Information System (MMIS) and Your Health Information Exchange (HIE) - - PowerPoint PPT Presentation

Presentation to: CMS Region 4 & 6 Meeting Presented by: Stacey Harris, Director of Health IT Innovation Division of Health IT

Date: September 16, 2014

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

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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.

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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

• f health information technology

– Achieving improvements in care efficiency and population health

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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

• 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. – ePrescribing – TeleHealth – Digital health devices – Health informatics, and more

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Georgia’s Health IT Continuum

Electronic Health Records ePrescribing Digital health tools Patient Engagement Widespread provider connectivity Population Health Management

Strengthen privacy and data protections Evaluate effectiveness of health IT initiatives Support public-private health IT collaborations

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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 2014.

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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) Q3 2014 Children’s Healthcare of Atlanta (Epic) Q32014

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

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GAMMIS Web Portal

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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 E-Mail Address

• Ability to access the Georgia

Health Information Network (GaHIN) Patient Profile site

• Ability to submit/view applications

for the EHR Incentive Program (MAPIR)

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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

• perating 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

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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

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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.

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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.

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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.

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Access to the GaHIN

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A view to more patient information

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A view to more patient information

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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

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A view to more patient information

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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

• f our State Health Benefit Plan-BeWell SHBP to

support health and wellness – Personal Health Record

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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.

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Title or Chapter Slide (use as needed; feel free to delete)

Future Innovations

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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

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Thank You.

Questions and Answers

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Stacey Harris,

Director of Health IT Innovation Georgia Department of Community Health sharris@dch.ga.gov