For decades, child welfare agencies have struggled with finding technology solutions to support consistent connection and communication between case workers, families, vulnerable youth, and an extended team of stakeholders. COVID-19 exacerbated those challenges, bringing to a head the need for states to provide its workers and constituents tools that bring continuity and communication despite disruption. Microsoft has been working intently with state and local agencies, such as Illinois Department of Child and Family Services (IL-DCFS) and the Georgia Division of Child and Family Services (DCFS) to help them reimagine and modernize their connection and collaboration capabilities. In September, the Microsoft Team will be joined by both agencies at the 2021 Annual ISM Conference to discuss these topics, and more.

The gold standard for youth and families

Across Microsoft’s work with child welfare state agencies, the historical and universal question has been “how can technology improve the situation for children and families?” This is especially daunting given the myriad of challenges agencies face: high case worker load and turnover, connecting external teams, and the pandemic-related challenges of limited face-to-face interaction.

“This has been nebulous and frustrating because historically technology has not been able to address that need,” said Andy Pitman, Microsoft Director, US Health and Human Services Solutions. “The pandemic created a bigger focus on that problem, but the same challenge has been there for decades: how to create better continuity and real connection for the children and families relying on these extended support teams.”

Two years ago, Microsoft began talking with both the Georgia Division of Child and Family Services and Illinois Departments of Child and Family Services (IL-DCFS) about how to build upon the Microsoft Teams platform to augment communication among case workers, children, families, and external support teams.

The result of the collaboration with IL-DCFS is Ally, a child-welfare specific solution residing on the Microsoft Teams platform using unique micro-services, as well as a custom database to plug in with Illinois’ legacy Child Welfare Case Management System. Initially rolled out to 10 Ally groups, the adoption and success has been so positive that they plan to roll it out agency-wide (10,000+ Ally teams) in the fall of 2021.

“Ally has helped Illinois achieve a long-term goal in child welfare, bringing case participants together in a whole new way,” said Anna Corley, Microsoft Director of Business Development. “It was the confluence of the Teams infrastructure, the pandemic forcing alternatives to traditional practices, and people’s acceptance of this type of technology. There will always be a need for in-person interaction, but with Teams, Illinois has found the sweet spot for creating meaningful ongoing virtual connections and efficiency for the agency.”

One of the reasons for Illinois’ success is youth familiarity with apps to communicate. “This is something they’re familiar with,” said Corley. “It naturally leads towards an avenue they feel comfortable using and that is incredibly important whenever a case is transferred. Usually, kids go through intense anxiety and stress when there is disruption with their case workers. The video conferencing and ability to share key childhood moments, has reduced anxiety and improved the trust and open communication with children, foster families, and biological families.”

For IL-DCFS case workers, the Ally solution is also specific to their needs and provides tools for case management and team access that wasn’t previously possible. Case workers in every state have high caseloads and carry a huge amount of required documentation. In Illinois, the Ally solution is helping lift that load so they can spend more time on creating meaningful connections with children and families. Because of the immediate synchronicity of documentation, supervisors can get involved in emergency events as they develop and offer greater assistance. For case workers, they’ve been able to schedule meetings with two messages in Ally, versus relying on a cascade of 10-12 calls, texts, and emails to all the stakeholders in the past. This leads to not only more timely conversations, but more time for the case workers to individually connect with youth and families.

“Unfortunately, child welfare agencies will never have the necessary budgets and resources to adequately counter demand; but Teams is the ultimate capacity builder,” said Greg McKay, former child welfare agency head and Microsoft global director. “In person interactions will always be necessary for some situations, but Teams allows for less travel, limits unnecessary documentation, and reduces scheduling conflicts, all while bringing multiple pertinent parties together in one virtual space—finally a way to win for children, families, and the staff who serve them.”

Preserving the human connection

Georgia’s Division of Family and Children Services (DFCS) also began using the Microsoft Teams platform to facilitate quicker and more efficient communications and support for high-risk youth and families.

Using Teams, DFCS case managers coordinate calls and other communications with the Promoting Reasonable Efforts Team (PRE-Team) of 15-20 people, including DCFS leadership, case managers, and external interested parties such as the Office of the Child Advocate, legal counsel, and hospital personnel. These calls are typically in response to emergency situations and need to happen within an hour. In the past, this was a laborious and manual process of texts, emails, and phone calls. Now, with Teams, they pull together a PRE-Team meeting in a few minutes.

In addition to efficiency, Teams is also allowing for more meaningful connections during times of duress. “The case managers are dealing with anxious and worried family members,” noted Pitman. “Video connection between foster parents, youth, and case workers has made a huge difference in building the trust between those parties and showing up as partner in the process. Georgia’s DCFS is seeing more preservation of placements and changing the child’s and family’s perspectives about the support and continuity of their case. That is the most important thing we can achieve.”

Building connections for all

“Any state can take advantage of the Teams platform, regardless of where they are in their modernization path and process,” noted Pitman. “It can complement the oldest system in the world or easily plug in to a brand-new system. Plus, being platform agnostic, regardless of the agencies’ starting point, it will seamlessly connect and help create content, documentation, translation, notes—all providing speed and efficiency for case workers and their extended teams.”

Beyond child welfare, Microsoft is seeing other state agencies on similar paths towards implementing the Teams solution to propagate their services and meet ever evolving communication needs with their constituents.

“We are so proud to see how Illinois and Georgia have used this infrastructure to improve their child welfare agencies’ connections and communications,” said Corley. “Knowing this is helping change the lives of those in need is truly amazing and we are excited to see how it can be expanded to future use cases.”

Join us

We invite you to attend, either in person or virtually, the upcoming session on Reimagining Collaboration in the Government of Tomorrow at the 2021 ISM Annual Conference. You will hear directly from both Microsoft and Illinois DSCIS about how Ally and Teams is helping change the welfare and care experience for children, families, case workers, and how this can be expanded to other health and human services programs.

Get additional information on Illinois’ Ally solution and Georgia’s partnership with Microsoft.

Visit our web page to learn more about how Microsoft is improving outcomes for vulnerable people by enabling aware and connected public and social workers. Review public health and social service solutions that help to create opportunities for safety, wellness, and prosperity around the globe.

The post Helping governments reimagine collaboration and modernize services appeared first on Microsoft Industry Blogs.

In the US, Health information exchanges (HIEs) enable medical providers to securely share patient records and improve the cost, quality, safety, and speed of patient care. CRISP, the HIE for Maryland, and for West Virginia and DC via partnership, has been collaborating with Microsoft and Leap Orbit to create open-source solutions that other states’ HIEs can leverage and build upon. I recently spoke with David Horrocks, president and CEO of CRISP, to learn more about this ground-breaking initiative. He explained how building open-source infrastructure enables healthcare organizations to leverage limited technology resources for more efficient, accurate, and effective data sharing that drives better patient outcomes ⁠—­ and saves money to keep these HIEs viable. This US-based use case demonstrates benefits that can be unlocked by open-source solutions as healthcare organizations around the world move toward value-based care. Below is an edited and condensed version of our conversation.

Using data for health care solutions

CRISP is a non-profit founded 10 years ago to deploy health IT solutions pursued cooperatively. Our HIE is one such project and is our premier service, and it exists to support value-based care programs. HIEs have the unique ability to improve both care and costs through care-data analytics. This type of reporting and analytics can help public health agencies support better public health and outcomes.

Information is used in two primary stages of care: point of care and care management. Point of care includes doctors and pharmacists, who use the data to understand patients’ prescription drug histories, including whether or not the patient has been prescribed opioids recently.

Trigger points for care managers, who coordinate patient care, occur at admission or discharge. They use the information to track and analyze the most frequent hospital patients and those who have the highest total cost of care.

In a typical week, our system receives 90,000 point-of-care queries by clinicians for imaging results or notes. Information is pushed into electronic health records (EHRs) eight times as often as that – as much as 700,000 times per week for our prescription drug monitoring program (PDMP) and another 700,000 per week for everything else, such as tracking encounters for care managers. For example, that a patient showed up at the ER or was discharged.

Another advancement opportunity is risk-scoring analytics, using the raw data provided by the point-of-care queries. CRISP serves as an enabler to get this vast quantity of data to partners, who will then leverage machine learning in their efforts to apply the analytics to improving health outcomes in the communities they serve.

Application in community health

The foundation of the nation’s privacy model is HIPAA, and it relies on the doctor’s word that the patient has consented. Consent management is a weakness for some HIEs, so we built a cloud-based consent module that allows the patient to indicate consent to share their data, and with whom. We’re hoping others will adopt this technology.

CRISP uses relationship data to flag transactions that don’t make sense. For example, a query from a hospital to which the patient has never been admitted. Our open-source technology stack uses security methods including both automated technological solutions, like two-factor authentication and API throttling of unusual activity, as well as “break-glass processes,” like immediately asking the doctor to attest a second time when a query is flagged.

Developing open source infrastructure and sharing the wealth

We originally had various technology partners who provided core elements of the stack. However, as we started to deliver information in more innovative ways, we needed to adapt. As we began building out our tech stack, we didn’t try to build the whole thing at once. We began with open-stack modules that our peers can use without changing their vendor strategy or making massive changes.

Two years ago, we did not have much of a development capability, which is true of most HIEs. We had to learn agile development processes and to build a development infrastructure. Using the public cloud gives us scalability, better user experience, and faster response times, and it lets us focus on our core competencies. By building cloud-native applications, we don’t need to worry about backup and recovery infrastructure, or database administrators, or the network operations to support storage and switches. We just concentrate on the business needs we are trying to address.

It also gives us speed. Adopting agile and using the cloud enabled us to do standard DevOps at a game-changing pace we never thought would be possible: We can now go from concept to implementation and go-live in just over two weeks. Without that efficiency, we might not have achieved success.

We are pleased that open source lets us share our tools and best practices with other HIEs around the country, most of whom will find themselves in the same situation. Not only do many of the grants we’ve leveraged prioritize reusability for funded projects, but as a core principle, we believe that publishing tools for others to use grows our impact beyond our own region, for the greater public good. Open source creates greater interoperability among HIEs at the local and national levels. As federal HIE-related funds thin, an open-source option will help other regional HIEs as well as other non-traditional health information networks working to serve their communities.

Learn more

We’d be happy to share our insights and how to take advantage of these open-source solutions and build on Azure. Contact CRISP Health or come see us at the 2019 SHIEC Annual Conference, where we’ll also be presenting on the intersection of HIEs and the National Information Exchange models, as well as Medicaid integration and the value of using claims data at the point of care.

Learn more on building secure technology stacks on Microsoft Azure.

Get started learning on how Microsoft can help public health organizations transform their operations.

The post Enabling data sharing through Health Information Exchanges to improve patient outcomes appeared first on Microsoft Industry Blogs.

Louisiana’s Health and Human Services programs include child support and other critical public assistance and self-sufficiency programs. To better support the wide variety of services their citizens require across the state, they decided to revamp their call center operations through a case management system that could integrate seamlessly with existing state systems. Microsoft partner, YoungWilliams, is now working with the state of Louisiana to deliver services through a cloud-supported statewide customer service center. I recently spoke to YoungWilliams’ John Tidwell, CTO, John Stapleton, VP of Contact Centers, and Mary Johnson, VP of Special Projects to learn more.

Congratulations on winning the Louisiana Statewide Customer Service Center contract. Please tell me about that project, what’s in scope, and how it helps the State and its citizens?

YoungWilliams will operate Louisiana’s statewide customer service call center, with the option for state departments, political subdivisions, and other government entities to procure services as well. The first new customer service center under this master contract launched successfully on March 11, 2019, replacing previous call center operations for the Department of Children and Family Services (DCFS). We are now providing services for DCFS from our contact center in Bossier City, Louisiana and have plans to open a second facility in Baton Rouge. Our team responds to inquiries and generates outreach on behalf of child support, Family Independence Temporary Assistance Program (FITAP), Supplemental Nutrition Assistance Program (SNAP), and other programs under the umbrella of DCFS.

Please tell me more about YoungWilliams and what your team brings to this Louisiana project.

YoungWilliams is headquartered in Ridgeland, Mississippi. We have over 1,400 employees in 62 offices across 11 states and have provided services to state and local government agencies for over two decades. Our operations include statewide customer service centers, local child support offices, a payment processing center, and legal services for case management projects. Our primary focus is the needs of our state and local customers and their citizens, which has earned the company several awards for excellent customer care.

I understand part of YoungWilliams standard offering is Y-Trac, and that you’re moving that to the cloud. What does Y-Trac provide to Health and Human Services organizations, and what made you decide to move in the direction of the cloud?

The YoungWilliams Y-Trac™ application is a cloud-based dynamic case management solution designed for constituent case work. Y-Trac™ seamlessly integrates with state systems of record, our contact center solution, and Electronic Document Management Systems in order to bring all inbound and outbound channels of communications into a unified workflow, task, and workforce management application. Robust data analytics enable Y-Trac™ to recognize every action that is not automated and requires human intervention, then prioritizes and routes that task to the appropriate person/group who has the right skills to complete the work. All work can be reviewed for quality assurance and scored accordingly. Y-Trac™ provides an unprecedented view into current operations for supervisors, managers, and our state/local government clients to ensure actions are accurate, timely, and compliant with policy, service level agreements, and regulations.

Why did you select Microsoft and Azure as a partner for Y-Trac and the Louisiana project?

YoungWilliams has long been a customer of Microsoft and chose the .Net platform when building Y-Trac™. So, it was only fitting that when we decided to explore Cloud service providers, Microsoft’s Health and Human Services division approached us about partnering to offer state and local government Y-Trac™ and Microsoft Azure Government Cloud together. Because Y-Trac™ was built on Windows Server, Windows SQL Server, and the .Net platform, it proved to be an easy migration to Microsoft Azure Government Cloud. In addition, Azure Gov has the FedRAMP and IRS compliance that is required by our state and local government clients. Moving Y-Trac™ to Azure Gov allows our IT Team, developers, and management access to a wealth of tools, such as ChatBots, Robotic Process Automation, Data Lakes, and PowerBI to further enhance the power of our solutions for our government clients.

What are YoungWilliams’ plans for the future in terms of enhancing the Louisiana solution, Y-Trac, and beyond?

YoungWilliams is working with our partners, like Microsoft, to deliver personalized, proactive, and predictive experiences through advanced AI capabilities for customer service, employee engagement, and business optimization. Along with Robotic Process Automation in Y-Trac™, AI will further enhance our services, providing our clients and their constituents with better outcomes through timely, accurate, and personalized interactions. This will lower costs to state and local government while simultaneously improving performance. When combined with the scalability and security of Microsoft Azure Government Cloud, the sky really is the limit in terms of opportunities for government to transform their operations.

Get more information about Y-Trac^TM and YoungWilliams’ other solutions. You can also learn about the digital transformation of other Health and Human Services agencies.

The post Customer service on a statewide level appeared first on Microsoft Industry Blogs.

As once forgotten diseases start to reappear, state and local government agencies are looking to find new ways to ensure positive health outcomes for their citizens. I had a conversation with Steve and Claire Murchie at Envision Technology Partners. Their WebIZ immunization registry system is leveraging new technologies to help state and local government combat the recent outbreaks of diseases like mumps, measles, and other preventable illnesses.

Steve and Claire, recent measles outbreaks have reignited focus on the importance of immunizations so I’m hoping you can provide an update regarding what state and local governments are doing to ensure proper tracking of children’s vaccinations.

Yes, measles is a big issue – already in early April 2019 we have exceeded the number of cases nationwide for all of 2018. But it’s also mumps, pertussis and even hepatitis A, which has killed more than 40 people in one state alone. These are all vaccine-preventable diseases, which points the cause to less vaccine acceptance. The reasons for that are complex, but information is the best tool to combat vaccine hesitancy, and immunization information systems (IIS) are the primary tool used to track, measure and understand vaccination patterns at a public health level.

I understand health agencies in Delaware and Philadelphia are embarking on immunization data sharing that has the potential to improve immunization compliance and in turn diseases outbreak outcomes. Please tell us about that.

Due to various laws in the US, we don’t have a national registry of immunizations, so responsibility is passed to the state or local jurisdictions to run their own IIS. Until recently, there hasn’t been a clear legal and technology mechanism to facilitate sharing of data between two independent jurisdictions. For the past several years, though, there has been a project sponsored by the Office of the National Coordinator in the Department of Health and Human Services to kickstart this sharing of immunization data, allowing states to maintain a more comprehensive view of patient protection within their populations. ONC’s contribution has included both standardization of the data use agreements between jurisdictions, and they have also stood up a messaging hub which supports the actual data integration.

While the pilot has been open to all public health jurisdictions, the first to complete a production connection were the State of Delaware and the City of Philadelphia. Both happen to use our IIS platform – WebIZ – but we’re actively trying to include some other neighboring jurisdictions as well. The project is described in this March 2019 issue of AIRA’s (American Immunization Registry Association) SnapShots newsletter.

So, Envision’s WebIZ solution is the backbone of this data sharing success. Please tell us more about that solution and where it’s implemented.

WebIZ is used in twenty state, local and territorial jurisdictions overseen by the Centers for Disease Control. We’re a standardized, commercial-off-the-shelf solution that is highly configurable but managed as a single code base. As a result, we can deliver software quickly and reliably without a lot of site-specific customization. And our customers benefit by receiving all enhancements which are paid for by any other customer, which leverages their investment dollars. Like many state and local government agencies, public health has faced years of diminished budgets, so that is a real benefit to them.

Some of the WebIZ implementations are on the Azure Government Cloud. Why are governments choosing that option, and what are the benefits?

State IT budgets are also under pressure, so there is both a movement away from home-grown IIS applications to vendor-supplied solutions, as well as increased support for cloud-based solutions. We were an early adopter of the Azure Government Cloud and have transitioned most of our larger sites over to it. We include hosting as a requirement, and it actually makes our job a lot easier. IIS tend to have a lot of moving parts – web interface, messaging interface, flat file and vital records imports – so it helps if we can have unfettered access to help diagnose problems that may arise. Managing the application infrastructure – which is mostly IaaS today, but starting to take on more PaaS flavors – also means that we have more control over operational upgrades for performance, scalability and security.

Please tell us about innovations in the immunization registry market. With AI being the center of so much attention, is there anything you’re doing to utilize AI to improve immunization registration?

If there is any silver lining to the recent outbreaks, it’s that public health agencies are spending more time slicing and dicing their data in order to learn more about their populations. We’ve been receiving many requests for assistance creating data extracts, and we’ve been adding functionality to make it easier for customers to analyze their own data, but there is a lot of variability in the technical resources available to immunization programs. So, we’ve been looking at tools like Power BI to increase the options available to less-technical users, while expanding the power of more advanced analytics through machine learning and related features. Some of the machine learning features have potential in our ongoing challenges with patient-matching, which plagues most large-population, multi-contributor databases.

Get more information about WebIZ. You can also request a free trial of Microsoft Azure Government and learn more about Microsoft’s Health and Human Services Solutions.

The post Measles and mumps? Data sharing on the cloud to improve public health appeared first on Microsoft Industry Blogs.

As the human services agency for the State of Arizona, the Department of Economic Security (DES), led by Director Michael Trailor, offers more than 40 programs and services, which include child support services; child care assistance; employment services; unemployment insurance, nutrition, cash and medical assistance; shelter services; and supports for individuals with developmental disabilities.

DES’s first chatbot project focused on the Supplemental Nutrition Assistance Program (SNAP) and the associated policy manual that helps employees determine eligibility. The challenge was streamlining the eligibility process. The current process for determining eligibility for Nutrition and Cash Assistance can be complicated and create delays in several areas. In some cases, applicants wait in lines to meet with a DES employee to review his or her application, and the employee may need to look up the relevant policies in the online eligibility manual before making a determination. Because the eligibility process involves document verification and a series of questions, the added task of looking up policy online can make a long process even longer.

Andy Pitman, Director of State and Local Government Health and Human Services Solutions, recently sat down with Sanjiv Rastogi, CIO of Arizona DES, to discuss its chatbot progress.

Sanjiv, please tell us a bit about the mission of DES.

DES is the human services agency for the State of Arizona. We serve approximately 2.9 million citizens with services across the spectrum – from unemployment insurance to nutrition assistance to developmental disabilities to child support, for example. DES invests approximately $4 billion to serve those in need. Our mission is to make Arizona stronger by helping Arizonans reach their potential through temporary assistance for those in need, and care for the vulnerable.

So, part of that mission is assisting Arizona citizens in their enrollment for programs like SNAP.  I understand that can be challenging. Please explain why.

The programs we administer are supported through a combination of state and federal government funding. This funding requires eligibility determination before offering services. Due to the manual nature of the eligibility process and lengthy manuals, it is a complex process. Finishing these interviews in a timely manner with 100% accuracy has been nearly impossible until now, and some of our applicants must come back a second time and may have the decision for benefits impacted.

You felt that a chatbot could improve discovery of that information so that the citizens’ enrollment experience could be improved. Please tell us about that.

As we looked at areas of improvement to the quality of service to citizens, we met with the Division of Benefits and Medical Eligibility (DBME) and determined that the benefits eligibility process was the most significant friction point. Our employees required 16 weeks of training before they were qualified to interview applicants. Our evaluation uncovered three possible solutions:

• Easy access to Frequently Asked Questions (FAQs)
• More training
• Modernizing our technology

In the spirit of lean transformation through the Arizona Management System (AMS), we landed on implementing modern technology to truly address the problem, which led us to the idea of a chatbot. Thus, SEAN (Service Evaluation Answers Now) was born.

The SEAN bot enables employees to access FAQs and the exact section of the manual needed to move the interview process forward more accurately and quickly. By shortening the length of the interview and providing the correct determination of eligibility the first time, rather than requiring multiple visits. As a result, wait times are expected to reduce dramatically.

How did you build the chatbot, and why did you choose the Azure platform?

We already use Microsoft solutions and wanted to build on the systems we already had. It had to be a flexible, scalable, reliable platform, so we went to Microsoft partners to ask what suggestions they had. MAQ Software helped us decide on and implement a solution built on Azure with cognitive services, which gives us the grow-as-you-go infrastructure, platform, SaaS, and AI integration that DES needs. The level of confidence we have in this solution allows us to build, not just for today, but as an evergreen platform that will bring DES into the future.

What’s next for AZ DES in terms of using AI?

The majority of services provided by DES require eligibility evaluations and determinations, which inherently require the use of policies and manuals and regulations. We want to scale this solution to other services where the same kind of capabilities are needed.

Our goal is to expand the SEAN bot we built for SNAP across all divisions at DES, and eventually, create a citizen-facing bot, so they can access information in the policy manual and be more prepared when they come in for eligibility interviews. Technology has the unique ability today to help us leapfrog how we deliver services to our citizens.

We are looking at different possibilities to do that without having to change the underlying legacy systems immediately. Innovation with tech is our path forward.

Be sure to listen to our latest podcast and learn more about AI in social services.

The post SEAN: Arizona Modernizes the SNAP Eligibility Process via Chatbot appeared first on Microsoft Industry Blogs.

The startling headlines and statistics about prescription opioid abuse in the United States have become all too common: according to the Pew Research Center, opioid abuse and overdoses cost the national economy more than $500 billion annually.¹ A 2017 survey by the National Safety Council found that 7 in 10 businesses report negative outcomes, such as lost productivity and missed work, due to prescription opioid abuse.² And, the Centers for Disease Control reports that overdose deaths related to prescription opioids were five times higher in 2016 than 1999.³

To combat the dramatic rise in prescription opioid abuse and overdoses, states are regulating opioid prescriptions and dispensing through the use of prescription drug monitoring program (PDMP) systems. In fact, 49 states have laws mandating a PDMP, with 40 states requiring by law that healthcare professionals query a PDMP database before prescribing an opioid.

We spoke with Doug Rogers, a Senior Vice President with Microsoft ISV partner, NIC Inc. about their new solution RxGov – how it is transforming this industry and utilizes the best from the Azure platform. This solution was selected in January 2019 as the secure technology platform to collect information about controlled substances dispensed in the state of Maryland.

Q: Tell us about NIC’s role in combatting the prescription opioid epidemic.

A: For several years, state governments have had basic, compliance-driven PDMP systems in place. However, to keep pace with combatting the opioid epidemic, these systems now need to provide a broader array of services to several stakeholder groups beyond doctors and pharmacists. NIC developed its first PDMP systems in 2011 for the state of Montana, and our flagship system was built for the state of Wisconsin in 2017. Recently, NIC acquired technology assets in 2018 to enhance our PDMP offering, RxGov. This solution, powered by the Azure cloud, is a powerful new public health tool that will support more informed decisions by healthcare professionals.

Q: What is one of the main benefits RxGov offers that current providers do not?

A: In a market previously dominated by a single provider, one of the key benefits RxGov delivers is more transparent data. RxGov offers complete data traceability, with no data loss. Meaning, special alerts notify a healthcare provider or pharmacist if a particular field of data has an error, or data is missing. This prevents incorrect data entry of patient prescriptions ending up in a “black box.”

Q: With more and more news about artificial intelligence and machine learning in our society, are those technologies applicable to PDMP systems?

A: Absolutely. Healthcare is no exception. RxGov uses a unique patient-matching algorithm driven by machine learning to match nicknames, maiden names, former addresses, etc. into a single patient record. This is a key component to prevent doctor shopping by those addicted to prescription opioids.  We utilized Microsoft Azure Machine Learning to drive this capability, enabling access to powerful cloud-based AI functionality.

Q: Who are the primary users of PDMP systems and how do they help communities solve this crisis?

A: When communities have access to transparent data, they need to generate reports easily for a variety of needs. RxGov has extensive data visualization capabilities to help healthcare providers compare their prescribing habits to other professionals in their specialty and/or region; allows law enforcement to track hot beds of prescription opioid activity in a particular community; and researchers and public health officials can identify which prescription opioids are posing the greatest threat in their area.

Q: Tell me more about how RxGov will be used to provide better patient outcomes.

A: In the case of an overdose, seconds can mean the difference between life and death. In these situations, emergency room doctors need information immediately. RxGov provides this immediacy with real-time alerts that empower clinicians with information about doctor shopping or the fulfillment of prescriptions. And, RxGov integrates securely and seamlessly with electronic health records and health information exchanges, meeting privacy and security mandates. From the emergency room example where seconds make a big difference, to the convenience of providing care during a routine physician office visit, RxGov offers healthcare providers the integration that is important in providing the very best patient outcomes.

Q: What else should readers know about NIC’s RxGov solution?

A: While the opioid epidemic is a tough topic, it is an important one. This crisis is top of mind for our President, Congress, and Governors. A PDMP system like RxGov is an important step in combatting the epidemic. Our RxGov PDMP platform is available today. Not only does this new solution provide choice and enhanced functionality, but the launch followed an important federal announcement. On June 18, 2018, the Centers for Medicaid and Medicare Services (CMS) announced a 90/10 federal match program, allowing states to enhance or replace an existing system while only paying for 10 percent of the costs, with the federal government through CMS covering the remaining 90 percent. And in October 2018, the SUPPORT Act was signed into law by President Trump, which designates additional funding for PDMPs.

Now is the time for states to evaluate their current PDMP solution. RxGov provides new, more robust functionality and can now be funded affordably with the CMS matching grant.

Learn More:
RxGov’s national rollout continues, with the platform to be showcased at the 2019 Healthcare Information and Management Systems Society (HIMSS) Interoperability Showcase. Learn more about how your state can deploy this solution to help combat the prescription opioid epidemic.

¹ Rising, John and Doyle, Sheri, “The Industries Hardest Hit by the Opioid Crisis.” The Pew Charitable Trusts, August 30, 2018, http://www.pewtrusts.org/en/research-and-analysis/articles/2018/08/30/the-industries-hardest-hit-by-the-opioid-crisis

² “How the Prescription Drug Crisis is Impacting American Employers,” 2017 study, National Safety Council, https://www.nsc.org/Portals/0/Documents/NewsDocuments/2017/Media-Briefing-National-Employer-Drug-Survey-Results.pdf

³ General Information on prescription opioids, The Centers for Disease Control and Prevention, https://www.cdc.gov/drugoverdose/data/prescribing.html

The post Combatting the prescription opioid epidemic appeared first on Microsoft Industry Blogs.

As part of our concerted effort to deliver the vertically specific solutions state and local governments need, we work with industry leaders like Sagitec. I originally met David Minkkinen, Sagitec’s Senior Partner, about three years ago and was thrilled to catch up with him recently on how Sagitec is helping states modernize their unemployment insurance (UI) systems.

Many states seem to be modernizing their UI solutions. What’s driving that activity?

Our clients typically come from primarily paper-based legacy processes that are on a mainframe. It’s very costly to maintain a mainframe system and it’s difficult and time consuming for states to respond to frequent changes in UI federal policy with these rigid legacy systems. So they’re modernizing to reduce costs and be able to more quickly respond to policy changes. They also want to deliver better service to their constituents—which include employers, third-party administrators, and claimants—who expect efficient, online services.

How is Sagitec helping those states?

We offer states a modern technology solution called Neosurance^TM, which is an unemployment insurance, tax, benefits and appeals system. It’s a comprehensive, integrated system, which is critical because the tax and benefits systems share a lot of data. So it provides the customer with better data integrity.

It includes self-service portals for claimants, employers, third-party administrators, and UI agency staff. Each portal is tailored for the particular requirements of each of those constituencies.

Neosurance^TM also offers a very flexible architecture so states can quickly adapt the solution to State and Federal policy updates.

And because it’s on the Microsoft Azure Government cloud, states benefit from a proven and flexible solution that minimizes datacenter investments and helps them meet their requirements for security, compliance, and oversight.

Sagitec recently completed the South Carolina UI modernization. Tell us about that project.

South Carolina wanted a modern, cloud-based UI Tax system to replace its legacy tax system. The state wanted the new system to integrate with its UI benefits system so that UI business processes could be streamlined and overall data integrity improved. And they had a big emphasis on enabling self-service for their constituencies.

We helped South Carolina accomplish all of its objectives with tremendous success. In the first quarter, the state’s new system—which is on Microsoft Azure Government—was used, it achieved:

• A 97 percent self-service adoption rate for employer wage reporting, significantly reducing paper-based wage filings.
• A 98 percent self-service adoption rate for employer registrations.
• An 86 percent self-service adoption rate for employer account updates.
• Over 90 percent of tax payments were processed using electronic payment processes—virtually eliminating paper checks in the first quarter of implementation.

Since employers and third party administrators can do most of their own account management using the self-service portals, it frees up South Carolina’s staff to focus on more strategic, value-added activities.

Why is the cloud especially helpful for UI systems?

One of the big reasons is because the demand fluctuations on UI systems are huge. Our clients benefit greatly by being able to scale and pay as they go for cloud computing.

On the tax side, in the last few weeks of a quarter, there’s a significant uptick in demand as employers and third party administrators submit wages and tax payments—and the rest of the quarter is pretty quiet. And on the benefits side, claimants typically file at the beginning of the week—with very few claims the rest of the week.

So it’s much more cost effective for our clients to be able to scale computing capacity up or down based on demand fluctuation versus building out an infrastructure to peak capacity when they’d only use 20 percent of it most of the time.

How can people learn more about Sagitec’s offerings?

Check out www.sagitec.som, and download the Sagitec white paper, or contact Sagitec directly.  Learn more about Microsoft Azure Government, or contact Microsoft.

The post Why states are modernizing unemployment insurance (UI) systems with the cloud appeared first on Microsoft Industry Blogs.

Given the recent requirements from the Centers for Medicare and Medicaid Services (CMS), states are under pressure to start updating their state self-assessments (SS-As). Our partner Electronic Health Resources, LLC (EHR) can help them complete that rigorous process in a way that saves time and money.

I recently caught up with Claire Bradt, Director, EHR, to learn about how EHR’s latest version of ReadyCert—which is on Microsoft Azure Government, can help state Medicaid agencies and their technology vendors with not only their SS-As, but the entire CMS certification process.

What is ReadyCert?

ReadyCert is the only tracking tool that is specifically designed to make a state’s Medicaid Information Technology Architecture (MITA)-related tasks and CMS certification easy to understand and complete. It helps states and vendors assess Medicaid Enterprises and comply with all CMS certification activities.

ReadyCert also has the capability to assess the compliance in other Health and Human Services programs including National Human Services Interoperability Architecture (NHSIA), Substance Abuse and Mental Health Services Administration (SAMSHA), Health Information Technology for Economic and Clinical Health (HITECH), and National Institute of Standards and Technology (NIST) assessments. ReadyCert can actually be used for any assessment with defined requirements.

How does ReadyCert help state Medicaid agencies and their technology partners modernize Medicaid solutions and comply with MITA?

ReadyCert was developed to answer the call from state Medicaid agencies (SMAs) and technology vendors for a MITA-aligned tool for the current modular approaches to modernizing Medicaid solutions. It links the entire MITA framework to business, technical, and information architectural components—and subsequent deployed solutions.

ReadyCert supports the annual SS-A update process efforts through the CMS Medicaid Enterprise Certification Lifecycle (MECL) and the newly announced Medicaid Eligibility and Enrollment Lifecycle (MEELC). ReadyCert comes configured with the MITA 3.0 framework, including the Business Process Model (BPM), Business Capability Matrix (BCM), as well as downstream elements, like the newly released Medicaid Enterprise Certification Toolkit (MECT) 2.2 and Medicaid Eligibility and Enrollment Toolkit (MEET) 1.0.

What’s different about ReadyCert compared to other options?

ReadyCert makes the planning, procurement, and certification of state Medicaid enterprises a much easier proposition than it has been in the past. It drastically reduces the time and cost to conduct and maintain an SS-A.

It’s more than a spreadsheet—it’s an actual tool that allows for user roles, defined reports, analytics, and process monitoring through every step of an SS-A. And it makes the SS-A data available to all stakeholders as the Medicaid Enterprise moves from SS-A to later MECL activities—helping to increase collaboration.

How are you and your clients benefiting from ReadyCert being on Microsoft Azure Government?

We can meet the increasing and evolving needs of states across the country with the scalability of Microsoft Azure Government. It also helps us provide the cybersecurity, compliance, and reliability states need—its geo-redundant datacenters mean ReadyCert has a 99.95 percent uptime. The cost-effectiveness of the overall solution on Azure Government makes it much more accessible to all. And with cloud services, agencies can get the services they need without the overhead of maintaining infrastructure.

How can one learn more about ReadyCert?

Visit EHR’s website at www.ehr-llc.com to request a demonstration, or just contact Claire directly at cbradt@ehr-llc.com. You can also come see a demo at the Medicaid Enterprise Systems Conference, which is August 13 – 16, at EHR’s booth #66.

The post States’ CMS certification is easier with MITA tracking tool appeared first on Microsoft Industry Blogs.

Before Jim Calanni joined Microsoft partner Eccovia Solutions, he was chief technology officer for the Colorado Springs-based Community Health Partnership (CHP), which managed the care of over 180,000 members in Region 7 of Colorado’s Accountable Care Collaborative. Jim led the design and development of a comprehensive, data-sharing infrastructure linking primary care, mental health and social services providers across a region, in this case, Southern Colorado.

Jim recently shared his wealth of expertise in an Eccovia Solutions webinar to help other areas create their own comprehensive care plans for healthier individuals and families. Jim and his CHP colleagues used technology from Eccovia Solutions and Microsoft to develop a true community care program as opposed to the more typical solution revolving around historical charting of past medical issues. “The paradigm shift that I saw when I took my previous position at the Community Health Partnership was moving from disease treatment to a prevention model,” he explained. “How do we get in front of the problem of chronic conditions or social-economic factors that contribute to reduced health for folks?”

The CHP team first looked at healthcare costs and where money was being spent. They found that most dollars were going toward pharmaceuticals, with very little spent on preventing medical problems. To reverse that trend, Jim said, “we wanted to build an infrastructure that was capable of collecting data at the ground level and then moving that data into an organized fashion, coalescing it into information, and then moving that information into knowledge by beginning to apply some data analytics and science to it.” The outcome: getting enhanced information into the hands of the broad, coordinated health community to have a greater impact on the public becoming healthier through preventive measures.

CHP used Eccovia Solutions’ ClientTrack Care Coordination platform, powered by the trusted Microsoft Azure Government cloud, to manage patient care with multiple agencies across the care continuum. Over the past five years, their innovative community care program revolutionized the Medicaid delivery system through a collaboration of local health providers. The coordinated, community-based strategy also optimized the outcomes and care of high-risk populations, such as the homeless, children in foster care and those who overutilize emergency departments.

For communities considering developing a similar care coordination framework that enables a comprehensive care plan, Jim suggests asking these six questions:

• “Why are you trying to do this? It’s the most important thing to start with.”
• “Who controls the data you’re trying to get? It can be a very disruptive and complicated process … to get access to data.”
• “How are you going to impact what you’re trying to do? Do you have a leader in the community who’s going to drive this?”
• “What are you going to do with the information … how are you going to dispense it throughout the community?”
• “When do you want to do this? … You’re going to have to overcome the legal considerations of how you gather such data and very serious privacy considerations on how you distribute the data.”
• “Where are you placing the data? I personally have worked very closely with Microsoft’s Azure platform … a secure environment and Microsoft is leading the industry with machine learning … it’s an all-encompassing data environment.”

Jim called the “icing on the cake” of his Colorado experience the ClientTrack tool, which provides the flexible interface for rules-based sharing of data with the coordinated health community—hospitals, medical professionals, health and human services providers, nonprofits and more. It’s exciting that Jim is now sharing his experience and insights with more U.S. communities interested in pursuing a comprehensive health plan. To learn more, please see:

• Creating a Shared Community Care Plan webinar
• ClientTrack Community Care Coordination
• Microsoft Health and Human Services
• Microsoft Azure Government to request a free trial.

The post Developing healthier communities through comprehensive care plans appeared first on Microsoft Industry Blogs.

In Part 2 of our series on how Microsoft partner Pondera Solutions is helping state governments combat fraud, waste and abuse, we learn why Azure Government was selected to power its advanced prediction algorithms. Pondera’s founder and CEO Jon Coss also shares some compelling examples of fraud-detection results since forming the company in 2011. In case you missed Part 1, please click here; otherwise, enjoy Part 2!

Can you elaborate on why Pondera selected Microsoft Azure Government to deliver the cloud power for your solutions?

If a technology is already available to do what we need, then we’re not going to build it … We apply our intellectual property more on the fraud algorithms and fraud-detection services … We were building our stack using Microsoft for a number of years and decided to build our constraint-based modeling system on Microsoft. We think this system is critical to detect fraud patterns, both existing and emerging, in a way that traditional predictions tools cannot do. But this requires us to perform huge numbers of calculations in a short period of time—and Azure can accommodate this.

Then you (add) the work you are doing in artificial intelligence, Microsoft Azure Machine Learning, Azure Data Lake, etc.—those are all things that we can apply to this problem … We literally have this seamless platform and our clients don’t have to worry about the underlying technologies. They know that it’s secure, they know that it’s scalable, they see evidence of it being integrated and that we’re passing these very high-quality, investigation-ready leads to them. I think that you’re quite possibly the only company in the world that could have accommodated us!

Jon, can you provide a few examples of outcomes achieved for your government clients?

To date, our system has identified well over $5 billion in likely fraud; our clients have collected or prevented hundreds of millions (of dollars); we’ve seen dozens of indictments … We don’t talk about a lot of our clients’ cases … but some clients talk about their cases specifically. For example:

• One fraudster had set up a fictitious business (and) had actually stolen a number of IDs from people that were using student visas. The “business” was set up to hire employees using these fake or stolen IDs. Then, shortly after hiring them, they were fired and unemployment insurance claims started to get filed against the business from about five states … The one state that had our system was able to pinpoint what this person was doing and why they were suspicious … so they ended up prosecuting the case.
• We also helped bust a scheme where a couple of folks in a Southeast state had created a business in the Midwest. They started doing tax claims against that business, obviously for refunds, and the refunds were being sent to homes that were either foreclosed or for sale because no one was there to pick up the mail. They were likely working with a real estate agent that was telling them “here’s where you should send them” and then literally following the mail truck around to pick up the checks.
• We had one state that went to an industry trade show and said that, in the first three months of turning on our system, we identified $117 million worth of what they called high-collectable, high-yield fraud, waste and abuse.
• We had another state that when we turned the system on, they got more than 300 examples of fictitious businesses that were operating in the state that the state then closed down.
• Another program … using our system in combination with their detection team suspended about 30 percent of the Medicaid program providers, took 40 percent of the dollar flow out and issued a number of indictments.
• Where we do case management and we can directly measure results, typically our return on investment is just around 300 percent on detection—and that does not consider prevention, which would measure how long would someone have been able to operate if our system wasn’t in place to stop them?
• The opioids (crisis) is such a hot topic. Our system has helped states identify doctor shopping, pill-mill activities, those types of things. In some cases, we actually found patients that in a single quarter were receiving upwards of 200 prescription medications from different providers and pharmacies in a state … Most of those drugs that were obtained through the Medicaid program end up being sold on the streets.

How should prospective Pondera customers learn more?

They can certainly visit our website and I’d encourage them to watch our product videos and videos about some of our investigators. But we also like to put people in touch with one of our clients, because they’re our best salespeople … Then they learn more about techniques, about what has and hasn’t worked, how they use the analytics.

When they talk to us, they’re going to talk to somebody who came out of state programs. We hire more than half of our employees directly out of government; we have former FBI agents, state law-enforcement officers, data-mining specialists, Medicaid fraud control unit officers, unemployment insurance fraud investigators.

What about the future of fraud detection?

I think we’re heading in the right direction. This focus on investigation-ready leads should make companies like us a lot more accountable … Certainly this focus on sharing techniques and even data across states and programs. We’re all in this together, and if we build this club of vendors, of states, of programs and we look at this problem together, then what I’d really love to see is that we start talking about eliminating fraud instead of fighting fraud.

Anything else?

Microsoft seems to have made a real shift … The technology and Azure and the things you do to support us are great, but the fact that the company is behind us is really important … You’re trying to address real-world problems … that’s exciting to us … Fraud, waste and abuse in government is just a massive problem. We appreciate that Microsoft sees this and isn’t solely focused on selling us more Azure computing power. Instead, you’re helping us get the word out to more people about just how serious a problem this is. That kind of support from Microsoft is a really big deal to us.

My thanks to Jon for sharing his insights. We’re humbled to support such an innovative company that’s providing world-class services to governments—and benefiting taxpayers. Please:

• Contact Microsoft to find out how we or Pondera can bring an Azure planning session onsite to your team.
• Discover why Microsoft Azure Government is the most trusted cloud for U.S. government agencies.
• Learn more at the Pondera Fraudcast Blog.
• Read Government Technology’s recent article, “Pondera Uses Azure in Fraud-Detection-as-a-Service Solution.”

The post Using Azure to help governments fight fraud and waste—Part 2 appeared first on Microsoft Industry Blogs.