Demonstration Year 2 – Quarter 4 October 1, 2018 ...



center1905Washington State Medicaid Transformation Project demonstrationSection 1115 Waiver Quarterly Health IT Operational ReportDemonstration Year 2: (January 1, 2018 to December 31, 2018)Federal Fiscal Quarter: Fourth Quarter (October 1, 2018 to December 31, 2018)Demonstration Year 2 – Quarter 4 October 1, 2018 – December 31, 2018The Health IT Operational Plan is composed of actionable deliverables to advance the health IT goals and vision articulated in the Health IT Strategic Roadmap (). This work supports the Healthier Washington Medicaid Transformation (Transformation) in Washington State. The Health IT Roadmap and Operational Plan focuses on three phases of Transformation work: design, implementation and operations, and assessment. The Health IT Operational Plan includes 92 deliverables and tasks in areas including: Data, data analytics, data governanceHealth IT/health information exchange, including related training for the Accountable Communities of Health (ACHs)FinancingMaster person identifierProvider directoryEvaluation. In 2018, the work focused on identifying and providing the data needed by the state, ACHs, and providers, as well as supporting technology tools needed by providers for interoperable health information exchange (HIE) and existing infrastructure projects (e.g., Clinical Data Repository (CDR)).Success StoriesThe Washington State Health Care Authority (HCA) spent much of the 2018 fourth quarter finalizing the 2019 Health IT Operational Plan. This involved working with HCA leadership and Department of Health (DOH) leaders and staff, and with the ACHs. We submitted the 2019 Health IT Operational Plan to CMS on January 3, 2019.The Health IT team spent much of the fourth quarter focused on integrating the tasks in the Substance Use Disorder (SUD) Health IT Plan (a required component of the IMD 1115 Waiver) into our broader Health IT plans. This is a required component of the IMD 1115 waiver. Staff from HCA and DOH defined functionality and use of the prescription drug monitoring program (PDMP). This included exploring funding sources. Of particular interest is how certain provisions in the SUPPORT Act align with tasks in the SUD Health IT Plan, and could be used in Washington State to support our efforts. While we await federal guidance on the SUPPORT Act, the Health IT team has conducted a financial mapping exercise to document potential funding sources for the required tasks in the SUD Health IT Plan. Task 1 in the SUD Health IT Plan requires completing a financial map to identify resources that could be used to support the tasks in the SUD Health IT Plan. We submitted that deliverable to CMS on January 17, 2019. HCA continues to add individuals into the CDR. The CDR now contains more than 7.5 million “continuity of care documents”. It averages over 500,000 “continuity of care documents” per month. HCA continued encouraging providers to submit documents to the CDR, and is now reaching out to behavioral health providers. The state continues to align the various health IT plans, including the State Medicaid Health IT Plan, which it is currently updating. These efforts are coordinated with a multi-agency enterprise governance group. This group aligns technology investments of state health and human service agencies for planning and funding purposes. The enterprise governance group has begun prioritizing multi-agency projects to ensure coordination and resource alignment.Progress to dateDuring 2018, Washington State substantially advanced its Health IT Operational Plan. This work included:Coordinating with Tribes and ACHs on state and national HIE resources.Continuing the SUD HIE and Consent Management Workgroup.Aligning HIE elements into the Medicaid Transformation’s Independent External Evaluation.Developing a financial mapping tool for the SUD-IMD Health IT required projects.HCA, in collaboration with DOH:Identified Health IT tasks and deliverables needed to implement? the SUD Health IT plan in the IMD?waiver.Incorporated these tasks into the 2019 Health IT?Operational?Plan.?These deliverables identify funding resources to enhance the Prescription Drug Monitoring Program (PDMP) and further develop the?Health IT infrastructure for SUD care delivery.By the end of 2018, HCA had completed approximately 93% of all deliverables due in this year. Three deliverables remain at risk (see the challenges section of this report) and three items re-planned to 2019. The re-planned items include tasks with deliverables required in all quarters in 2018. Washington State continues to work on deliverables in all major categories. ChallengesWhile substantial progress has been made, there are two deliverables that are at-risk, and six that were re-planned for 2019. These include the following at-risk deliverables:?Task Number TaskComment02-006SAMSHA-HCA will identify and streamline BH reporting requirementsHCA is currently working to advance to advance BH reporting requirements and has contracted with project management support to advance this work. Work is underway and is scheduled to complete in April 2019.03-003HCA will invest in data aggregation in support of payment model 4HCA is currently evaluating the success of the Payment Model 4 test and it is unclear whether there will be a need to support data aggregation for this payment model going forward.Changes in Health IT Operational PlanThere were six items that were re-planned for 2019 due to pending decisions and resource constraints. All six are due in the first quarter of 2019:Task 02-008 (Develop patient/provider attribution approach). HCA identified several different attribution approaches currently at use by state agencies and Medicaid Managed Care Organizations. HCA convened a workgroup to review these attribution methodologies and determine whether a single approach is appropriate. If so, this group will be tasked with recommending a singular attribution approach. This work will continue throughout 2019.Task 03-014 (HCA will identify components to pilot the exchange of consent management for 42 CFR part 2) This task was removed from the 2018 Health IT Operational Plan due to resource constraints. In 2018, resources were used to develop needed educational materials and an exchange of information consent form, subject to 42 CFR Part 2. Educational materials and sample consent form will be disseminated by the end of March 2019.In addition, and if funds allow, the 2019 Health IT Operational Plan will include development of a technical solution for the electronic exchange (transmit, view, download) of SUD information through the statewide HIE and the CDR. If funding is approved, this work is expected to begin in July 2019.Task 05-020 (HCA will work with OneHealthPort (OHP) to identify EHR tools that do not support ProviderOne IDs) This task was re-planned because HCA asked OHP to focus on launching the CDR instead of focusing on this report.Task 05-029 (Contract of white paper describing best security practices for HIT/HIE) This work has been re-planned to be completed by the end of Q2 2019.Task 05-030 (Disseminate security practices white paper) HCA is working to identify the specific elements to feature in a security practices white paper. This paper is scheduled to be drafted in the first quarter of 2019. When done, it will be shared with HCA partners.Task 06-007 (HCA will procure Fraud Abuse Detection System Tools for use in the Enterprise Data Warehouse database)HCA is making progress in procuring a fraud abuse detection system to align with the enterprise data warehouse. HCA has created a charter for gathering requirements, and initial meetings have occurred.Next StepsHCA is implementing the 2019 Health IT Operational Plan. As noted, implementation of several tasks is contingent on funding decisions. We are continuing to align the Health IT Operational Plan with the State Medicaid Health IT Plan (SMHP) and other state technology plans. We plan to complete aligning the SMHP with the Health IT Operational Plan and other state technology plans by the end of April 2019. Top 20 Organizations by total successful CCD submissionsRankOrg NameCCD CountRankOrg NameCCD Count1.University of Washington77,31811.Seattle Childrens13,9752.MultiCare67,34412.The Vancouver Clinic11,9023.Providence Health & Services64,munity Health Care11,4654.Swedish First Hill41,37514.Confluence Health10,6815.Tri-Cities Community Health37,39415.Valley Medical Center6,8516.Health Point CHC32,47816.The Everett Clinic5,3767.Neighborcare Health23,89517.Country Doctor5,1168.Kadlec Regional Medical Center21,36518.Pacific Medical Center4,5879.Yakima Neighborhood Health15,25019.Valley View Health Center4,53710.PeaceHealth14,91920.Moses Lake Community Health4,356Number of Provider Organizations in UAT in last month: 6CDR Tickets at HCA:3 and CDR Tickets at OHP: 9Map showing clients by county Map showing clients by ACH Map showing clients with claims by county Map showing clients with claims by ACH Init.% CompleteStartEndDeliverable DescriptionQtrStatusCategory01-00110002/01/1812/31/18HIT Operational Plan monthly meetingsQ4CompleteMonthly Meetings02-00210010/02/1712/31/18Create a list of data sources needed for project implementationQ4CompleteData02-00310010/02/1712/31/18Ensure data inventory will include comprehensive data listQ4CompleteData02-00410001/01/1807/31/18Propose recommended policies, governance and infrastructure changesQ3CompleteData02-00510004/02/1812/31/18HCA will review P1 project artifacts related to whether HCBS providers are HIPAA covered entitiesQ4CompleteData02-0068304/02/1812/31/18SAMSHA-HCA will identify and streamline BH reporting requirementsQ4At RiskData02-0089410/02/1712/31/18Develop patient/provider attribution approachQ4ReplannedData03-00110010/02/1709/28/18HCA will define data aggregation and present optionsQ3CompleteData Governance03-00210004/02/1812/31/18HCA will support and monitor progress of APCDQ4CompleteData Governance03-0037504/02/1812/31/18HCA will invest in data aggregation in support of payment model 4Q4At RiskData Governance03-00410001/01/1812/31/18HCA will support Master Data managementQ4CompleteData Governance03-00510001/01/1812/31/18HCA will support Truven/IBM data model-phase 2Q4CompleteData Governance03-00610008/01/1703/30/18Payment Model 2 analytic support from AIM/RDAQ1CompleteData Governance03-00710004/02/1804/06/18HCA will explore Provider One updates to support FQHC/RHC APM4Q2CompleteData Governance03-00810001/01/1812/31/18HCA will develop and disseminate data governance guidelinesQ4CompleteData Governance03-00910001/01/1812/31/18HCA will support ACHs in adhering to HCA data governance guidelinesQ4CompleteData Governance03-01010010/02/1703/30/18HCA and DSHS will consult with SAMHSA on 42 CFR Part 2Q1CompleteData Governance03-01110010/02/1703/30/18HCA will collaborate with ONC on state collaborative for SUD and other sensitive informationQ1CompleteData Governance03-01210001/01/1806/29/18HCA will encourage other state agencies to participate in ONC state learning collaborativeQ2CompleteData Governance03-01310001/01/1809/28/18HCA will share information about consent management of sensitive/SUD informationQ3CompleteData Governance03-0145007/02/1803/29/19HCA will identify components to pilot the exchange of consent management for 42 CFR part 22019ReplannedData Governance03-01510001/01/1812/31/18Develop DSAs that adhere to state and agency policies for data governanceQ4CompleteData Governance03-01610004/02/1806/29/18Consult with ONC to understand 21st century cures actQ2CompleteData Governance03-01710004/02/1812/31/18Statewide DSA strategy CompleteQ4CompleteData Governance03-01910007/02/1809/28/18HCA will encourage ACHs to partner with jails and corrections to ease burdens at transitionQ3CompleteData Governance04-00110011/01/1712/31/18HCA will build out dashboards for Medicaid standard reportingQ4CompleteData Analytics04-00210010/02/1703/30/18HCA will create analytic ready data productsQ1CompleteData Analytics05-00110010/02/1712/31/18HIT/HIE Assessment strategy completeQ4CompleteHIT/Health Information Exchange05-00210010/02/1707/31/18Determine scope and results of HIT/HIE assessments of providers in ACHsQ3CompleteHIT/Health Information Exchange05-00310001/01/1803/30/18Introduce ACHs, Providers and other to CMS Health information sharing assessmentQ1CompleteHIT/Health Information Exchange05-00410001/01/1809/28/18If needed, HCA will support ACHs in assessing provider HIT capacityQ3CompleteHIT/Health Information Exchange05-00510001/01/1807/31/18Explore HIT/HIE solutions to address barriers/gaps in ACH projectsQ3CompleteHIT/Health Information Exchange05-00610001/01/1803/30/18Participate in round table discussions with tribal governmentsQ1CompleteHIT/Health Information Exchange05-00710001/01/1806/29/18Provide a presentation on HIE to tribal government leadersQ2CompleteHIT/Health Information Exchange05-00810010/02/1703/15/18HCA will consult with Tribal Government leaders to understand concerns related to privacy issues and identify solutions to address concernsQ1CompleteHIT/Health Information Exchange05-00910010/02/1712/29/17Tribes and IHCP will submit a IHCP planning funds plan for statewide improvement in AI/AN behavioral health#N/ACompleteHIT/Health Information Exchange05-01010001/01/1809/28/18HCA and Tribal governments will consult and collaborate on HIE and PHM activitiesQ3CompleteHIT/Health Information Exchange05-01110001/01/1806/29/18HCA and ACHs will identify shared HIT/HIE care coordination tools, funding for HIE tools, and shared contracts/contracting languageQ2CompleteHIT/Health Information Exchange05-01210004/02/1809/28/18HCA will pursue 10% matching funding to support HIT/HIE assessment activitiesQ3CompleteHIT/Health Information Exchange05-01310001/01/1803/30/18HCA will explore CRM tool for ACHsQ1CompleteHIT/Health Information Exchange05-01510004/02/1812/31/18HCA will design and disseminate a quarterly report by provider and MCO that shows progress in who is using the CDRQ4CompleteHIT/Health Information Exchange05-01610010/02/1712/31/18HCA will convene a clinical group to provide guidance/feedback on the type and format of info in CDRQ4CompleteHIT/Health Information Exchange05-01710010/02/1712/31/18FHCQ will lead effort to create "high priority" use cases for CDRQ4CompleteHIT/Health Information Exchange05-01810004/02/1809/28/18HCA will convene group to prioritize CDR needs to meet the Medicaid transformationQ3CompleteHIT/Health Information Exchange05-01910001/01/1809/28/18HCA and OHP will develop a catalog of OHP services, provider types registered, and future servicesQ3CompleteHIT/Health Information Exchange05-020001/01/1803/29/19HCA will work with OHP to identify EHR tools that do not support ProviderOne IDs2019Re-plannedHIT/Health Information Exchange05-02110001/01/1807/31/18HCA will work with OHP to launch CDR provider portalQ3CompleteHIT/Health Information Exchange05-02210010/01/1812/31/18HCA will consider the need to provide individual level access to health informationQ4CompleteHIT/Health Information Exchange05-0231004313243465Monthly TA meetingsQ4CompleteHIT/Health Information Exchange05-0241004310143280Identify TA topicsQ2CompleteHIT/Health Information Exchange05-0251004310143280Determine TA activities by QUALISQ2CompleteHIT/Health Information Exchange05-0261004328343371HCA will consider needs to implement alternative TA and training support models to assist providersQ3CompleteHIT/Health Information Exchange05-0271004328343371HCA and ACHs will explore engaging private philanthropic organizationsQ3CompleteHIT/Health Information Exchange05-0281004328343465HCA annual HIT/HIE roadshowQ4CompleteHIT/Health Information Exchange05-02904328343553Contract for white paper describing best security practices for HIT/HIE2019Re-plannedHIT/Health Information Exchange05-03004319243553Disseminate security practices white paper2019Re-plannedHIT/Health Information Exchange05-0311004319243465Identify performance measures related to adoption of HIT/HIEQ4CompleteHIT/Health Information Exchange05-0321004328343465Share HIT/HIE performance measures with independent evaluatorQ4CompleteHIT/Health Information Exchange05-0331004328343371Disseminate performance measuresQ3CompleteHIT/Health Information Exchange05-0341004319243465HCA will explore methods with MCOs to encourage provider use of HIE technologiesQ4CompleteHIT/Health Information Exchange05-0351004301043465HCA will compile and disseminate contact listQ4CompleteHIT/Health Information Exchange05-0361004313643465ONC quarterly updatesQ4CompleteHIT/Health Information Exchange05-0371004301043465Reporting to Federal GovernmentQ4CompleteHIT/Health Information Exchange06-0011004319243280HCA will identify 90/10 funding sourcesQ2CompleteFinancing06-0021004301043465HCA will pursue funding sources to meet HIT needsQ4CompleteFinancing06-0021004319243280HCA will seek federal guidance on 10% matchQ2CompleteFinancing06-0031004310143465HCA will actively explore opportunities to leverage 90/10 matchQ4CompleteFinancing06-0041004319243465If needed identify a leg. StrategyQ4CompleteFinancing06-0051004319243465identify opportunities for shared HIT financial investmentsQ4CompleteFinancing06-0061004310143465HCA will support identified funding requestsQ4CompleteFinancing06-0071004310143280HCA will procure Fraud Abuse Detection System tools for EDWQ2Re-plannedFinancing07-0011004310143280HCA will discuss options and authority to advance Master patient identifierQ2CompleteMaster Person Identifier07-0021004337443465If appropriate, HCA will pursue 90/10 funding to implement master patient identifierQ4CompleteMaster Person Identifier08-0011004301043465Determine feasibility of using 90/10 funding for provider directory tasksQ4CompleteProvider Directory08-0021004301043312Consider enhancements to current provider license interface with ProviderOneQ3CompleteProvider Directory08-0031004328343465HCA, will identify provider directory use casesQ4CompleteProvider Directory08-0031004328343465Master Data Management provider files from Truven have been createdQ4CompleteProvider Directory08-0031004328343465Procured list of PCPsQ4CompleteProvider Directory08-0031004328343465Cat 1 Provider data files in Excel form are available to ACHs in Q4CompleteProvider Directory08-0031004328343465Determine resources to complete the tasksQ4CompleteProvider Directory08-0031004328343465Developing understanding of what is available in the Master Data ManagementQ4CompleteProvider Directory08-0031004328343465Complete Dashboard using the provider data file for the ACHsQ4CompleteProvider Directory08-0031004328343465Communicate availability of the Cat 1 provider filesQ4CompleteProvider Directory09-0011004328343465HCA will present to leadership approaches for displaying P4P measures and means to explore sub-populationsQ4CompleteData Visualization09-0021004337443465HCA (if appropriate) will determine costs of data visualization and identify funding sourcesQ4CompleteData Visualization10-0011004313243465An independent evaluation of Health IT/HIE activities will be conducted in accordance with evaluation protocolQ4CompleteProject Evaluation ................
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