electronic Long-Term Services &
Supports (eLTSS) Initiative
All-Hands Workgroup Meeting
November 5, 2015
1
Meeting Etiquette
•
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•
•
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S&I Framework to Participants:
addressed publically in the chat, or discussed in the From
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meeting (as appropriate).
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2
Agenda
Topic
Presenter
Timeframe
Welcome
Announcements
eLTSS Roadmap
Evelyn Gallego
10 mins
eLTSS Pilot Plan Presentations
• KY Office of Administrative &
Technology Services (Sheena
Batts)
• MD Department of Health &
Mental Hygiene (Kale Sweeney)
• CT Department of Social
Services Division of Health
Services (Minakshi Tikoo)
• CO Department of Health Care
Policy & Financing (Kelly
Wilson)
80 mins
3
Announcements
• NATE and the California Association of Health
Information Exchanges (CAHIE) Call for Participation:
New National Forum for Provider Trust Community
• What: NATE and the California Association of Health Information
Exchanges (CAHIE) recently announced that CAHIE is assuming
administration of the NATE Provider-to-Provider Trust Bundle for
Direct messaging among providers. We are now looking for
participants to serve on a new national forum to help establish a
voluntary governance process to manage and govern the new
national trust community.
• When: Interested parties should respond as soon as possible
• For information: http://www.ca-hie.org/news/call-for-participantsnational-forum
4
Announcements, cont’d…
• Connecting Health and Care for the Nation: A Shared
Nationwide Interoperability Roadmap version 1.0
– What: This draft interoperability roadmap lays out a clear path to catalyze the
collaboration of stakeholders who are going to build and use the health IT
infrastructure. These documents include all the public comments that were
submitted during the public comment period.
– Roadmap Website: https://www.healthit.gov/policy-researchersimplementers/interoperability
– Rules:
https://www.federalregister.gov/articles/2015/10/16/2015-25595/medicareand-medicaid-programs-electronic-health-record-incentive-program----stage3-and
https://www.federalregister.gov/articles/2015/10/16/2015-25597/2015edition-health-information-technology-certification-criteria-2015-editionbase-electronic
5
Announcements, cont’d…
Common Clinical Data Set
•
•
•
Renamed the “Common MU Data Set.” This does not impact 2014
Edition certification.
Includes key health data that should be accessible and available for
exchange.
Data must conform with specified vocabulary standards and code
sets, as applicable.
Patient name
Lab tests
Sex
Lab values/results
Date of birth
Vital signs (changed from proposed rule)
Race
Procedures
Ethnicity
Care team members
Preferred language
Immunizations
Problems
Unique device identifiers for
implantable devices
Smoking Status
Assessment and plan of treatment
Medications
Goals
Medication allergies
Health concerns
ONC Interoperability
Roadmap Goal
2015-2017
Send,
receive, find
and use
priority data
domains to
improve
health and
health
quality
Red = New data added to data set
Blue = New standards for data
6
Announcements, cont’d…
• mHealth Summit
– What: The 2015 mHealth Summit explores what is new in
mobile, telehealth and connected health—from the impact
on healthcare delivery, clinical care and patient/consumer
engagement to new technologies, research, investment
activities, policy and shifts in the business environment.
– When: November 8 –11, 2015
– Where: Gaylord National Resort and Convention Center ~
Washington, D.C.
– To register: http://www.mhealthsummit.org/registration
7
Announcements, cont’d…
• National Call for Applications Opens: Community Health
Peer Learning Program
– What: In July 2015 the Office of the National Coordinator for Health
Information Technology (ONC) has awarded AcademyHealth $2.2 million to
lead the Community Health Peer Learning Program (CHP). Throughout this
two-year program, AcademyHealth will work in partnership with ONC to
establish a national peer learning collaborative for 15 competitively-awarded
communities to address specified population health management challenges
through increased sharing and use of data.
– When: Application Due Date November 10, 2015 ~ Anticipated Award Date
January 8, 2016
– For more information:
http://www.academyhealth.org/Programs/ProgramsDetail.cfm?ItemNumber=
16918&navItemNumber=17093
– To apply:
http://www.academyhealth.org/Programs/content.cfm?ItemNumber=17238
8
Announcements, cont’d..
• Aging 2.0’s AgeTech Expo – Charting the Course:
Innovations in Aging
– What: The Aging2.0 AgeTech Expo brings together aging
services providers and tech companies for cross-sector
innovation insights and collaboration opportunities. The 2-day
conference and technology exposition features innovation tours
and workshops, inspiring keynotes, practical education panels,
technology exhibits and the live “Pitch-for-Pilots (P4P)” session.
– When: November 19-20, 2015
– Where: Hyatt Regency Hotel ~ San Francisco, CA
– For more information: http://www.aging2.com/expo/
– To register: http://www.aging2.com/expo/#registration
9
Announcements, cont’d…
• CMS needs your comments on discharge planning proposed rule
on patient preferences
– What: The proposed rule emphasizes the importance of the patient’s goals and
preferences during the discharge planning process. CMS advises that in planning
transitions providers should consult with Aging and Disability Resource Centers, Area
Agencies on Aging, and Centers for Independent Living, or SAMHSA’s treatment
locator. These improvements should ensure that patients and their caregivers can work
with organizations that provide community supports and help promote their personal
goals upon discharge from the hospital or post-acute care setting.
– When: CMS will accept comments until January 4, 2016
– Submit comments: http://www.regulations.gov
– Proposed Rule – Revisions to Discharge Planning Requirements (CMS-3317-P):
https://www.federalregister.gov/articles/2015/11/03/2015-27840/medicare-andmedicaid-programs-revisions-to-requirements-for-discharge-planning-for-hospitals
– CMS Press Release: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Pressreleases/2015-Press-releases-items/2015-10-29.html
10
eLTSS Initiative Timeline
DEC 14
JAN
Kick Off
11/06/14
Pre-Discovery
FEB
MAR
APR
Use Case &
Functional
Requirements
MAY
JUN
JUL
AUG
SEP
OCT
Pilot Guide Development
NOV
DEC 15
JAN 16
Phase 1 Pilots &
Testing …
Evaluation...
eLTSS All-Hands Work Group
Use Case
1. eLTSS Use Case
Pilot Guide Development
1. Candidate Standards & Technologies
2. Three-tiered implementation
Approach
3. Functional Requirements Matrix
Pilot Execution
Content
Work Stream
eLTSS Plan Content
SWG
1. eLTSS Plan Domains & Data
Elements
11
Goals for the eLTSS Initiative
• Identify key assessment domains and associated data
elements to include in an electronic Long-term Services
& Supports (eLTSS) plan
• Create a structured, longitudinal, person-centered eLTSS
plan that can be exchanged electronically across and
between community-based information systems, clinical
care systems and personal health record systems.
12
eLTSS Artifacts
• Final published Project Charter: http://wiki.siframework.org/electronic+LongTerm+Services+and+Supports+%28eLTSS%29+Charter
• eLTSS Glossary: http://wiki.siframework.org/eLTSS+Glossary
– The eLTSS Glossary is a working document containing eLTSS-relevant terms,
abbreviations and definitions as defined by stakeholders
• Final published Use Case: http://wiki.siframework.org/electronic+LongTerm+Services+and+Supports+%28eLTSS%29+Use+Case
• Pilot Artifacts
– Pilot Starter Kit: http://wiki.siframework.org/electronic+LongTerm+Services+and+Supports+%28eLTSS%29+Pilots#Pilot Starter Kit
• The Pilot Starter Kit includes the Pilot Guide (consisting of a ReadMe overview, Functional
Requirements Matrix/FRM and Tiered Approach), the Requirements Traceability Matrix (RTM),
and Pilot Plan Templates
– Pilot Resource Materials: http://wiki.siframework.org/electronic+LongTerm+Services+and+Supports+%28eLTSS%29+Pilots#Pilot Resource Materials
• Pilot Resource Materials include overview documentation, design process documentation, and
13
the Domain Harmonization Matrix
14
Pilot Plan Presenters – Contact
Information
• KY Office of Administrative & Technology Services
– Sheena Batts ~ sheena.batts@ky.gov
• MD Department of Health & Mental Hygiene
– Kale Sweeney ~ kale.sweeney@maryland.gov
• CT Department of Social Services Division of
Health Services
– Minakshi Tikoo ~ minakshi.tikoo@uconn.edu
• CO Department of Health Care Policy & Financing
– Kelly Wilson ~ kelly.wilson@state.co.us
15
Tentative Presentation Schedule
DATE
ORGANIZATION
TEFT/NON
Point of Contact
10/15/2015
Janie Appleseed
Non TEFT
Lisa Nelson
10/22/2015
National Disability Institute
Non TEFT
Mary Lynn Revoir
FEi Systems
Non TEFT
Chirag Bhatt
Kno2
Non TEFT
Dane Meuler
ADvault
Non TEFT
Scott Brown
MN Department of Human Services
TEFT
Tom Gossett
GA Department of Community Health
TEFT
Bonnie Young
Care at Hand
Non TEFT
Andrey Ostrovsky
Meals on Wheels
Non TEFT
Allison Thompson
KY Office of Administrative & Technology Services
TEFT
Sheena Batts
MD Department of Health & Mental Hygiene
TEFT
Kale Sweeney
CT Department of Social Services Division of Health Services
TEFT
Minakshi Tikoo
CO Department of Health Care Policy & Financing
TEFT
Kelly Wilson
10/29/2015
11/05/2015
11/12/2015
Maryland
Department of Health and Mental
Hygiene
Thursday, November 5, 2015
17
Agenda
Introduction
Goal of Pilot
Tier Piloting
Activity to Pilot
Role of DHMH in the pilot
Standards and Technologies Under Consideration
Logistics
Ecosystem
Defining Success
Resources/References
Introduction: Pilot Team
Name
Role
Email
Kale Sweeney
Co-Project Lead
kale.sweeney@maryland.gov
David Wertheimer Co-Project Lead
david.wertheimer@maryland.gov
Whitney Moyer
Chief, ISAS
Division
whitney.moyer@maryland.gov
Lorraine Nawara
Deputy Director,
Community
Integration
Programs (Long
Term Care)
lorraine.nawara@maryland.gov
Christin Whitaker
Chief, COA
Division (Long
Term Care)
christin.whitaker@maryland.gov
Introduction: Organization
• Maryland Department of Health and Mental Hygiene (DHMH), aka Maryland
Medicaid
• We are the state Medicaid agency for the State of Maryland and one of the main
payers for Maryland beneficiaries
• The state plan for Maryland Medicaid includes providing Long Term Supports and
Services for Maryland beneficiaries
• Maryland launched its electronic LTSS system (LTSSMaryland) using funds from the
Balancing Incentive Program (BIP). LTSS currently includes the beneficiary groups
of Community Options Waiver, Money Follows the Person, Community First Choice
(State Plan), Community Personal Assistance Services (State Plan), Increased
Community Services, and Brain Injury, with Community Pathways (DD Waiver) and
Medical Day Care planned for the future. We also have the In-home Supports
Assurance System (ISAS) to ensure that service providers are in the beneficiaries
homes caring for them when they say they are.
Pilot Introduction: Business Drivers
• Long Term Care (CFC, CO Waiver Programs,
Brain Injury Waiver)
• Business use case: A platform where service
plan information can be stored and service
providers can be tracked. Use case is
provider-based.
21
Goal of the Pilot
User Story 2
Pilot Workflow
• The current workflow is all user-initiated
• The desired workflow is that we want to have
the users to
– View their plan
– Trigger specific events where a supports
planner would be able to assist them in the
modification of their plan
23
Which Tier are you piloting?
• Round 1: Tier 1
• Round 2: Tier 2
What are you intending to pilot?
• Pick which one(s) apply
• Access, View, Review Plan
• Have you identified a Service provider with which to work, if so
who?
• In Progress
• Do you know if they have an electronic system?
• To Be Determined
• Do you know which sub-domains from the FR document will you
pilot:
– Work, Community, Choice & Decision Making, Relationships, Self-Direction, Demographics,
Person-Centered Profile, Medication, ADLs/IADLs, Safety, Behavioral Needs, Restrictions,
Service, Financial/Payer Information, Service Information, Family Information, Community
Connections, Access & Support Delivery, Information & Planning, and Health
What role do you play in the pilot?
•
•
•
•
•
Beneficiary System
LTSS/Case Management Information
LTSS/Service Provider System
Payer
Please describe the role you intend to play in the
pilot:
– Identify population
– Give access to plan
– Monitoring compliance, user behavior, user
feedback
Standards Under Consideration:
• Tier 1
– Non Electronic – paper documents
• Tier 2
– Electronic – .pdf or export files such as CCDs
• Tier 3 (future phase)
– Secure exchange methods (HIE)
Pilot Logistics:
•
•
Timeline – (April 2016 is end date for round one pilots)
• Kick off: November 2015
• Identify Partners/Providers/Beneficiary Pilot Population – December 2015
• Complete Partner Data Use/Sharing Agreements – January 2016
• Develop methods for producing and sharing eLTSS data – February 2016
• Exchange eLTSS data via paper, fax, or other secure method – Early to Mid
March 2016
• Receive Pilot Population Feedback – Mid to Late March 2016
• Complete Pilot: April 2016
Challenges:
• Beneficiary access to technology
• Beneficiary education and training
• Setting baselines to monitor performance standards and improvement
• Building incentives for beneficiary participation, both for pilot and beyond
• Assessing business needs and modification of workflow within DHMH
Pilot Ecosystem
• Current or Potential Partners/Providers:
– DHMH Long term care staff, supports planners,
agency providers, beneficiaries and their
guardians/caretakers
• What electronic systems/what vendor(s) do they use
to support their work:
– Maryland LTSS/ISAS
• What electronic systems/what vendor(s) do you use
to support your work:
– Maryland LTSS/ISAS
How do you define success?
• Tier 1
– Whether or not we can get beneficiary/participant
buy-in
– User behavior and engagement with their
supports planners should be higher
– Beneficiary Survey (before and after pilot)?
• Tier 2
– System-level metrics
– User behavior within client profile and/or service
plan
Helpful References
• Maryland Medical Assistance Programs:
https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx
• Maryland Money Follows the Person (MFP):
https://mmcp.dhmh.maryland.gov/longtermcare/SitePages/Maryland%20Mo
ney%20Follows%20the%20Person.aspx
• Maryland Home and Community-Based Services (HCBS):
https://mmcp.dhmh.maryland.gov/waiverprograms/SitePages/Home.aspx
Next Steps
• Schedule your Pilot Plan Presentation
• Next available date: Nov 12th
– Please schedule your presentation by emailing
jamie.parker@esacinc.com or any member of the
support team and we will schedule you
• If you are interested in piloting, please express your
interest using the Pilot Interest Survey form:
– http://wiki.siframework.org/electronic+Long+Term+Ser
vices+and+Supports+Pilot+Interest+Survey
32
Useful Links
• eLTSS Pilot Starter Kit
• http://wiki.siframework.org/electronic+LongTerm+Services+and+Supports+%28eLTSS%29+
Pilots#Pilot Starter Kit
• eLTSS Glossary:
• http://wiki.siframework.org/eLTSS+Glossary
• eLTSS Reference Materials
• http://wiki.siframework.org/electronic+LongTerm+Services+and+Supports+%28eLTSS%29+Ref
erences
Connecticut TEFT
November 5, 2015
34
Agenda
Introduction
Goal of Pilot
Tier Piloting
Activity to Pilot
Role of Connecticut in the pilot
Standards and Technologies Under Consideration
Logistics
Ecosystem
Defining Success
Resources/References
Introduction: Pilot Team
Name
Role
Email
Dawn Lambert
DSS Project Director
Dawn.lambert@ct.gov
Minakshi Tikoo
Project Director
Minakshi.Tikoo@uconn.edu
Rachel Rusnak
Research Assistant
Rachel.Rusnak@uconn.edu
Giuseppe Macri
Research Assistant
Giuseppe.Macri@uconn.edu
Ben Abrahamsson
Research Assistant
Benjamin.Abrahamsson@uconn.edu
Paul Ford
DSS liaison with UCONN
Paul.Ford@ct.gov
Dr. Minakshi Tikoo is Connecticut’s Health IT Coordinator, who heads the
eLTSS and PHR component of the TEFT grant. As Health IT Coordinator, Dr.
Tikoo works to promote synergy amongst the Health IT projects across the
state.
The team is also comprised of consumers & advocates. Outreach and
education to our consumers is of utmost importance to us. In order for
innovative technology to be adopted and meaningfully used, consumer input
must be included as part of the process.
Introduction: Organization
Who we are?
• We are CT TEFT, focusing on empowering consumers through the use of Health IT.
We are comprised of staff from the CT Department of Social Services & the
University of Connecticut.
What we currently do?
• The team goes out into the community to gather input from consumers &
advocates on how HealthIT solutions can best serve consumers. The team has
developed educational materials, and will offer PHR training to users.
How are we involved in services and support?
• The team engages consumers& advocates in interactive dialogues, allowing them
to express their views on Health IT while providing feedback on the project.
• We analyze consumer & advocate responses in order to better understand their
concerns.
How do we currently carry out eLTSS activities?
• Connecticut does not have an eLTSS system or HIE. Rather, the state still uses
paper processes for a majority of LTSS communications. This data is typically
shared by fax.
Pilot Introduction: Business Drivers
Business Drivers for CT:
• Empower consumers via information sharing
• Improve consumer health through Health IT
• Streamline workflows
Business Use Case:
• CT will pilot the ability to create & share an eLTSS Plan. CT will
also evaluate the utility of the established domains &
subdomains. The CT team will pilot a version of User Story 2,
“Sharing a Person-Centered eLTSS Plan”.
• A Business Use Case is in development to reflect CT specific
process related to the Community First Choice program.
38
Which Tier are you piloting?
CT will pilot Tier I: Basic, Non-Electronic Information Exchange
Objectives:
• Develop tangible, high-level Use Case of mutual interest and value
between participating partners (applicable to Tier I technology and
objectives)
• Identify gaps in what data elements captured, and what data elements
are available using workflow analysis
• Identify data elements, for future use, which can be shared as a report
from a system using existing content standards, in an effort to validate
data elements within Tier I.
• Exchange eLTSS data in a paper format.
• Assess the value of engaging the beneficiary in developing and sharing
their LTSS data electronically in the future.
• Engage front-line staff throughout the entire change management
process, including process redesign and improvement
• Draft and submit a report documenting the risks, challenges, findings,
recommendations and outcomes of the Tier I piloting process
User Story 2
Connecticut intends
to pilot User Story 2:
Sharing a personcentered eLTSS plan.
Paper eLTSS plans will
be transmitted
between actors.
40
Pilot Workflow
• Current State:
Person (or designee) creates the plan. The plan is submitted to the access agency,
who then submits the plan to DSS. No established process for the plan to be shared
with the person post approval.
Person
Access
Agency
DSS
Person
• Pilot Workflow:
Person (or designee) creates the plan, and shares to the plan access agency, who
then submits the plan to DSS. The plan is rerouted to the person, who can also
share it with all relevant parties. Recipients can communicate back to the person
(or designee) regarding the plan.
DSS
Access
Agency
PCP
Person
Physical
Therapist
Visiting
Nurse
Advocate
41
What are you intending to pilot
• CT TEFT will pilot:
• Plan Creation
• Transfer/Sharing of the Plan
• Validity of Domains & Subdomains
Sub-domains
Domains
Work
Personal
Information Residence
Community Inclusion
Choice & Decision making
Relationships
Self- Direction
Demographics
Person-Centered Profile
Service Coordination
Service
Personal Finance Information
Planning
Service Information
and
Goals
Crosscutting sub- Units of Service
Intervention(Technology)
domains
Priorities
Issues
Domains
Family
Indicators
Sub-domains
Family Information
Community Connections
Access & Support Delivery
Information and Planning
Health,
Health
Wellness Medications
and Rights ADLs/IADLs
Safety
Wellness
Psychological Well-being
Restrictions
Respect & Rights
CT eLTSS Data Element Crosswalk
43
What role do you play in the pilot
• CT TEFT team will act as educators, advocates and
researchers during the pilot.
• The team will advocate for consumer access to their
health data. A major component of the grant is to enable
consumer access in order to empower them.
• The team will research the best practices for eLTSS plan
implementation to encourage stakeholder participation
in the process. The team expects to go into the
community and gain input on how an eLTSS plan should
look and be used.
Standards Under Consideration:
• Tier 1
• Paper transfer
• Secure Direct Messaging
Pilot Logistics:
• Timeline:
• Establish Pilot Plan: October & November 2015
• Identification of Partners: November & December 2015
• Launch Pilot: January & February 2016
• Completion of Pilots: April 2016
• Challenges:
• Time Constraints
 Time to organize and conduct outreach
• Data definitions:
 Did not leverage existing standards
 Fluidity of definitions
Pilot Ecosystem
Minakshi Tikoo - PHR - MFP
10/09/2015
47
Pilot Ecosystem Cont.
• CT TEFT will pilot the eLTSS Plan with the Community First
Choice population
• For Round 1 piloting, CT TEFT will utilize Tier 1: Basic, NonElectronic Information Exchange
Potential Outcomes/Value Add:
48
 Validate target eLTSS Use Cases
 Develop options to be executed in future tiers
 Assesses impact on workflow improvements and process redesign for participating
providers
 Establish a transport framework that is scalable
 Assists in identification of TEFT Pilot Evaluation metrics
 Identify standards that can be leveraged to create eLTSS output, in various forms, from
multiple and disparate LTSS MIS systems
 Engage CB-LTSS stakeholders (providers, beneficiaries, advocates, accountable entities
and payers) in more valuable ways
 Promote user friendly electronic information
 Provide knowledge and guidance to assist in quality improvement for subsequent tiers
How do you define success
The overarching success metric will be significant uptake and use of
an eLTSS plan & information sharing. Potential ways to capture this
data include:
• Surveying stakeholders
• Significant increase in communication between consumers and providers
• Town Hall style meetings with interactive discussion
The goal of CT TEFT’s eLTSS pilot is to empower consumers through
Health IT in order to improve health outcomes.
Helpful References
Name
Phone
Email
Minakshi Tikoo
860-679-5559
Minakshi.Tikoo@uconn.edu
Rachel Rusnak
860-679-7317
Rachel.Rusnak@uconn.edu
Giuseppe Macri
860-679-7314
Giuseppe.Macri@uconn.edu
Ben Abrahamsson
860-679-2643
Benjamin.Abrahamsson@uconn.edu
CT Health IT Website: http://www.ct.gov/dss/cwp/view.asp?a=3922&q=562672
CT TEFT Website: http://www.ct.gov/dss/cwp/view.asp?a=3922&q=562672
PHR outreach presentation: http://www.ct.gov/dss/lib/dss/hit/phrltc.pdf
CT Health IT Resources: http://www.ct.gov/dss/cwp/view.asp?a=3922&q=563576
State of Colorado
Health Care Policy and Financing
Colorado TEFT Team
November 5, 2015
51
Agenda
Introduction
Goal of Pilot
Tier Piloting
Activity to Pilot
Role of Colorado TEFT Team in the pilot
Standards and Technologies Under Consideration
Logistics
Ecosystem
Defining Success
Resources/References
Our Mission
Improving health care access and outcomes for
the people we serve while demonstrating sound
stewardship of financial resources
Introduction: Colorado TEFT eLTSS Pilot Team
Introduction: Colorado TEFT Team
•
Who we are:
–
–
–
•
What we do:
–
–
–
•
CO Department of Health Care Policy and Financing, TEFT Grantee
CORHIO - Colorado Regional Health Information Organization
QHN – Quality Health Network
HCPF administers Medicaid, Child Health Plan Plus, and other health care programs for Coloradans
who qualify.
CORHIO – HIE on the front range connecting hospitals, labs, physicians, emergency services,
behavioral health, skilled nursing, home health, hospice and
QHN – HIE on the western slope - first HIE in Colorado
Collaborative:
–
–
–
Colorado TEFT Team includes members of the HCPF LTSS department, internal IT Interchange staff,
quality and health improvement unit and the Governor’s Office of Health IT
Two state HIE’s, Quality Health Network and CORHIO
Focus Group members in five communities across the state of Colorado
Pilot Introduction: Business Drivers
• Business Drivers:
– Comprehensive assessment and re-assessment of clients
– Person-centered services provided to clients
• Business Use Case:
– Create and test new means of sharing LTSS data
electronically with clients and our current LTSS Service
providers and stakeholders
– Identify new and efficient ways of exchanging information
– Include both clinical and non-clinical data
Goal of the Pilot
Colorado will be
using:
User Story 1 for
our Pilot in
Round One:
LTSS Eligibility,
eLTSS Plan
Creation and
Approval
User Story 2
User Story 2:
Sharing a Person-Centered
eLTSS Plan
Tier 2 – Pilot in Round 2
58
Pilot Workflow
•
Single Entry Point: Case managers have approximately 100 clients in their caseload
– Annual assessments per case mangers average 8-10 in-home each month
– Each assessments can take up to three hours
– Assessments are currently conducting by taking notes on paper - with an ink
pen 
– All assessments must be entered and submitted within 10 days of conducting
the assessment into the BUS (Business Utilization System)
•
Intake Case managers conduct between 20-30 assessments per month and follow
same workflow process.
•
The BUS is the living document for clients’ assessments and service plans.
•
If clients meet functional eligibility through the assessment, case managers need
to check financial eligibility. This process differs among agencies.
•
Currently information gathered for clients include ADLs, IADLs and service plans.
59
Which Tier are you piloting in Round 1?
•
The Colorado TEFT Team will be using a three tiered approach with each tier building on
the previous tier with advancing technology.
•
We will be piloting Tier 1 - Basic non-Electronic Information Exchange in Round One –
targeting workflow redesign and testing to facilitate future electronic information
sharing
•
Objectives:
– Share what eLTSS data elements are currently in use
• Ex. SEP enters all information online onto the BUS (Benefits Utilization System
at HCPF).
• PAR (Prior Authorization Requests) Client face sheets and the Professional
Medical Page all on paper
– Identify gaps in data elements
– Evaluate if any subdomains overlap
– Develop tangible Use Case piloting options of mutual value between participating
providers and clients
– The eLTSS data will be shared as a file compatible with existing standards (ie. CCDA)
– Assess the value of engaging the client in developing and sharing their eLTSS plan
Which Tier are you piloting in Round 2?
• We will be piloting Tier 2 – in Round 2 – Secure, Electronic Data Exchange
– Tier 2 will build on the objectives in Tier 1 and incorporate electronic
information exchanges with readily available services, transport standards,
and content standards.
– Tier 2 will target use of the data, reports, and files defined in Tier 1 and
exchanging them with participating providers by means of established
secure exchange standards.
• Objectives:
– Use the data/reports/files from Tier 1 and exchange with participating
providers using established secure exchange standards
– Investigate additional methods available to participating providers to utilize
established e-Health secure exchange methods
What are you intending to pilot
•
Pick which one(s) apply
– Tier I - Create Plan
– Tier II– Send and Receive Plan
• Update Plan
– Tier III – Send and Receive Plan
• Update Plan
•
Have you identified a Service provider with which to work, if so who?
– We have identified two Focus Group Communities:
• Northern Colorado – Weld County and Larimer County
• Southern Colorado – Colorado Springs area
•
•
Do you know if they have an electronic system?
– Northern Colorado Focus group members do not utilize an electronic system
– Southern Colorado Focus Group providers are connected to CORHIO and one
provider is in implementation with Care At Hand
Do you know which sub-domains from the FR document will you pilot:
– The sub-domains will be discussed with both communities for their input and
agreement
What role do you play in the pilot
Colorado TEFT Team
Our role will be to work with the two Focus Group Communities to:
•
•
•
•
•
•
•
•
•
Identify and recruit providers in the LTSS continuum
Train/educate providers on the pilot and objectives
Inventory existing Provider technology
Assess readiness of Provider to work with eLTSS data
Map data elements in plan to the eLTSS dataset
Share data elements among partners
Develop Use cases of mutual interest
Document and implement changes to provider workflow
Test secure exchange of data
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Standards Under Consideration:
• Tier 1
– E.g. Non Electronic – Paper to an on-line submission into the BUS
(Benefits Utilization System)
– E.g. Electronic – exchange eLTSS data as a report object
• Tier 2
– E.g. CCDA
– Use the data/reports/files from Tier I and exchange with participating
providers using established secure exchange standards
• Option: FEi and Care At Hand
• Tier 3:
– E.g. CCDA (content and transport), OAUTH (security), FHIR etc.
Pilot Logistics:
• Timeline
• Kick off: November 2015 –On-site meetings at both communities
• Identification of Provider staff and clients- December 2016
• Completion of Provider Data Use/Sharing Agreements – January
2016
• On-site meetings with the vendor technology and readiness –
January 2016
• Develop methods to produce eLTSS data appropriate for sharing –
February 2016
• Exchange eLTSS data via paper, fax or other secure method –
March 2016
• Completion of Pilots: April 2016
• Challenges:
– Identification of common data elements across providers
Pilot Ecosystem
• Partners:
– Two Northern County Department of Human
Services/SEP working with EBD Waiver clients
• Case Managers and EBD clients
– Southern Colorado – Regional Care Collaborative
Organization, Community Center Boards,
combination of EBD and SLS ID/DD clients
• Systems:
– HCPF systems include MMIS, BUS, BIDM, PAR
(financial eligibility determination), as well as the
new care assessment redesign tool
.
How do you define success
• Support from the two Focus Group Communities to assist in
TEFT/Evaluation and validates eLTSS Use Cases
• Engages the eLTSS Focus Group members and clients in new ways
• Pioneer methods of creating eLTSS output, in various forms, from multiple
LTSS Health IT Systems to increase access
• Gap analysis with domains completed
• Impact workflow by reducing time in processing paper notes into
electronic exchanges
• Establishes transport framework that will be built upon in Tier 2 and Tier 3
Helpful References
For more information:
Colorado Department of Health Care Policy and Financing
https://www.colorado.gov/hcpf
Colorado Regional Health Information Organization HIE
www.corhio.org
Quality Health Network HIE
www.qualityhealthnetwork.org
Comments/Discussion
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eLTSS Initiative: Project Team Leads
•
ONC Leadership
– Mera Choi (mera.choi@hhs.gov)
– Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov)
•
CMS Leadership
– Kerry Lida (Kerry.Lida@cms.hhs.gov)
•
Community Leadership
– Mary Sowers (msowers@nasddds.org)
– Terry O’Malley (tomalley@mgh.harvard.edu)
•
Initiative Coordinator
– Evelyn Gallego-Haag (evelyn.gallego@siframework.org)
•
Project Management
– Lynette Elliott (lynette.elliott@esacinc.com)
•
Use Case & Functional Requirements Development
– Becky Angeles (becky.angeles@esacinc.com)
•
Pilot Guide Development
– Grant Kovich (grant.kovich@accenture.com)
•
Pilots Management
– Jamie Parker (jamie.parker@esacinc.com)
•
Standards and Technologies Identification
– Angelique Cortez (angelique.j.cortez@accenture.com)
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