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MITA Gateway 5010 Overview May 18th 2009.

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Presentation on theme: "MITA Gateway 5010 Overview May 18th 2009."— Presentation transcript:

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

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