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

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…

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.

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...

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.

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.

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