care delivery professionals who are challenged with depending on outdated claims data to improve their care delivery. HIE Personal Health Record Project - Through SIM, HIN will leverage the HIE’s recent work in federal initiatives (Beacon, REC, SAMHSA) to further evolve the use of real-time clinical data to advance care plan management processes. Specifically, HIN will engage the most important and underutilized member of the care management and planning team, the patient and their family, by providing the patient access to their statewide HIE record. HIN will test and pilot providing the patient community with access to their statewide HIE record leveraging the Button” “Blue standards promoted by the Office of the National Coordinator for HIT (ONC). HIN will make the patient chart available via a certified EHR portal administered by a health system and/or provider organization. The most underutilized member of the healthcare community is the patient, their family, and caregivers. The Blue Button concept will be tested and measured against improving the ability for a patient to participate and have access to a more complete clinical record that ever before. This project is developed to test the impact and the choices that patients/consumers make when they engage the health system with open and transparent access to their full medical record. HIN Behavioral Health Projects - Through SIM, HIN will support the inclusion of up to 25 behavioral health agencies in the HIE. In addition a meaningful use-like incentive program will be available to up to 20 behavioral health organizations to assist them in adopting EHRs, connecting to the HIE, and actively participating in quality measurement programs promoted by SIM. These activities will vastly improve MaineCare’s understanding of health care utilization and outcomes for persons with a behavioral health disorder. They will also allow for behavioral health providers to be more active members of the Health Homes and PCMHs. Timelines and Milestones - Detailed IT infrastructure work plan with timeline and milestones 11. Process/mechanisms for data collection Administrative Claims Data - Overview of Data Sources and Uses: What is collected Complete claims information is collected including person, subscriber, and eligibility information, plan identifiers, coverage, payment, provider information, type of service, diagnoses, and procedures. Claims are processed, service categories created, clinical groupings, conditions, episodes of care are created, person level risk scores calculated, and other member characteristics created and assigned including treating provider, enrolled and attributed. Workflow processes
care delivery professionals who are challenged with depending on outdated claims data to improve their care delivery. HIE Personal Health Record Project - Through SIM, HIN will leverage the HIE’s recent work in federal initiatives (Beacon, REC, SAMHSA) to further evolve the use of real-time clinical data to advance care plan management processes. Specifically, HIN will engage the most important and underutilized member of the care management and planning team, the patient and their family, by providing the patient access to their statewide HIE record. HIN will test and pilot providing the patient community with access to their statewide HIE record leveraging the “Blue Button” standards promoted by the Office of the National Coordinator for HIT (ONC). HIN will make the patient chart available via a certified EHR portal administered by a health system and/or provider organization. The most underutilized member of the healthcare community is the patient, their family, and caregivers. The Blue Button concept will be tested and measured against improving the ability for a patient to participate and have access to a more complete clinical record that ever before. This project is developed to test the impact and the choices that patients/consumers make when they engage the health system with open and transparent access to their full medical record. HIN Behavioral Health Projects - Through SIM, HIN will support the inclusion of up to 25 behavioral health agencies in the HIE. In addition a meaningful use-like incentive program will be available to up to 20 behavioral health organizations to assist them in adopting EHRs, connecting to the HIE, and actively participating in quality measurement programs promoted by SIM. These activities will vastly improve MaineCare’s understanding of health care utilization and outcomes for persons with a behavioral health disorder. They will also allow for behavioral health providers to be more active members of the Health Homes and PCMHs. Timelines and Milestones - Detailed IT infrastructure work plan with timeline and milestones 11. Process/mechanisms for data collection Administrative Claims Data - Overview of Data Sources and Uses: What is collected Complete claims information is collected including person, subscriber, and eligibility information, plan identifiers, coverage, payment, provider information, type of service, diagnoses, and procedures. Claims are processed, service categories created, clinical groupings, conditions, episodes of care are created, person level risk scores calculated, and other member characteristics created and assigned including treating provider, enrolled and attributed. Workflow processes
SIM-Operational-Plan-7-29-2013.docx