics welcomed...questions encouraged...email or comment here.
Wednesday, January 16, 2008
We're back
After a long sabatical, Mikey is back and MITA blogging once again and I have news from friends at the HL7 work group meeting in San Antonio.The good news is that it looks like the MITA Information Architecture is going to get a well-needed boost from the newly-formed HL7 MITA Project work group!
Day one at the work group meeting was spent getting oriented with the HL7 process and procedures and members of the group getting to know each other. The HL7 MITA project is a step child of the HL7 Financial Management (FM) group and they have provided solid support for the HL7 MITA Project team.
The HL7 MITA Project is a nice mix of State folks and representatives from the vendor community and CMS even sent a few government types down there to make sure that the project team didn't have too much fun. Day 2 was spent learning about the relationship of HL7 to MITA and a discussion about how MITA will benefit from the work that has already been done within HL7 in terms of the Reference Information Model (RIM).
The emphasis of day three was on business cases, the RIM and how to model MITA business services. Tomorrow, day 4 will be focused on planning and how work on the MITA Information Model will progress over the next 3 months. Some good websites to check out, related to today's activities include the following:
http://hl7projects.hl7.nscee.edu/projects/mita/
http://mita.wikispaces.com/
The takeaway so far from this work group meeting seems to be that there are many very smart people who believe strongly in the concept of interoperability and are willing to graciously lend thier time and talent to the MITA effort. If you think that MITA is a fad or a flash in the pan, perhaps you should think again...
Monday, December 17, 2007
Yep...One of Those Days
This picture pretty much captures the essesnce of the start of my week. I feel your pain little man.....ugh.Tuesday, December 11, 2007
Free HL7 - MITA Orientation Today
Today is the day that CMS is sponsoring a brief orientation session for folks that are attending the HL7 Work Goup session in January. This session also appears to be a good, high-level introduction to HL7 for anyone interested in learning more about this DSMO. The orientation session is being held from 1:00 - 3:00 p.m. EST.
There is a WebEx component, which is a website that one logs onto and can then view a ppt presentaion and also make comments and also a teleconference number to participate in the audio portion of the orientation.
The WebEx site will be available for logon at 12:45 at this URL:
https://eval.webex.com/eval/j.php?ED=97461447&UID=1017175357
The telconference number is: 866-469-3239
When prompted, please enter the Meeting Number: 921 175 287 and then # sign.
The agenda includes an overview of HL7, information on how HL7 relates to MITA and State Mediciad, and some info about how best to participate if you are attending the January HL7 Work Group meeting in San Antonio next month.
There is a WebEx component, which is a website that one logs onto and can then view a ppt presentaion and also make comments and also a teleconference number to participate in the audio portion of the orientation.
The WebEx site will be available for logon at 12:45 at this URL:
https://eval.webex.com/eval/j.php?ED=97461447&UID=1017175357
The telconference number is: 866-469-3239
When prompted, please enter the Meeting Number: 921 175 287 and then # sign.
The agenda includes an overview of HL7, information on how HL7 relates to MITA and State Mediciad, and some info about how best to participate if you are attending the January HL7 Work Group meeting in San Antonio next month.
Friday, December 7, 2007
Dear Abby M. Zealot
From MITA Zealot to Dear Abby, I would like to take this opportunity to share a reader’s comment with you since the response may be valuable in your life, love, and pursuit of MITA happiness. In response to my “get involved” post, “Sue” (name may have been changed to protect the innocent) writes:
[Dear Abby M. Zealot]
I agree, there needs to be more participation but with all of the subgroups involved, it is not easy to figure out how to get involved where and when. Any help you could offer is appreciated. Thanks.
Sue,
Thanks for your question! While I will never espouse full comprehension of all interactions, below is the world as I know it.
CMS – We all know who they are and the only way to join is to become a Fed. (grin!)
CMS MITA Team – The contracted team assisting CMS in MITA’s continuing evolution is also closed to the general public.
NMEH MITA SWG – This group reviews MITA artifacts allowing states to have input into modifying/improving new versions of the Business and Information Architecture. Open to all state staff members and their sponsored participants, this group is 800+ members and both public/private sector.
HL7 MITA Project – This group will convene in January to begin the process of modeling the MITA Business Processes using Unified Modeling Language (UML) and HL7 standards. Both public and private sector individuals are invited to participate. Membership in HL7 is required to have a vote on proposed standards.
Systems Technical Advisory Group (STAG) – This group is sanctioned as an advisory body to CMS and has been on many issues preceding the introduction of MITA. They continue to act as a conduit for CMS to disseminate MITA related information. CMS selects one representative from each region to participate, by invitation only.
Private Sector Technical Advisory Group (PS-TG) – Comprised of vendors in the same private industry role as the STAG, this group is recognized as an advisory body to CMS. Their MITA focus is in continued development of the Technical Architecture. The group is open to all vendors and rumor has it that some of the more tech-savvy state reps may have been invited to participate as well.
Business Architecture Review Board (BARB) – The newest addition to the family, this group is also by invitation only and is comprised of invited state staff who will participate in the governance process established to moderate MITA’s evolution.
With so much to choose from, you may find yourself asking, “Where should I start?” Here are my recommended steps for interested parties from both the public and private sectors:
Public (State and Federal Staff)
1. Join the NMEH Listserv! This is the broadest group and most of the relevant information flows through here at one point or another. Email Andrea.Danes@FOXsys.com for information on how to enroll.
2. Participate in the HL7 MITA Project. Even if you cannot get approved to travel in January, hook up with the project’s cochairs (Marykay.McDaniel@azahcccs.gov or wbranch@csc.com (Bill Branch)) to stay in the loop on their activities, many of which may be done remotely in between face-to-face trimester meetings.
3. Identify your state’s primary point of contact for STAG and insure that he/she is aware of your interest in MITA so information from the STAG can be forwarded to you.
4. Techno-geeks only: If you proudly wear your propeller hat in public, an email to the PS-TG to see if they would let you participate in their Technical Architecture discussions might be in order. Email dwalsh@ESRV.COM with your qualifications for more information.
Private (The “other side” comprised of vendors and fiscal agents)
1. If you are currently working on a state contract and the lead for that state likes you well enough, you could ask for sponsorship to join the NMEH Listserv. Email Andrea.Danes@FOXsys.com for information on how to enroll.
2. Just like step two for the public sector folks, participate in the HL7 MITA Project. Even if you cannot get approved to travel in January, hook up with the project’s cochairs (Marykay.McDaniel@azahcccs.gov or wbranch@csc.com (Bill Branch)) to stay in the loop on their activities, many of which may be done remotely in between face-to-face trimester meetings.
3. Since you are a vendor or fiscal agent, the propeller hat is optional for participation in the PS-TG. If you would like to learn more about the private sector participation in MITA’s evolution, send an email to the PS-TG for information about membership. Dues are a modest $50 per year so it will not break the corporate bank. Email dwalsh@ESRV.COM for more information.
The world as we know it is subject to change. But while we still know who’s on first, now is the time to swing for the fences!
Sincerely,
Abby M. Zealot
[Dear Abby M. Zealot]
I agree, there needs to be more participation but with all of the subgroups involved, it is not easy to figure out how to get involved where and when. Any help you could offer is appreciated. Thanks.
Sue,
Thanks for your question! While I will never espouse full comprehension of all interactions, below is the world as I know it.
CMS – We all know who they are and the only way to join is to become a Fed. (grin!)
CMS MITA Team – The contracted team assisting CMS in MITA’s continuing evolution is also closed to the general public.
NMEH MITA SWG – This group reviews MITA artifacts allowing states to have input into modifying/improving new versions of the Business and Information Architecture. Open to all state staff members and their sponsored participants, this group is 800+ members and both public/private sector.
HL7 MITA Project – This group will convene in January to begin the process of modeling the MITA Business Processes using Unified Modeling Language (UML) and HL7 standards. Both public and private sector individuals are invited to participate. Membership in HL7 is required to have a vote on proposed standards.
Systems Technical Advisory Group (STAG) – This group is sanctioned as an advisory body to CMS and has been on many issues preceding the introduction of MITA. They continue to act as a conduit for CMS to disseminate MITA related information. CMS selects one representative from each region to participate, by invitation only.
Private Sector Technical Advisory Group (PS-TG) – Comprised of vendors in the same private industry role as the STAG, this group is recognized as an advisory body to CMS. Their MITA focus is in continued development of the Technical Architecture. The group is open to all vendors and rumor has it that some of the more tech-savvy state reps may have been invited to participate as well.
Business Architecture Review Board (BARB) – The newest addition to the family, this group is also by invitation only and is comprised of invited state staff who will participate in the governance process established to moderate MITA’s evolution.
With so much to choose from, you may find yourself asking, “Where should I start?” Here are my recommended steps for interested parties from both the public and private sectors:
Public (State and Federal Staff)
1. Join the NMEH Listserv! This is the broadest group and most of the relevant information flows through here at one point or another. Email Andrea.Danes@FOXsys.com for information on how to enroll.
2. Participate in the HL7 MITA Project. Even if you cannot get approved to travel in January, hook up with the project’s cochairs (Marykay.McDaniel@azahcccs.gov or wbranch@csc.com (Bill Branch)) to stay in the loop on their activities, many of which may be done remotely in between face-to-face trimester meetings.
3. Identify your state’s primary point of contact for STAG and insure that he/she is aware of your interest in MITA so information from the STAG can be forwarded to you.
4. Techno-geeks only: If you proudly wear your propeller hat in public, an email to the PS-TG to see if they would let you participate in their Technical Architecture discussions might be in order. Email dwalsh@ESRV.COM with your qualifications for more information.
Private (The “other side” comprised of vendors and fiscal agents)
1. If you are currently working on a state contract and the lead for that state likes you well enough, you could ask for sponsorship to join the NMEH Listserv. Email Andrea.Danes@FOXsys.com for information on how to enroll.
2. Just like step two for the public sector folks, participate in the HL7 MITA Project. Even if you cannot get approved to travel in January, hook up with the project’s cochairs (Marykay.McDaniel@azahcccs.gov or wbranch@csc.com (Bill Branch)) to stay in the loop on their activities, many of which may be done remotely in between face-to-face trimester meetings.
3. Since you are a vendor or fiscal agent, the propeller hat is optional for participation in the PS-TG. If you would like to learn more about the private sector participation in MITA’s evolution, send an email to the PS-TG for information about membership. Dues are a modest $50 per year so it will not break the corporate bank. Email dwalsh@ESRV.COM for more information.
The world as we know it is subject to change. But while we still know who’s on first, now is the time to swing for the fences!
Sincerely,
Abby M. Zealot
Thursday, December 6, 2007
Business Architecture Update
MITA Governance has established a foothold and is under way. The MITA Business Architecture Review Board (BARB) has been formed and is scheduled to begin a review of the existing MITA business processes. It has been reported that CMS is working on a MITA repository that will provide public access to the revised and governance-reviewed business architecture artifacts in the not-too-distant future. Progress!Calvin and UML
(click on pictures for a larger view)Calvin was obviously having some trouble conveying his sandwich design concept to the sandwich developer. The result was less than desirable, especially for our young end user. Perhaps our friend Calvin should have tried communicating a more object oriented design request using UML. It may have looked something like this:
The major advantage to using UML is that it is a communications platform that bridges the communications barrier between people. UML allows developers, and even non-developers to understand design in a very simple, common, and straight-forward method.Anybody want to take a stab at writing the xml for Calvin’s order?
Tuesday, December 4, 2007
Old MacDonald got FFP for HL7!
A public service reminder that State staff may be eligible for Federal assistance to attend the HL7 Work Group Sessions. Budgets in Implementation Advance Planning Documents (IAPDs) for new systems being built using MITA methodology can be written to include implementation-related activities that would include attendance at HL7.For systems that are currently operational, job enhancement activities can be reimbursed by the Feds at 75%. HL7 training for ongoing maintenance and operations of your systems can be applied for through an APD update or claimed on quarterly CMS financial reports and justified on the basis that upcoming HIPAA-related claims attachments will likely be based on HL7 standards. In addition, many states are now developing EHRs and PHRs through Medicaid Transformation Grants. Some grant applications have line items for training and standards for the content of these electronic records will also likely come out of HL7.
See your friendly neighborhood CMS Regional Office Staff for details on this exciting offer.
Monday, December 3, 2007
Intimidation, MITA style
While sincerely flattered by the invitation to guest post, I must admit my reluctance to do so is directly related to the level of intimidation I feel in the presence of Mikey. I mean, how do you compete with the SOA to turkey dinner analogy? I am so intimidated by someone so knowledgeable about MITA that I just want to sit on the sidelines and maintain quiet observation so as not to reveal my inadequacy. And then it occurred to me…
Isn’t that why the blog, the NMEH MITA SWG call, and possibly the HL7 meetings are so quiet? It seems like there are those in the world that understand this all so well that the rest of us are left in the dust, trying not to choke, and definitely without breath to comment. But is that really the way it has to be? I vote, “No!”
See, MITA is a vision and goal established by CMS. But CMS is comprised of humans who know they are human and are trying their best to draw the rest of us humans into the conversation with them. Far from the edict descending from the mountain, CMS has invited each of us to bring our respective talents and experience to the table expecting the final product to be more comprehensive as a result.
So whether it is guest blogging, responding, or participating in the NMEH and HL7 workgroups, we should PARTICIPATE! With an endeavor that requires many perspectives and much collaboration, every single participant is valuable. And valued. While this “little” MITA project will likely take all of my career and part of the next generation’s, we are working on something that will change the world as we know it. And won’t that be fun to share around the family holiday table??
Thanks for the invite, Mikey! Hope I did not make you regret it!
Isn’t that why the blog, the NMEH MITA SWG call, and possibly the HL7 meetings are so quiet? It seems like there are those in the world that understand this all so well that the rest of us are left in the dust, trying not to choke, and definitely without breath to comment. But is that really the way it has to be? I vote, “No!”
See, MITA is a vision and goal established by CMS. But CMS is comprised of humans who know they are human and are trying their best to draw the rest of us humans into the conversation with them. Far from the edict descending from the mountain, CMS has invited each of us to bring our respective talents and experience to the table expecting the final product to be more comprehensive as a result.
So whether it is guest blogging, responding, or participating in the NMEH and HL7 workgroups, we should PARTICIPATE! With an endeavor that requires many perspectives and much collaboration, every single participant is valuable. And valued. While this “little” MITA project will likely take all of my career and part of the next generation’s, we are working on something that will change the world as we know it. And won’t that be fun to share around the family holiday table??
Thanks for the invite, Mikey! Hope I did not make you regret it!
CMS Announcement of HL7 Training
CMS has made an official announcement of the HL7 Workgroup pre-conference training session to be held next week. Here is the announcement:
On December 11, 2007 from 1:00 pm – 3:00 pm, Eastern Standard Time (EST), you are invited to attend a CMS Webinar. The purpose of the Webinar is to explain Health Level 7 (HL7) and its relationship to MITA activities, and why you may want to attend the upcoming January, 2008 HL7 Working Group Meeting. The December 11th Webinar will:
Inform you of the objectives of the upcoming January 15 – 18, 2008 HL7 Working Group Meeting to be held in San Antonio, Texas that will be of interest to business/program staff, and State MITA representatives, as well as staff who are planning to, or are already building, MITA business/information models. More about the HL7 Working Group Meeting can be found at this site: http://www.hl7.org/index.cfm (early registration closes on December 14, 2007).
Invite you to attend orientation sessions in San Antonio for 1st time HL7 attendees, to be offered jointly by the National Medicaid EDI Health Workgroup (NMEH), and CMS, to orientate principally State folks about HL7 and the HL7 MITA sub-workgroup (SWG).
Introduce you to the collaborative activities of the HL7 MITA SWG, which is a subset of the general HL7 meeting, and their on-going activities, and demonstrate how your role in this activity can help.
Provide justifications, and explain allowable funding, for Medicaid State staff attendees.
The WEBINAR will provide you with high-level information about the HL7 meeting, how MITA fits within HL7, and reasons why you should think about attending the HL7 meeting in San Antonio, Texas in January 2008. We promise that the terms “UML” and "WSDL" will be excluded from the conversation!
Please join us on December 11, 2007 from 1:00 pm – 3:00 pm (EST). Webinar details will be sent to you the week of December 3rd.
Thursday, November 29, 2007
HL7 Training Update
Update on CMS plans to hold a pre-HL7 Conference training session…CMS announced this week that Tuesday, 12/11/07 is the planned date for this training. This call is being coordinated by CMS with the STAG, PSTG, and other interested individuals related to HL7 MITA development. Anyone interested or involved in MITA State Self-Assessments, or MITA-related HL7 development is invited to attend. The agenda will include multiple speakers providing information about the next MITA steps and the January HL7 meeting objectives. Specific dial-in information and the exact time of the training is expected to be available soon.
I will try to post the training agenda when it is made available from CMS.
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