Tag Archive for Technology

Illinois DHS Digitizes Forms, Leverages Mainframe Technology

To most efficiently realize cost savings with an IT transformation, the Illinois Department of Human Services (DHS) decided against digitizing paper benefit eligibility forms the agency has been accumulating for years. Instead, starting early last year, the department started digitizing all new eligibility forms.

DHS secretary Michelle R.B. Saddler said the agency, which is responsible for providing integrated services through 100 Family and Community Resource Centers, generates 7 million paper forms a year. Given recent leadership changes at the state level, Saddler said the agency began looking for a new way to reduce paper and improve file management while maintaining cost efficiency.

“Part of the initiative led to discussion of needing to digitize file cabinets, but digitizing and imaging for the thousands of file cabinets that we have was really cost prohibitive,” Saddler said.

DHS CIO Doug Kasamis then spearheaded efforts to digitize and store three types of benefit eligibility determination forms, which collectively make up nearly 70 percent of the agency’s total form volume. These forms are currently created on the department’s mainframe technology.

But instead of sending the forms to a print queue for printing, they are now turned into PDFs with their corresponding metadata – like case number and recipient ID – and then stored securely in an IBM content management system. Within four weeks’ time, the content management system was deployed statewide for the DHS’ 200 offices and 2,000 case workers.

Kasamis said that the department determined it was more cost effective for the agency not to scan and digitize forms the department already has stored in file cabinets, and to only digitize forms from present day forward. The department’s records retention policy requires that forms be stored for five years, so as the DHS continues to digitize forms, forms that are currently stored in hard copy will be phased out.

“Rather than trying to figure out a way to scan all that legacy paper, we’re basically getting rid of 20 percent of our problem every year over the next five years,” Kasamis said.

The IBM technology cost the department $325,000 and Kasamis said the DHS saw return on investment within three months of deployment. In the future, the DHS plans to integrate its other 15 form types into the system to be digitized and stored electronically. Currently the electronic data is housed in Illinois’ statewide data center, but there are no immediate plans to migrate the data into a cloud computing environment.

Ken Bisconti, vice president of products and strategy for IBM’s enterprise content management software, said because the content management system is designed to hold large amounts of data, there isn’t a pressing need to delete files from the system after the forms have been stored electronically for their required five years.

“These content management systems are capable of storing hundreds of millions, if not billions, of items and documents,” Bisconti said.

According to Kasamis, the DHS has seen a reduction of 650,000 paper forms each month since the IBM technology was deployed in early 2012. The department has already reduced its paper load by 7.5 million forms.

Saddler said the new system will prevent the DHS from using 40 10-foot-by-10-foot file storage rooms per year for storing paper files.

In October of this year, the DHS will also implement a new system to follow new Affordable Care Act requirements. The agency plans to implement the Medicaid eligibility system and integrate it with its IBM content management system. According to the DHS, some legislative uncertainties remain regarding the Affordable Care Act, so issues surrounding the new system’s compliance requirements are subject to change before its October implementation.

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Join the Government Technology HIX TweetChat on Jan. 10

On Thursday Jan. 10, 2013, at 1:00 PM ET, follow #GTonHIX to participate in our TweetChat: Innovation in Focus – States & Health Insurance Exchanges.

Government Technology Staff Writer Sarah Rich (@SarahRichforGT) will host this TweetChat with industry experts about the role Health Insurance Exchanges (HIXs) will play in helping states enhance their delivery of services to citizens.  Chat participants will include: 

John Sweeney (@JJS_HIX), IBM’s Senior Product Manager for the Curam solution 

Dan Schuyler (@LeavittPartners), Director for Leavitt Partners’ HIX practice 

The chat will address the following questions. 

What are the benefits for both states and their citizens in building these exchanges?Are there any lessons learned from states that have implemented or are in the process of implementing an exchange? What are the technical challenges the states face in implementing HIXs? How different will the HIXs be across states? How can states maximize the cost benefits of implementing these HIXs? What are some of the innovative approaches to these exchanges?

We hope to see you there!

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Can Technology ‘Cure’ Health Care’s Future?

Aneesh Chopra, senior adviser of health-care technology strategy at the Advisory Board Co., envisions a scenario where once a doctor has all necessary patient data, she could begin to look at how to best engage the patient in newer ways to improve his overall health outcomes. Photo courtesy of shutterstock.com.

One day soon, patients will routinely interact with doctors via remote telepresence. It’ll be common for people to take digital photographs of medical conditions and send them to health-care professionals for evaluation. And improvements in data capture and analysis will lead the way toward better, more cost-effective medical care.

These are just a few predictions for how health care will evolve over the next 25 years. But the future of health care is cloudy at best, given the broad array of changes that will take place in the health-care system over the next several years. What’s clear is that technology will play a vital role in improving health care for Americans and making the system more sustainable. Whether it’s used to help ease the Medicaid burden on states or to enable patients to be diagnosed more quickly and easily, technology has huge implications for the future of health care … whatever that future may bring. 

In 2009, Medicaid costs accounted for an average of 15.7 percent of states’ general fund spending, according to Medicaid and State Budgets: Looking at the Facts, a publication of the Center for Children and Families. By 2011, that amount had risen to 16.8 percent, with no sign of slowing in sight. Medicaid as it exists today is simply not sustainable. A new model that meets the needs of an aging population is necessary. The Affordable Care Act (ACA) requires states to take a number of steps over the next several years to reform the system. And while the ACA’s future also is in question (Gov. Mitt Romney has promised to repeal all or part of it if he’s elected president), the need for significant reform still is evident, and technology will likely play a role in a number of areas, including enrollment and eligibility, pay-for-performance and electronic medical records.

Cheryl Camillo is a senior researcher with Mathematica Policy Research, a Princeton, N.J.-based research organization. Camillo focuses on ACA and Medicaid and is also the former executive director of the Maryland Office of Eligibility Services. Camillo said the ACA is motivating states to use technology to change the future of Medicaid application and enrollment processes.

“From 2014 through 2019 there will be a substantial transformation of Medicaid due to ACA,” said Camillo. “If it all works out, the Medicaid program in 2020 will be very different than it is today, especially in the eligibility and enrollment areas. The use of IT systems will be a significant part of that.”

Rather than apply to numerous programs to determine eligibility, future applicants would fill out one electronic application and be automatically routed to the most appropriate program with minimal interaction and paperwork — a scenario dramatically different than today’s complex, paper-driven process.

“Information technology is essential to making that happen,” Camillo said. “It will allow people to apply electronically, and the systems will interface behind the scenes. The data needed to determine eligibility would be pulled from sources where it already exists electronically.”

Technology could also play a significant role in changing how providers interact with and manage chronic care patients. According to Alain Enthoven, professor of public and private management at Stanford University and a founder of the Jackson Hole Group, a national think-tank on health-care policy, Medicaid’s open-ended, fee-for-service payment system is a major contributor to the high level and rapid growth of spending. In 2009, the Massachusetts Special Commission on the Health Care Payment System said that fee for service “rewards overuse of services, does not encourage consideration of resource use, and thus cannot build in limitations on cost growth.”

Moving to a fee-for-performance scenario would change how doctors are rewarded while also promoting better outcomes. “Medicaid as we know it is a 1950s-era concept based on acute, episodic care and built around a doctor making a living,” Enthoven said. “In the future it will be more about doctor performance, actually helping improve health, and reducing patient dependence on the doctor. Coaching and electronic exchange of information would replace many in-person visits, and patients would be encouraged to manage their own health.”

Aneesh Chopra, senior adviser of health-care technology strategy at the Advisory Board Co., envisions a similar scenario. “Once a doctor has all the data they need, they could begin to look at how to best engage the patient in newer ways to improve their overall health outcomes. Technology tools could be used to collect patient monitoring data, and doctors could text or call patients instead of having them travel to the office,” Chopra said. “I envision an iPhone App Store scenario where patients download and use tech tools that support behavior change and help them make better health decisions.”

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