1. Online applications for Medicaid and/or CHIP an overview of current capabilities and opportunity for improvement. (PDF, 850.45 KB)
Authors: The Henry J. Kaiser Family Foundation
Summary: This Issue Paper provides an overview of current online applications for Medicaid and/or CHIP and examines the extent to which they incorporate features that streamline and simplify the enrollment process for individuals.

2. Joint OCIIO/CMS Guidance for Exchange and Medicaid Information Technology (IT) Systems. (PDF, 185.89 KB)   
Authors: Department of Health and Human Services, Office of Consumer Information and Insurance Oversight, Centers for Medicare & Medicaid Services
Summary: The purpose of this document is to assist states as they design, develop, implement, and operate technology and systems projects in support of the Affordable Care Act relating to the establishment and operation of Health Insurance Exchanges as well as coverage expansions and improvements under Medicaid and the Children’s Health Insurance Program (CHIP), and premium tax credits and cost-sharing reductions under the Affordable Care Act. This guidance seeks to help states achieve the necessary degree of interoperability between IT components in the federal and state entities that work together to provide health insurance coverage through the Exchange, Medicaid or CHIP programs.

3. Health Insurance Exchange Basics (PDF, 126.42 KB)  
Authors: Alan Weil, Adi Shafir, and Sarabeth Zemel
Summary: The purpose of this brief is to set forth the major requirements for health insurance exchanges as described in the federal law. These requirements provide states with sufficient guidance to define the overall parameters of their exchanges, recognizing that states will likely revisit or refine these decisions as the federal law is clarified through federal regulations.

4. The MITA Touch: State CIOs and Medicaid IT Transformation
Author(s): NASCIO - National Association of State Chief Information Officers
Source: NASCIO - National Association of State Chief Information Officers
Summary: Consuming nearly a third of state budgets nationwide, Medicaid serves as the county's largest insurance program. As of FY 2007, over 55 million people were Medicaid beneficiaries and approximately $355 billion dollars per year are spent by federal and state governements to administer Medicaid services. Implementation of MITA is certain to affect state CIOs, particularly as agency and department CIOs look to the state CIO to provide and enterprise view on linking disparate agency silos in order to implment the MITA framework.

5. Data Standards and Improvement of Quality and Safety in Child Health Care
Author(s): S. Andrew Spooner, MD, FAAP, David C. Classen, MD, MS
Source: Pediatrics, Jan 2009; 123: S74 - S79
Summary: Progress in using information technology to achieve the goal of high-quality health care is hindered by the lack of coordinated data standards. To accelerate quality improvement in pediatrics, child health providers must participate actively in the creation of health care data standards. To do so will require far greater understanding on the part of pediatricians and other pediatric providers regarding the scope and role of data standards in advancing health information systems for children, as well as how data standards could improve quality in child health, what kinds of data standards hold the most promise for quality improvement in child health, and how child health professionals can engage in the work of creating data standards.

6. A Comparison of the Completeness and Timeliness of Automated Electronic Laboratory Reporting and Spontaneous Reporting of Notifiable Conditions
Author(s): Overhage, J. M., Grannis, S., and McDonald, C. J.
Source: Am J Public Health (2008)
Summary: This paper examines whether automated electronic laboratory reporting of notifiable-diseases results in information being delivered to public health departments more completely and quickly than is the case with spontaneous, paper-based reporting. The conclusion is that automated electronic laboratory reporting improves the completeness and timeliness of disease surveillance, which will enhance public health awareness and reporting efficiency.

7. Data standards in clinical research: gaps, overlaps, challenges and future directions
Author(s): Richesson, R. L. and Krischer, J.
Source: J Am Med Inform Assoc 14 (6), 687 (2007)
Summary: Current efforts to define and implement health data standards are driven by issues related to the quality, cost and continuity of care, patient safety concerns, and desires to speed clinical research findings to the bedside. The President’s goal for national adoption of electronic medical records in the next decade, coupled with the current emphasis on translational research, underscore the urgent need for data standards in clinical research. This paper reviews the motivations and requirements for standardized clinical research data, and the current state of standards development and adoption–including gaps and overlaps–in relevant areas. Unresolved issues and informatics challenges related to the adoption of clinical research data and terminology standards are mentioned, as are the collaborations and activities the authors perceive as most likely to address them.

8. A self-scaling, distributed information architecture for public health, esearch, and clinical care
Author(s): McMurry, A. J., C. A. Gilbert, et al.
Source: Journal of the American Medical Informatics Association 14(4): 527-533. (2007)
Summary: This study sought to define a scalable architecture to support the National Health Information Network (NHIN). This architecture must concurrently support a wide range of public health, research, and clinical care activities. Study Design: The architecture fulfils five desiderata: (1) adopt a distributed approach to data storage to protect privacy, (2) enable strong institutional autonomy to engender participation, (3) provide oversight and transparency to ensure patient trust, (4) allow variable levels of access according to investigator needs and institutional policies, (5) define a self-scaling architecture that encourages voluntary regional collaborations that coalesce to form a nationwide network. Results: Our model has been validated by a large-scale, multi-institution study involving seven medical centers for cancer research. It is the basis of one of four open architectures developed under funding from the Office of the National Coordinator of Health Information Technology, fulfilling the biosurveillance use case defined by the American Health Information Community. The model supports broad applicability for regional and national clinical information exchanges. Conclusions: This model shows the feasibility of an architecture wherein the requirements of care providers, investigators, and public health authorities are served by a distributed. model that grants autonomy, protects privacy, and promotes participation.

9. How to create awareness and ensure broad dissemination of health informatics standards
Author(s): Williams, P.
Source: Int. J. Med. Inform. 48 (1-3), 49 (1998)
Summary: There is a range of organizations with responsibility for information standards development within Australia. These include Standards Australia, which is formally linked to the International Organization for Standards (ISO), the National Health Information Management Group, which deals with the government sector and several statutory organizations such as the Australian Institute of Health and Welfare and the National Centre for Classification in Health. The different constituencies involved with each of these organizations, the scope of healthcare informatics and the rate of organizational and technological change in the industry present a significant challenge in ensuring that the standard setting process is highly visible, responsive and capable of demonstrating its value through effective implementation. Creating awareness and ensuring broad dissemination of healthcare informatics standards is a key component in meeting this challenge. This can operate at a number of levels from strategic to operational. At the strategic level, it requires active engagement and commitment of the key decision-makers, both political and professional. This may require directly lobbying and promoting the benefits of standardization to those decision-makers but can be achieved even more effectively by creating industry awareness and demand through carefully targeted presentations on the impact of standards to broader health industry forums. At the tactical level, the standards development medium itself can be used to engage and gain commitment from government, professionals, vendors and the health industry by operating as an inclusive, open and effective process. At the operational level, there is the opportunity for much more efficient use of technology to create awareness of both these processes and their outcomes. The establishment in Australia of a web enabled National Health Information Knowledge base built around ISO standards is one example of the type of development which will assist in the acceleration of awareness of standards and standardization, which is needed to cope with the increasing demand.