Presentation of Key Findings and Recommendations from the 2012 SOC National Symposium

1. Presentation of Key Findings and Recommendations from the 2012 SOC National Symposium D R A F T

2. Meeting Agenda • Introduction & Meeting Goals • Symposium Overview • Purpose, Attendees, Design, Outputs, Artifacts • Video Overview • Synthesis & Analysis • Methodology • Key Challenges • Recommended Actions • Short Term and Long Term Recommendations • Define Linkages and Benefits to Health • Next Steps and Plan of Action D R A F T

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4. Presentation Development Participants • Uma Ahluwalia • Robin Chacon • Cathy Crabtree • Shell Culp • Rick Friedman • Kevin Gaines • Ivan Handler • Bill Hazel • Howard Hendrick • Carrie Hoff • Elizabeth Lower Basch • Megan Lape • Helly Lee • Susan Lerman • Nick Macchione • Shawn Messick  • Carrie Miller • David Mix • Laura Morlock • Kim Richeson  • Valerie Rogers • Ginny Puddefoot D R A F T

5. What Organizations Attended? D R A F T

6. Symposium Goals • Expand networks, teach/learn, and build an interoperability community. • Identify information and actions to accelerate integration and interoperability among human services, health, public health, courts and education. • Facilitate dialogue among government, industry, academia, judicial and associations to identify ways to improve outcomes rapidly. • Drive thought leadership about interoperability. D R A F T

7. Integrated Symposium Agenda D R A F T

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10. Methodology For Synthesizing Challenges and Recommendations 2.5 Days of Presentation, Discussion & Thinking Gather Recommendations Categorize Challenges Categorize Actions Select High Priority Actions D R A F T

11. Key Challenges Summary • Lack of Common Vision • Limited Communications • Policy Confusion • Confidentiality Barriers • Lack of Collaboration • No Governance Models • Best Practices Not Shared • Lack of HHS Architecture • Lack of Standards • Few Use Cases • Limited Open Source Software • Limited Federal Programs, Funding, Flexibility • Limited Reuse of Ideas and Software • Education and Training Gaps • Limited Guidance to States • State/Local Resistance • Procurement Hurdles D R A F T

12. Summary of Recommendations • 1. Enhance Federal leadership and collaboration capabilities to support client-centered HHS interoperability 5. Provide advanced education and training to empower workforce to leverage interoperability efforts being driven by ACA 2. Clarify policy to reduce confusion and to incentivize strategic change and innovation 3. Develop architecture, standards, use cases and open source software to support holistic & integrated health and human services 4. Provide additional guidance and resources to/from states and local entities that support innovation, prototypes and pilots D R A F T

13. #1 Enhance Federal Leadership and Collaboration Capabilities to Support Client-centered HHS Interoperability Short Term Actions Longer Term Actions Establish a federal program to connect Human Services to HIE/X efforts Provide funding for plan and assessment for HHS interoperability Acknowledge business redirection (in vendor community) to support improved systems • Establish a mechanism to form, lead and/or support the HHS Interoperability community • Create a national interoperability Center of Excellence • Articulate the interoperability vision: Bring message and vision to a larger audience across agencies (e.g. Public relations, other Communications) • Include end-users in system development: Collaborative business process development D R A F T

14. #2 Clarify Policy to Reduce Confusion and to Incentivize Strategic Change and Innovation Short Term Actions Longer Term Actions Increase flexibility of funding between systems Create clear legal framework for data sharing and use by/within state and local governmental programs ALONG WITH Federal Government to clarify data sharing policies Design incentives to encourage interoperability between programs (e.g. enhanced match; 7 C&S) • Clarify and communicate differences (and overlaps) between HITECH, ACA, 90/10 • Develop white papers/matrix to define confidentiality, privacy of data elements • Use policy/funding levers to ensure end users are engaged in product development D R A F T

15. #3 Develop Architecture, Standards, Use Cases and Open Source Software to Support Holistic & Integrated Health and Human Services Short Term Actions Longer Term Actions Utilize federal health architecture and change to support better links of data and training Automate Privacy Protection: Create open source module to address different consent components Capitalize open health initiative/Include population data to be shared at open government level Establish data models and standards/Follow-up with normalization of data across agencies Create verification and validation process to measure interoperability progress (in health and human services) • Accelerate development (and dissemination) of Human Services NIEM Domain & the National Human Services Interoperability Architecture (NHSIA) • Clearly articulate business goals with supporting use cases • Create and disseminate templates for data linkages: Best practices and use cases • Create Toolkits for change management and transformation BPR D R A F T

16. #4 Provide Additional Guidance And Resources To/From States and Local Entities that Support Innovation, Prototypes, Pilots Short Term Actions Longer Term Actions Include end-users in system development: Create collaborative business process development for (reusable) modules Use policy/funding levers to ensure end users are engaged in product development • Leverage 90% Medicaid funding to enhance (human) service benefits (state and local) • Support local collaborations: Help to inform federal and state policies • Write and disseminate examples of business use cases and agreements (MOUs, DURSAs) D R A F T

17. #5 Provide Advanced Education and Training to Empower Workforce to Understand and Leverage Interoperability Efforts Driven By ACA Short Term Actions Long Term Actions Utilize universities to grow (and train) future workforce Understand your enterprise: Know inefficiencies, improve workflow, and be able re-envision the whole enterprise Utilize federal health architecture to support better linkages of data and training Create return on investment and performance measures linked to outcomes across programs and agencies • Improve research and distribution of learning about interoperability • Create appropriate linkages, convert data into actionable knowledge D R A F T

18. Short Term Recommendations Also Support Core Health Goals • Implement State Health Insurance Exchanges and Eligibility Systems by October 2013 • Validate compliance with condition 7 of the Seven Standards and Condition for Funding (Condition #7/Interoperability with Human Services) • Leverage existing human service program information to identify already eligible clients • Support rapid innovation and testing • Increase access and communications with counties to improve coordination with state operations • Bend the Health Care Cost Curve • Reduce hospital re-admissions, improve care coordination, improve decision making, prevent illness • Improve health and well being outcomes by treating the whole person (and avoid readmissions) • Programs and resources in place to replicate successes (and avoid mistakes) in other jurisdictions • Demonstrate value of Human Services coordination on health care costs and vice versa • Effective and Efficient use of Federal Funding • Reuse newly available Medicaid funded components and services to build new human service eligibility and enrollment systems that support health outcomes • Improve fraud detection through single data source for clients • Encourage using shared services, common practices and streamlined business processes to maintain and update systems • Avoid costs of fragmented and duplicative eligibility systems for human service programs • Extend and expand MITA D R A F T

19. Priority Short Term Recommendations D R A F T

20. Federal Governance & Funding for Interoperability Establish governance for coordinating programs and funding to support interoperability across Health and Human Services Agencies at the federal level.  Specific Actions • Establish and resource an Interagency Steering Group (CMS, ACF, FNS, …) • Resource an Interoperability Program Office • Fund state and local interoperability pilots • Leverage the COE to collaborate with states, locals, and other stakeholders D R A F T

21. Interoperability Center Of Excellence Establish a national interoperability Center of Excellence to facilitate sharing knowledge, collaboration, and innovation across all segments of the HHS. Example Activities • Establish and maintain an HHS interoperability clearinghouse • Develop various roadmaps using the A-87 Exception for states • Develop a state HHS interoperability architecture example • Prototype multi-organization privacy and security solutions Categories of Activities • Community of Practice Organization • Policy & Practice Analysis • Systems Engineering • Prototypes & Pilots • Education & Training D R A F T

22. Discussion: Priority Short Term Recommendations D R A F T

23. Backup Material D R A F T

24. Cross Walk Health Goal, Symposium Recommendations and Expected Impact on Health D R A F T

25. Cross Walk Health Goal, Symposium Recommendations and Expected Impact on Health D R A F T

26. Cross Walk Health Goal, Symposium Recommendations and Expected Impact on Health D R A F T