Microsoft Health and Human Services

1. Microsoft Health and Human Services William O’Leary Executive Director, Health and Human Services Microsoft U.S. Public Sector

2. Interoperability • History of disconnected silos • From legacy to interoperability • Changing role of CIO • Consumer centered HHS • HHS Business and Architectural Vision • Common Client Index • Example: Alabama • Moving toward consumer centered care from different vantage points

3. History of disconnected silos • Disconnected silos • Categorical Government financing • Enabling legislation • Professional licensing/education • Advocacy • Disconnected transfer and legacy systems

4. From legacy to interoperability • Business • Post 9/11, and Katrina • Health care: access, quality, costs • Electronic Health Records • Health Coverage • Morphing commercial and public sector approaches • Intersect of health and human services • Education • Technology • Enterprise Architectures • Human Service Frameworks • Web Services • COTS • Don’t need to rip and replace organization or technology investments

5. Changing Role of CIO • Web services provide access to data otherwise locked away… • Public health, child welfare, Medicaid • Common client index, case management, Enterprise Architecture • Provide greater satisfaction to front line workers – mobile devices • Business Decision Makers need IT for pressing problems – changing business: • CIO’s can provide roadmap: flexibility, sequencing and timing • Immediate ROI: fraud and abuse reduction • Strategies to finance IT infrastructure

6. Changing role of CIO Public Professional Public CIO • Build relationship with CIO / IT • Understand the power of Web Services / Shared Services • Look beyond agency boundaries • Focus on consumer / citizen- centered Business Applications • Embrace data-sharing and collaboration as a strategy • Understand funding streams and grant opportunities • Leverage Crisis / Visibility • Become Trusted Advisor to Public Professionals • Strategic planning for IT • Develop IT Roadmap • Establishment of IT Investment / Governance Boards • Cost vs. Benefit decision models • Enable business focused / consumer-centric services • Consolidation of Operations • Outsourcing non-core government competencies • Increasingly operating more as private sector entities • Increased emphasis on Measurement/Performance Connected HHS

7. Community Based Organizations Client Centered Services -- -- -- -- -- -- -- -- Managing Outcomes Case Workers Client Consumer County / Local Agencies State Agencies Federal Agencies Consumer Centered Human Services • Focus on Customer Need • Expand access to care • Measure outcomes • Consumer-centered service delivery • Enable efficiencies and reduce fraud and abuse • Protect the consumer and the public • Enabling choice and flexibility for providers, payers and Clients

8. Consumer Centered Human Services • Move toward connected HHS enterprise: • Common business processes across multiple systems • Client can be best served through coordinated services • Legacy transfer/re-use limitations • Coordinating care at the point of service delivery: • Community based organizations • Counties/Cities • Indian reservations • Military family services • State agencies framework development

9. HHS Architectural Vision To guide HHS to: • Leverage existing investments • Transform operations through phased initiatives leading to holistic, integrated solutions • Achieve near-term cost savings and significant service improvements Focus upon: • Common business processes across multiple systems • Roadmap from interoperability to legacy replacement • Strategies to finance IT • Presented through scenarios, service components and technologies- CCI, mobility, b.i., case management, eligibility

10. Common Client Index • Information exists in disparate systems, and at poor quality levels • Systems use their own identifiers to identify citizens, patients, properties, assets and incidents • Makes it difficult to create a trusted view of a person’s information across multiple systems within a single organization • Many times more difficult when sharing with external agencies • The demand is for a Common view of cross-organizational data… • Applications: health records, human services • with a method to keep it synchronized • to enable integration of functions & services

11. Alabama -- Family centered care • Governor’s Task Force to Strengthen Alabama Families • State agency interoperability • Development of family service centers • Identification of shared services • Pre-eligiblity • Resource locator • Common client index • Shared services architecture • Implementation strategies

12. Moving toward consumer centered care from different vantage points: - health care- child and family services- public health

13. Microsoft Platform and 3rd-Party COTS • Rules Engines • Workflow Engines • Web portals • Call Center Management • Translators • Automated letter generators • Desktop publishing systems • Computer Based Training (CBT) systems • Automated, Web-based survey tools MMIS Architecture

16. Next Generation SACWIS Topology County Systemsand ProgramsCBO’s & Non-Profits SACWIS Legacy IntegrationOther Applications Interoperability .NET Web Application Intake Web-Services Interfaces TANF Child Support Sharepoint Portal Access Eligibility SQL DW-BIReporting /Analysis Medicaid Case Management Internet Internet Finance /Payments BizTalk NCANDS Resource Management Interfaces and Interoperability Juvenile Justice ProgramAdministration Social Security Court Systems

17. Next Generation SACWIS Topology County Systemsand ProgramsCBO’s & Non-Profits SACWIS / AFCARS Req’s Intake Eligibility Case Management Resource Management Court Processing Financial Management Administration Interfaces / Interoperability Quality Assurance New Initiatives / Legislation SACWIS Interoperability • Title IV-A (TANF) • Title IV-D (Child Support) • Title XIX (Medicaid) • NCANDS • Others… • Social Security System • Court System • Child Support • Juvenile Justice System • Dept of Education Legacy IntegrationApplication Interoperability .NET Web Application Intake Web-Services Interfaces TANF Child Support Sharepoint Portal Access Eligibility SQL DW-BIReporting /Analysis Medicaid Case Management Internet Internet Finance /Payments SACWIS Solutions, Integration, Project Management BizTalk NCANDS Resource Management Interfaces and Interoperability Juvenile Justice ProgramAdministration Social Security Court Systems

18. Electronic Public Health Record • Start with integrated view of Clients (Common Client ID) • Create interoperability layer (data hub) at center of strategy • Creating an Electronic Public Health Record (EPHR) • Starting with Newborn Child Application • Moving to Immunization, Vital Statistics and Lab Information Systems • Eventually to include legacy data and connections to Medicaid (MMIS), Dept. of Licensing, etc.

19. Approach:Create Electronic Public Health Record Data HubInteroperability

20. Approach:Connect Community Health Centers A place where patients routinely go for primary care regardless of ability to pay A place that meets linguistic, cultural, social and medical needs of the people it serves A place where records are maintained • Need EMR System & Infrastructure • Move Care from Emergency Rooms to Community Health Centers • Improves outcomes in Public Health while mitigating burden on Medicaid

21. Approach: Public Health & Medicaid • Connect Community Health Centers Hospitals • Reduce costly-inappropriate use of Emergency Rooms • Get underserved connected to Community Centers • Expanded access to care for low income, uninsured people at lower cost • Data driven, high quality care • Governance through non-profit consortium • Eventually connect to RHIO’s

22. Approach: Public Health Mobile Nurses • Goal is more time spent helping clients / less time spent on administrative tasks • Web-Based Referral System connected to database of community’s public health nurses and data • Mobile nurse / Tablet PC • RESULTS: • Re-engineer cumbersome paper process to streamlined electronic process • Increase accuracy and completion rates • Reduced response time between case referral and client contact • Reduce response time for 1st client visit by nurse • Increase time available for direct services from nurse to client (reduce admin work)

23. Discussion • Roadmap toward interoperability • Financing models • Leveraging commercial markets • Government as a service • Resistance to change – fail to recognize innovation • Business process re-engineering • Diffusion