Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsMMIS is aligned closely with the Medicaid Information Technology Architecture (MITA) and supportsthe core principles of business, technical, and information architecture.Business ArchitectureFrom a system perspective, business architecture articulates the structure of an enterprise in terms of itsbusiness processes and business information. The business processes describe the "how" of achieving thegoals of the enterprise. In articulating the process and information, the business architecture considers allstakeholders of the enterprise (including providers and members) to ensure that the entire end-to-end flowis captured. The MITA business architecture synthesizes these business processes into business areagroups and decomposes each of those process groups into processes. The MITA framework provides agood reference point for determining the maturity and comprehensiveness of the business architecture ofany solution. eCAMS, with its SOA designed architecture and the EXACT SOA framework, ensures thatthere is a very close alignment with the MITA process groups and areas, and also provides tools andservices to continuously improve the business process capabilities.The new MMIS has a portfolio of business and technical services that enable it to support businessprocesses more effectively. The new MMIS' business-driven architecture employs the use casemethodology, where business cases drive the overall technical solution. The solution provides thecapability to support current and new business processes for successful operations, and is in alignmentwith the MITA business architecture.The new MMIS addresses system usage from different stakeholder perspectives by considering thedifferent viewpoints that business users experience from both form and function of the system. Thefollowing diagrams show how the proposed solution addresses the business needs of the three keystakeholders of the new MMIS:• Department's executive and management team• Provider Community• Member CommunityThe executive management view, shown in Figure 9-3, is one of the perspectives used to providetransparency and visibility to the Department about the performance and health of the overall program.This view uses the key performance indicators (KPI) which have been agreed-upon for the project, toevaluate the overall health of the program. The key aspect that the new MMIS shows is the trends of theseKPIs to predict and forecast potential issues in a given business process area. This enables a moreproactive mode in to be used in managing the program. The business process areas and their associatedmetrics are also mined to identify cause-and-effect and correlation between these metrics to provideunique perspectives in the different aspects of the program. This is implemented by integratingtechnology tools and frameworks, such as business activity monitoring (BAM), to achieve improvedbusiness processes, enhanced data quality and accessibility, and conversion to standard formats. The viewprovides the user with timely, accurate, and actionable information on the status, trend, and health of theoverall business processes. All this is delivered via eCAMS HealthBeat which provides a rich userinterface, interactive graphs, and actionable data sets.9 | 6