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The Massachusetts State Innovation Model (SIM) initiative, funded by the Center for Medicare & Medicaid Services (CMS), is driving enhancements to health information technology and data collection infrastructure across the Commonwealth.  The SIM initiative is a coordinated inter-agency effort to use advancements in technology to better care for residents, while creating more efficiency in care delivery.

These are some projects that are promoting care coordination, increasing efficiency, advancing quality measurement, and enhancing payment reforms.

All Payer Claims Database Provider Portal

The Center for Health Information and Analysis (CHIA) plans to leverage the Massachusetts All Payer Claims Database (MA APCD) to provide claims-based reports through a provider portal. The MA APCD Provider Portal would allow providers to access information that can  help them better manage the care of their patients.

Community Links Portal

computer, elderly, doctorThe Community Links Portal, developed by the Executive Office of Elder Affairs (EOEA), allows caregivers and medical professionals web-based access to an Electronic Health Record (EHR) regarding consumers enrolled in the Massachusetts Home Care Program.  The EHR contains customized views for clinicians and caregivers, including service plan and assessment information from Aging Service Access Point (ASAP) case managers & registered nurses. The portal supports coordination of care between members of an  interdisciplinary care team, including physicians, ASAP care managers & nurses, the patient and the patient’s family.  Community Links Portal went live this summer and the EOEA team continues to deploy to ASAPs, who enroll and train users and partner with community health organizations.

Data Infrastructure for Long Term Services and Supports

The Executive Office of Elder Affairs (EOEA) has implemented electronic systems to replace two important manual processes: 1) determination of eligibility for the Adult Foster Care (AFC) and Group Adult Foster Care (GAFC) programs, and 2) processing of Section Q referrals.  The AFC/GAFC Determinations streamline is designed to reduce the amount of time typically required to reach a determination, allowing eligible seniors and adults with disabilities to get the care they need, faster.  The electronic Section Q referral workflow is similarly designed to streamline a referral process for nursing home residents who wish to return to the community.  Both electronic systems are now live, and early results indicate that the new processes are improving operational efficiencies and increasing coordination of care.

e-Referral  

e-referralThe Department of Public Health (DPH) is implementing a bi-directional, vendor-neutral, open-source referral system. This system enables clinical providers to send electronic referrals directly from their electronic health records (EHRs) to community services such as the Tobacco Quitline for smoking cessation and YMCAs for evidence-based weight loss programs. The community-based resources can then send feedback reports to be embedded back into the patient’s EHR. Three pilot community health centers and their selected community resources are currently live with e-Referral.  One of the deliverables for this grant is to package this software will be deployed in nine pilot community health centers, each with a minimum of three different community partners (e.g., Tobacco Quitline, Visiting Nursing Associations, YMCAs and Local Councils on Aging). The open-source software will be freely available after the pilot program.

Health Information Exchange & Behavioral Health 

The Executive Office of Health and Human Services Information Technology (EOHHS IT) department is providing Health Information Exchange adoption technical assistance to behavioral health providers partnered with MassHealth providers participating in the Primary Care Payment Reform program.  Behavioral health providers are not eligible for Medicare and Medicaid HIT incentive payments, which may offset the cost of implementing HIT for other providers, leading to reduced rates of adoption among behavioral health providers.  The EOHHS IT technical assistance program will help behavioral health partners connect to the HIE to enable full integration of behavioral health services within the Primary Care Payment Reform program.

Written By:


Health Care Innovation Program Director

Communications Director, Executive Office of Health and Human Services

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