1. Health Information Technology: Is Medicaid Keeping Pace?
Mark Frisse, MD, MBA, MSc Director, Regional Initiatives, Vanderbilt Center for Better Health June 5th, 2006

2. What Is Efficiency? Goods or services per unit of effort required
Efficiency is based on perspective
Patient
Provider
Government
Public
Efficiencies for one may come at the expense of others

3. What We Do Not Want

4. Complexity: The Enemy MMIS Evolution and Trends 1975-2000 1975 1985
Reporting
Systems
(MARS and (SURS)
Decision Support
Systems (DSS)
Ad Hoc
Query Tools
Extract
Files
Financial
Data
Warehouses
Multidimensional
Databases
Web
Analytics
Executive
Information
Systems (EIS)
World Wide
Online Analytical
Processing
(OLAP)
Enterprise
Portals
Data Mining
Analytic
Applications
Relational
1975
1985
1990
1995
2000
Source: Modified from Data Warehousing and E-Commerce, William J. Lewis
Claims Transaction System
Immunization Registries
Point of Service (POS) Pharmacy and EVS

5. Major Areas of Emphasis
Saving Time
Eligibility
Measuring outcomes
Fraud and abuse
Saving money
Fraud
Better disease management
Creating new opportunities
From claims to clinical information

6. Opportunities Internal Medicaid and state systems
Working with other clinical and administrative systems in delivery systems
Working with other plans, states, Federal government
Workforce development

7. Medicaid and State Systems
MITA can work with other systems to ensure:
Identity management
Single entry; multiple use
Enforcement of confidentiality and business rules
Consumer portals; immunization records

8. Other Plans and States People move and change coverage
A Personal health record for all Americans
Consumer access
Portability and standards are key
Security and confidentiality concerns

9. Similarities with Commercial Plans
Data standards
Eligibility
Credentialing
Authorization and certification
Disease management
Outcomes measurement & analysis