2Gateway 5010 - Agenda MITA TAC Group Gateway 5010 Goals Gateway 5010 DeliverablesGateway 5010 ArchitectureBusiness ServicesInquire Member EligibilityTechnical Services and FunctionsConnectivity - CORE ServiceEligibility AdapterAuthentication & AuthorizationAuditingPrototypeNext Steps
3MITA TAC Group Recommends technical standards for use within MITA Made up of states and leading healthcare vendorsEnsure MITA aligns with industry standards and directionCreates working prototypes and proof of concepts
4Gateway 5010 – Goals Align TAC committees to real working projects Collaborative development of one MITA business service and associated technical servicesIterative approach going from very simple to complex interfacePublish recommendations to the TARBDeliver real solution setsRecommend rules for interoperabilityIdentify and integrate with other industry initiativesHITSP, HL7, OASIS, WS-I …….
5Gateway OverviewPowerPoint has new layouts that give you more ways to present your words, images and media.CORE Service – S2M1Provides connectivity and specifies protocolsAdapter – S3M3Transforms data into the MITA compliant formatMITA Service – S1M3MITA business service performs the functionalityGateway 5010Architecture
6Gateway 5010 – Deliverables Publish recommendations to the TARB on details of the MITA technical architectureDeliver solution sets that will allow any CORE compliant provider to conduct eligibility inquires with any MMIS that deploys the solution setCreate technical service(s) in the Gateway suite of technical services that will allow MITA to exchange standards based dataA development community that has been educated on building MITA based systems
7Gateway 5010 – Architecture Provides pathway for implementing new X StandardIncludes use of a MITA business serviceInquire Member EligibilityIncludes use of MITA technical services and functionsConnectivity – CORE ServiceTranslator – Eligibility AdapterAuthenticationAuthorizationAuditing
10Inquire Member Eligibility Service (IME) Business Service from the MITA business modelInterface developed iterativelyS1M1 – Simple interface using Member IdS1M2 – Interface has some complex objects e.g. returns a list of benefitsS1M3 – Interface has complex and more complete objects e.g. more benefit and healthcare provider dataS1M4 – Interface uses some HL7 base objects to define data such as address and providerIncorporating HL7 objects in the data schema definitionDeveloping standard WSDL to be used by all implementers
13CORE Service Developed by CAQH Widely used within the Healthcare industryAdopted as a HITSP standard – HITSP-T85Provides communication via a web service or MIME MultipartSupports real time and batch processingInterface will be implemented iteratively - 3 options for SOAP/HTTP(S) implementationS2M1 – Uses username and password (unencrypted)S2M2 – Uses username and password (encrypted)S2M3 – Uses certificates for authenticationOne option for the MIME Multipart implementationS2M4 – Uses username and password
16Inquire Member Eligibility Adapter Technical service that transforms an X request into a MITA compliant message and transforms a MITA compliant response into an X responseWill be able to communicate with multiple Eligibility systems
18Gateway 5010 – CMS TARB Artifacts For each technical and business service the following artifacts will be generated and submittedBusiness or Technical template describing the serviceUML Model of the serviceThe data schemas (XSD) and Web service Definition Language(WSDL) for the serviceDocument describing how the service works
19Gateway PrototypeBased on an existing Eligibility system in productionThe front end application was modified to call the CORE Service for connectivityThe CORE Service calls the Eligibility AdapterTranslates the 270 request into MITA compliant requestTranslates MITA compliant response into a 271 responseThe Eligibility Adapter calls the MITA compliant Eligibility ServiceThe Eligibility Service retrieves that data from the eligibility database or legacy system.
21Gateway 5010 – Next StepsComplete the interface specification for Inquire Member EligibilityCreate a package of IME artifacts for the TARB reviewTAC members to implement the published IME interfaceShow a demo of IME at the MMIS conference in August 2009