Exchange IT Systems. Information technology will be a component of many business functions of the Exchange, including those set forth in Section 1311(d)(4) as well as the requirements in Sections 1411, 1412 and 1413 related to eligibility and enrollment. This Core Area encompasses the performance of the Exchange in planning for and establishing these systems in these various functional areas. When planning or developing Exchange IT systems, the State should take steps to ensure a modular, flexible approach to systems development, including use of open interfaces and exposed application programming interfaces; the separation of business rules from core programming; and the availability of business rules in both human and machine readable formats. Milestones related to information technology for establishment of an Exchange will be located under each of the Exchange business functions. Exchanges will be required to follow all applicable Federal IT guidance. In addition, States are encouraged to leverage the expertise of the State health information exchange program (HIE). HIE is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care. HIE is also useful to Public Health authorities to assist in analyses of the health of the population.
Exchange IT Systems see below for IT system work plan (Xxxxxxx Xxxxxxxx, Healthcare CIO and Xxxx Xxxxxx, Interim IT Systems Project Manager)
Exchange IT Systems. During the planning grant period, California made material progress in four key IT areas: ▪ Requirements analysis; ▪ Gap analysis; ▪ Collaboration; and ▪ Project planning.
Exchange IT Systems. IT system assessment, design and development will be a major component activity during the Level I grant period. A fundamental assumption of this grant application is that California does not have a preconceived notion of the high-level technical design of Exchange IT systems at this time, and that the preliminary gap analysis does not suggest a compelling business case for a definitive configuration. California's approach to developing the necessary IT support for establishing a State-operated Exchange, as reflected throughout this Level I grant, uses a timeline framework based upon the following line of reasoning: ■ Most Exchange functionality must be operational by the third quarter of calendar 2013, therefore, most system development must begin in early 2012; ■ California lacks the resources to undertake system development efforts of this magnitude using state staff, therefore the services of contractors will be required; and ■ Acquisition of contractor resources must take place during the second half of 2011. Given the foregoing, the immediate IT challenge before California is to support development of an Exchange business and operational plan that will provide answers to the questions necessary to permit creation of the business requirements and architectural and integration framework. These elements will inform the development of an IT approach, an acquisition strategy and one or more vendor acquisition processes to be conducted in late 2011. This first phase of the Level I IT activity, already begun, is targeted for substantial completion in September 2011 and encompasses ongoing analysis of requirements and development of alternatives, identification of business decision criteria, recommendations and a selected approach for IT that supports the business and operational plan of the Exchange. In this phase, major activities include: ■ Ongoing analysis of the regulations and guidance that will continue to emerge from DHHS in 2011; ■ Participation in the development of the business and operational Plan; ■ Consultation with partners within state government, in particular the DHCS (Medi-Cal program) and the MRMIB (Healthy Families program); ■ Consultation with stakeholders outside of state government, in particular consumers, employers, and health plans; ■ Completion of the detailed evaluation of existing California systems that may support or interface with Exchange business functions; ■ Evaluation of the possibilities for using or otherwise benefiting...
Exchange IT Systems. Investing in a Consumer-Focused System From the earliest days of the California Exchange, the Board, staff and stakeholders, in partnership with other state partner agencies have maintained intense focus on the design and development of CalHEERS. The California Exchange is making significant progress toward designing and building the IT systems needed to support Exchange business and operational processes through design and development of core elements and functionality in CalHEERS. During the Level 1 grant periods, Covered California conducted multiple solicitations and selected vendors related to IT development and CalHEERS, including a solicitation for a system integrator to design, develop and deploy CalHEERS functionality to meet federal requirements; a solicitation and contract for a vendor to provide project management and technical consulting services to support State project staff during the design, development and implementation of CalHEERS; and a vendor to provide project Independent Verification and Validation Services. The California Exchange established an Executive Steering Committee composed of the executive leads of the Exchange and DHCS to oversee extensive collaborative planning and research initiated during the early Exchange planning period. The planning and research in this time period led to joint solicitation and selection of vendors to design, develop and deploy software functionality to meet ACA requirements, to maintain and operate the software functionality, and to provide related services. In May of 2012, Accenture was selected to serve as the System Integrator for the Project. The goals of the CalHEERS solicitation and vendor selection process were: Provide an open, fair, and accurate process that maximizes competition while allowing the California Exchange the flexibility to acquire the highest quality goods and services. Conduct a solicitation and project to meet California and federal deadlines, and deliver a high quality solution while minimizing risk. Award a price-competitive contract for a solution that is compliant with federal requirements, including funding requirements.
