1. MITA Gateway 5010 Overview
May 18th 2009

2. Gateway 5010 - Agenda MITA TAC Group Gateway 5010 Goals
Gateway 5010 Deliverables
Gateway 5010 Architecture
Business Services
Inquire Member Eligibility
Technical Services and Functions
Connectivity - CORE Service
Eligibility Adapter
Authentication & Authorization
Auditing
Prototype
Next Steps

3. MITA TAC Group Recommends technical standards for use within MITA
Made up of states and leading healthcare vendors
Ensure MITA aligns with industry standards and direction
Creates working prototypes and proof of concepts

4. Gateway 5010 – Goals Align TAC committees to real working projects
Collaborative development of one MITA business service and associated technical services
Iterative approach going from very simple to complex interface
Publish recommendations to the TARB
Deliver real solution sets
Recommend rules for interoperability
Identify and integrate with other industry initiatives
HITSP, HL7, OASIS, WS-I …….

5. Gateway Overview
PowerPoint has new layouts that give you more ways to present your words, images and media.
CORE Service – S2M1
Provides connectivity and specifies protocols
Adapter – S3M3
Transforms data into the MITA compliant format
MITA Service – S1M3
MITA business service performs the functionality
Gateway 5010
Architecture

6. Gateway 5010 – Deliverables
Publish recommendations to the TARB on details of the MITA technical architecture
Deliver solution sets that will allow any CORE compliant provider to conduct eligibility inquires with any MMIS that deploys the solution set
Create technical service(s) in the Gateway suite of technical services that will allow MITA to exchange standards based data
A development community that has been educated on building MITA based systems

7. Gateway 5010 – Architecture
Provides pathway for implementing new X Standard
Includes use of a MITA business service
Inquire Member Eligibility
Includes use of MITA technical services and functions
Connectivity – CORE Service
Translator – Eligibility Adapter
Authentication
Authorization
Auditing

8. Gateway 5010 – Architecture

9. Gateway 5010 – Architecture

10. Inquire Member Eligibility Service (IME)
Business Service from the MITA business model
Interface developed iteratively
S1M1 – Simple interface using Member Id
S1M2 – Interface has some complex objects e.g. returns a list of benefits
S1M3 – Interface has complex and more complete objects e.g. more benefit and healthcare provider data
S1M4 – Interface uses some HL7 base objects to define data such as address and provider
Incorporating HL7 objects in the data schema definition
Developing standard WSDL to be used by all implementers

11. Inquire Member Eligibility – Data Model

12. Inquire Member Eligibility – Overview

13. CORE Service Developed by CAQH
Widely used within the Healthcare industry
Adopted as a HITSP standard – HITSP-T85
Provides communication via a web service or MIME Multipart
Supports real time and batch processing
Interface will be implemented iteratively - 3 options for SOAP/HTTP(S) implementation
S2M1 – Uses username and password (unencrypted)
S2M2 – Uses username and password (encrypted)
S2M3 – Uses certificates for authentication
One option for the MIME Multipart implementation
S2M4 – Uses username and password

14. CORE Service – Real Time Model

15. CORE Service – Batch Model

16. Inquire Member Eligibility Adapter
Technical service that transforms an X request into a MITA compliant message and transforms a MITA compliant response into an X response
Will be able to communicate with multiple Eligibility systems

17. IME Adapter – Model

18. Gateway 5010 – CMS TARB Artifacts
For each technical and business service the following artifacts will be generated and submitted
Business or Technical template describing the service
UML Model of the service
The data schemas (XSD) and Web service Definition Language(WSDL) for the service
Document describing how the service works

19. Gateway Prototype
Based on an existing Eligibility system in production
The front end application was modified to call the CORE Service for connectivity
The CORE Service calls the Eligibility Adapter
Translates the 270 request into MITA compliant request
Translates MITA compliant response into a 271 response
The Eligibility Adapter calls the MITA compliant Eligibility Service
The Eligibility Service retrieves that data from the eligibility database or legacy system.

20. IME Activity Diagram

21. Gateway 5010 – Next Steps
Complete the interface specification for Inquire Member Eligibility
Create a package of IME artifacts for the TARB review
TAC members to implement the published IME interface
Show a demo of IME at the MMIS conference in August 2009

22. Gateway Questions