NC IT Roadmap - Health & Human Services NC IT Roadmap: Health & Human Services NC IT Roadmap Education Economic Development Environment Health & Human Services Government Operations Public Safety Transportation Next Generation 911 Technology Foundations Increasing access to care for North Carolinians will help them live healthier, more productive lives. -Dr. Mandy Cohen, Secretary NC Department of Health and Human Services One of the most important responsibilities of our government is to advance the health, safety, and well-being of all North Carolinians. This requires collaboration with a wide variety of partners and stakeholders. Battling the Opioid Epidemic The opioid epidemic is devastating families and communities throughout our state. In 2017 alone, 1,700 North Carolinians lost their lives to unintentional opioid overdose. NC DHHS is leading the charge to reduce opioid addiction and overdose deaths. The DHHS Division of Mental Health Developmental Disabilities and Substance Abuse Services manages the NC Controlled Substances Reporting System (CSRS), which collects information on dispensed controlled substance prescriptions and makes this information available to prescribers and dispensers. The CSRS is used as a clinical tool to improve patient care and safety while avoiding potential drug interactions and identifying individuals that may need a referral to substance use disorder services. While we are making progress in our fight against this epidemic, there is much left to do. Using Data and Technology to Battle the Opioid Epidemic: The Government Data Analytics Center (GDAC) is working with DHHS to enhance the CSRS data model, integrate additional data sources, and develop more than 12 reports to support internal and external users of the system. In addition, GDAC is developing reports for research-ready data, which will be shareable with researchers who can conduct further analysis and make policy recommendations for combatting the opioid epidemic. Connecting CSRS and NC HealthConnex: The Strengthen Opioid Misuse Prevention (STOP) Act of 2017 requires health care providers who prescribe controlled substances to access a patient report from the CSRS to verify a patient’s prescription fill history prior to writing prescriptions for targeted controlled substances. The act also requires the CSRS to be fully connected to the state-designated health information exchange (HIE), NC HealthConnex, for the act to be fully implemented. NC HealthConnex is working with DHHS to build a single sign-on to the NC HealthConnex clinical portal. This integration will allow users already accessing the longitudinal NC HealthConnex clinical portal to view the CSRS report along with the risk scores without leaving the HIE Portal. When the provider views the report, the system automatically records the access into the audit logs, providing support for CSRS use requirements in the STOP Act. Provider Connectivity and Record Sharing The more information your health care provider has about you the better they will be able to diagnose a problem and help to solve it. The sharing of patient information can reduce the number of redundant or unnecessary tests, medications and procedures patients receive. It can also improve care transitions and coordination providing for better outcomes. Developing secure, electronic ways of sharing patient records can not only save a great deal of money, but also save lives. NC HealthConnex: Managed by the North Carolina Health Information Exchange Authority (NC HIEA), North Carolina’s state-designated HIE, is a secure electronic network that gives authorized health care providers the ability to access and share patient information across a statewide information network. It improves health care quality, enhances patient safety, improves health outcomes, and reduces overall health care costs by making health information available to participating health care providers. NC HealthConnex currently links more than 4,500 health care facilities, including hospitals, physician practices, long-term care facilities, local health departments, behavioral health providers, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), radiology centers and others. More than 4,000 additional facilities are currently in the onboarding process, among them, laboratories and Emergency Medical Services. The HIE's roadmap for 2021 covers five developmental areas: Maintain and build upon a strong HIE foundation to support health care providers, Medicaid and other health plans, public health and North Carolina patients. Broaden exchange capabilities and pathways to include nationwide networks and more than 95 percent of North Carolina health care providers, ensuring high utility for users. Advance notification services to make HIE data actionable, digestible, and strategically designed to fit the health care community’s changing needs and workflows. Expand on and refine population health and analytics applications for better health care management at the individual, community and state public health levels. Embrace the NC HIEA’s role as a facilitator of patient-centered, value-based care by promoting universal use of health information exchange statewide. Electronic Death Registration System (EDRS): DHHS is designing a new Electronic Death Registration System (EDRS) that will establish a single state-level database from which all death certificates will be issued. Implementation of the EDRS will improve the timeliness of collecting, registering and processing accurate state certified death certificates. It will also improve the timeliness of notifying state and federal partners about deaths to prevent benefit payments to deceased individuals and fraud, and update voter registration records. In addition, it will improve the timeliness of analysis in response to potential public health concerns and establish a platform for electronic retention of death records. Access to Services Access to comprehensive, quality health care services is essential for promoting and maintaining health, preventing and managing disease, reducing unnecessary disability and premature death, as well as achieving health equity for North Carolinians. One of our government’s key responsibilities is managing the delivery of services to our most vulnerable populations, including children, seniors, people with disabilities, and low-income individuals and families. We believe that our job is to make it as easy as possible to administer and receive these services. Technology is vital to this endeavor. NCCARE360: NCCARE360 is a statewide public-private partnership of philanthropy, healthcare and community partners administered by the Foundation for Health Leadership and Innovation (FHLI). While DHHS will not administer NCCARE360, the tool is an integral component of the state’s Healthy Opportunities strategy. To truly achieve health and well-being for all North Carolinians, it is critical to unite our healthcare sector and communities. The platform will be the foundation for connecting people with community resources they need to improve their health and well-being and to decrease health care costs and utilization. NCCARE360 will be a robust statewide resource database that will include a call center and will serve as a referral platform for providers, social workers, care coordinators and others to connect patients directly to community resources. It will foster resource connections, link health and social services in communities and develop high-quality data regarding the non-clinical factors impacting health outcomes and costs. Importantly, it will track outcomes. The platform will be open to all providers, payers, community-based organizations, agencies and residents across North Carolina. Telemedicine: Telehealth services can bridge health care disparities and healthcare professional shortages, reduce the burden of extensive travel to healthcare sites and provide affordable access to world-class care for citizens in areas with limited health care options. The first telehealth program in North Carolina centers around telepsychiatry and behavioral health, with the N.C. Statewide Telepsychiatry Program (NC-STeP), based out of the Brody School of Medicine at East Carolina University. The program expects to connect 80 or more hospital emergency departments across the state. In February 2019, the Department of Information Technology (DIT) and the DHHS Office of Rural Health (ORH) were awarded a grant from the Appalachian Regional Commission to investigate extending resources to implement telehealth infrastructure in 20 counties in the western part of the state. In addition to existing behavioral health services, expanded telehealth services could include things like remote consultation between physicians, or monitoring a patient’s medication adherence, blood pressure, or other conditions. DHHS will coordinate efforts with the DIT to match broadband capacity to ORH listings of “telehealth ready” sites to build capacity for innovative delivery models, including the delivery of specialty physical health and dental services, behavioral health, and substance use services into rural areas. Veteran Information Portal (VIPP): The VIPP, managed by the Department of Military and Veteran Affairs (DMVA), is a multi-functional portal that compiles and distributes veteran data from multiple sources, enabling DMVA to better serve veterans in North Carolina. The portal provides on-demand analytics to help manage the State’s military and veteran workforce, and enables DMVA’s executive leadership to view federal veteran-related expenditures by county or congressional district, allowing for more fruitful engagement with legislators on veteran matters. For the veterans interacting with the portal, it provides access to multiple services provided by the State. Updates to the portal will include the auto-population of retirement records into the Veterans Case Management System (CRM) currently used by Veteran Service Centers (VSCs) across the State. These files will be sent to Veteran Services Officers strategically positioned statewide, so they can proactively reach out to veterans upon relocation to their respective areas and offer to assist with housing, employment, substance abuse, education, etc. Future integrations with the DMV, NC Wildlife Resource Commission, and other providers of data will improve the efficiency of services provided to veterans and ultimately make it easier for veterans to interact with the State. Medicaid Reform and Transformation We are working hard to improve the health and well-being of North Carolinians through our Medicaid Transformation Program. DHHS is transitioning our Medicaid and NC Health Choice programs to Medicaid Managed Care in 2019. Our Medicaid program will be moving from a predominantly fee-for-service (FFS) structure to managed care. This is the most significant change to our Medicaid program in over 40 years. Under managed care DHHS will remain accountable for all aspects of the Medicaid and NC Health Choice programs. DHHS will delegate the direct management of certain health services and financial risks to PHPs, who will contract with care providers to provide services for their members. There are multiple IT initiatives attached to this program, some of which are described below. Medicaid Reform: Medicaid Reform will require changes to existing software applications and IT systems or procurement of new software applications/IT systems that support NC Medicaid. This includes primary systems such as NC FAST, NCTracks, NCAnalytics, and secondary systems. DHHS will implement a replacement for the current Medicaid Management Information System (MMIS) and the associated Reporting Analytics (R&A) technology. Once federally certified, the new Medicaid Enterprise System (MES) will ensure our ability to continue Medicaid claims processing while supporting Medicaid Transformation. Electronic Visit Verification (EVV): DHHS is working to meet a federal requirement that providers delivering in-home personal care services and home health care services clock in and out when they begin and finish providing services, using a combination of telephone and internet-based resources. This will reduce the risk of fraud due to improper self-reporting of time spent providing a service. This must be implemented by January 1, 2020 to ensure that the State’s Federal Financial Participation is not reduced. A reduction in Federal Financial Participation funds would increase the cost for the State to maintain the same level of services for clients. Strategic Initiatives: DHHS will explore strategic automation initiatives to improve Customer Relationship Management (CRM), Document Management, Hearings and Appeals Management, and enterprise resource planning (ERP) procurement functionality. Successful automation of the support functions for NC Medicaid will result in significant operational efficiencies. Data Governance: DHHS will implement a data governance strategy, including the tools and resources necessary to manage, control and audit the governance process. Governance of data from the NC Medicaid program will reduce data hurdles and roadblocks due to data quality issues; result in the establishment and use of standard processes, data definitions, and standards; and put controls and audits in place for business intelligence processes and NC Medicaid data, all of which ensures NC Medicaid data availability will support an innovative, coordinated, and whole-person centered system that addresses both medical and non-medical drivers of health.