Medicaid Health Home Impacts And Implications: Chief Information Officer

In this final installment of GSI Health’s series examining the impacts and implications of the Medicaid Health Home model, today’s post focuses on the shifting roles, responsibilities and requirements faced by Chief Information Officers (CIOs).

If you missed the previous posts in this series, it’s not too late to catch up:

Click here to read about how Medicaid Health Homes are changing the role of Chief Medical Officer.

Click here to read about how Medicaid Health Homes are changing the role of Chief Operating Officer and VP of Care Management.

Click here to read about how Medicaid Health Homes are changing the role of Chief Financial Officer.

The Changing Role Of The CIO Under Medicaid Health Homes

Technology designed for use by Medicaid Health Homes and Totally Accountable Care Organizations is, by definition, for coordinating patient care “outside the four walls” of any single provider organization. It picks up where today’s fee for service-based, “inside the four walls” electronic health records leave off by providing collaboration and information tools and analytics and performance managements tools spanning the continuum of care.

It’s the responsibility of the CIO to assure that technology is secure, scalable and extensible, meeting the clinical, operational and analytical needs of the Medicaid Health Home. In order to provide this assurance, a shared SaaS (Software-as-a-Service) platform is essential. This platform should offer every participating care provider seamless access, facilitating the transition from volume to value-based payment, silo to team-based care delivery and fragmented to whole-person care.  An essential element is a data warehouse and analytics infrastructure that collects information from multiple sources including claims, clinical, administrative and care coordination systems and harmonizing the information into a common language for robust analysis and reporting.

Key Steps:

1. Provide a shared, HIPAA compliant solution accessible to all stakeholders

2. Ensure all stakeholders have required internet connectivity and standard browser and mobile app to access solution

3. Ensure a dynamic, coordinated care plan for whole person care (medical, behavioral, social)

4. Provide collaborative tools for care teams to share information and manage patients through common workflow

5. Provide analytical tools to measure outcomes and operational impact of program and assess patient risk for events and costs

6. Build bridges with internal EHR systems for a coordinated user experience linking “inside the four walls” and “outside the four walls”

Care Continuum Realization Technology

While the responsibilities and key steps detailed above provide a solid foundation, they are by no means the only elements required for a Medicaid Health Home’s success. In addition to shifting roles such as the Chief Information Officer, you need a health IT solution capable of providing unprecedented access to information that spans each patient’s entire continuum of care. You need a platform that connects people not systems, one that helps you fill in the information and communication gap with easily accessible and actionable patient care knowledge.

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