Part 4 - Iowa Medicaid Enterprise

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RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsIn addition to its focus on reusability and singularity, Team Noridian's approach to interface managementprovides the following capabilities:• Scheduling and orchestrating data exchanges in a completely-configurable fashion. EXACT'sOrchestration services provide the flexibility to address needs of individual interface partnersexchanging data with the new MMIS. Combined with its rules, translation, and other services as well asthe suite of services inherent to eCAMS, which are accessible through EXACT's Integration Services(ESB, Mediation, and translation services), Team Noridain's new MMIS enables automation of theinterface process. As a result, manual intervention will only be required to handle unique exceptions.• Completes the communication loop by providing feedback to the business partners. Feedback to thesystem administrator and interface partners as to the successful transmission of data and otherpertinent information. This functionality is configurable on an individual interface level.• Provides automated alerts and notifications to the external system and system administrators wheninterface events are not occurring according to an interface's Definition.• Applies checks and balances on the incoming interface data to ensure data integrity, quality, andvalidity before the data is applied to the new MMIS. Where appropriate, pre-validation of data caninclude complex business rules, including initiating a workflow in OnBase.• EXACT's Integration Services, comprising of EXACT's ESB, Mediation and translation services,controls the data traffic between the new MMIS and the external interfacing systems.• Provides data transfer security. The web service and file-based interface framework provide a robustframework that transmits data in a secure manner. When implementing Web services and file-based,interfaces, this implementation adheres to the Health Insurance Portability and Accountability Act(HIPAA) security guidelines. An internal communication framework also provides a securecommunication path between the eCAMS core system and the EXACT framework.Team Noridian's interface management approach to automate the management and monitoring of the newMMIS interfaces include the following:1. Team Noridian will document all external system interfaces in Interface Control Documents (ICD)(Deliverable 3.5) to document the inbound and outbound interfaces with systems external to theMMIS. The ICDs will include the message structures and protocols, data structures, mapping logic,business process and rules, audit trail and error messaging requirements, escalation procedure,notification channel, scheduling, and other pertinent interface information (collectively, an interface's"Definition"). The ICDs will be organized by business process area and will be further categorized bythe set forth in the Interface Plan section below.2. Pre-built eCAMS interfaces that align with the current MMIS external interfaces set forth in RFPSection 7.1.5 will be modified as needed in accordance with each interface's definition. The definitionwill be stored in the eCAMS ISR.3. New interfaces will be built according to the requirements set forth in the applicable interfaceDefinition. The definition for each interface will be published as a service to EXACT's ServicesRegistry, which uses UDDI standard to store and register services.4. The business process for each interface will be determined by its Definition. The process will be builtusing EXACT's Orchestration services, which leverages and enhances the capabilities of theActiveVOS BPEL/BPMN engine used by EXACT.5. EXACT will automatically synchronize the contents of the ISR and the EXACT Service Registry,updating the EXACT Service Registry on a predefined schedule as well as upon a triggering event,such as a modification of an eCAMS pre-built interface.6. EXACT's Service Registry will maintain a universal interface catalog that provides a single source oftruth as to the current status and historical changes for all interfaces.8 | 30
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS Operations7. Real time access and reporting capabilitieswill be available via the eCAMSHealthBeat Dashboard. Figure 8-19illustrates the synchronization service anduniversal interface catalog maintained byTeam Noridian's new MMIS.8. In the event of a transfer error or failure,EXACT will initiate the alert andescalation procedures according to theinterface's Definition stored in the ServiceRegistry. EXACT supports multiplechannels of communication includingemail, Simple Network ManagementProtocol (SNMP) and can send alerts to aNetwork Management Console or NetworkOperation Center. EXACT also supportsthe use of Business Activity Monitoring,which can be access through the eCAMSHealthBeat Dashboard.9. In addition to automating the managementand monitoring of interfaces, EXACT alsoinherently provides the ability to automatepre-validation of data prior to upload toeCAMS. EXACT's dynamic capabilitiescan support simple pre-validation rules aswell as complex rules which may requireaccess to data located on internalDepartment systems or external third-partysystems.10. Likewise, EXACT can enable theautomation of error handling and exceptionresolution. An automated process caninclude reconciling transfer data withupdated information located eitherinternally or externally to the Department.11. EXACT automatically produces a full audittrail of all service activities for an interface.This information, including error logs,exception resolution status, and success orfailure of any particular transfer is accessiblevia the eCAMS HealthBeat Dashboard.Figure 8-19. Team Noridian's Universal InterfaceCatalog and Synchronization Service. This catalogprovides the Department a single source of truthand access to the current status of interfaces andhistorical changes.Team Noridian's new MMIS recognize the following four interface functional groups:8 | 31
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Part 4 - Iowa Medicaid Enterprise

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