mita tac group gateway 5010 goals gateway 5010 deliverables gateway 5010 architecture business...
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MITA Gateway 5010 Overview
May 18th 2009
Gateway 5010 - Agenda MITA TAC Group Gateway 5010 Goals Gateway 5010 Deliverables Gateway 5010 Architecture Business Services
Inquire Member Eligibility Technical Services and Functions
Connectivity - CORE Service Eligibility Adapter Authentication & Authorization Auditing
Prototype Next Steps
MITA TAC Group
Recommends technical standards for use within MITA
Made up of states and leading healthcare vendors Ensure MITA aligns with industry standards and
direction Creates working prototypes and proof of concepts
Gateway 5010 – Goals
Align TAC committees to real working projects Collaborative development of one MITA business
service and associated technical services Iterative approach going from very simple to
complex interface Publish recommendations to the TARB Deliver real solution sets Recommend rules for interoperability Identify and integrate with other industry
initiatives HITSP, HL7, OASIS, WS-I …….
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Gateway 5010 Architecture
Gateway 5010 Overview
CORE Service – S2M1• Provides connectivity
and specifies protocols
Adapter – S3M3• Transforms data into the
MITA compliant format
MITA Service – S1M3• MITA business service
performs the functional-ity
Gateway 5010 – Deliverables
Publish recommendations to the TARB on details of the MITA technical architecture
Deliver solution sets that will allow any CORE compliant provider to conduct eligibility inquires with any MMIS that deploys the solution set
Create technical service(s) in the Gateway suite of technical services that will allow MITA to exchange standards based data
A development community that has been educated on building MITA based systems
Gateway 5010 – Architecture
Provides pathway for implementing new X12 5010 Standard
Includes use of a MITA business service Inquire Member Eligibility
Includes use of MITA technical services and functions Connectivity – CORE Service Translator – Eligibility Adapter Authentication Authorization Auditing
Gateway 5010 – Architecture
Gateway 5010 – Architecture
Inquire Member Eligibility Service (IME) Business Service from the MITA business model Interface developed iteratively
S1M1 – Simple interface using Member Id S1M2 – Interface has some complex objects e.g. returns a list
of benefits S1M3 – Interface has complex and more complete ob-
jects e.g. more benefit and healthcare provider data S1M4 – Interface uses some HL7 base objects to define data
such as address and provider Incorporating HL7 objects in the data schema defi-
nition Developing standard WSDL to be used by all im-
plementers
Inquire Member Eligibility – Data Model
Inquire Member Eligibility – Overview
CORE Service Developed by CAQH Widely used within the Healthcare industry Adopted as a HITSP standard – HITSP-T85 Provides communication via a web service or MIME Mul-
tipart Supports real time and batch processing Interface will be implemented iteratively - 3 options for
SOAP/HTTP(S) implementation S2M1 – Uses username and password (unencrypted) S2M2 – Uses username and password (encrypted) S2M3 – Uses certificates for authentication
One option for the MIME Multipart implementation S2M4 – Uses username and password
CORE Service – Real Time Model
CORE Service – Batch Model
Inquire Member Eligibility Adapter Technical service that transforms an X12 270
request into a MITA compliant message and transforms a MITA compliant response into an X12 271 response
Will be able to communicate with multiple Eligibility systems
IME Adapter – Model
Gateway 5010 – CMS TARB Artifacts
For each technical and business service the following artifacts will be generated and submitted
Business or Technical template describing the service
UML Model of the service The data schemas (XSD) and Web service Definition
Language(WSDL) for the service Document describing how the service works
Gateway 5010 - Prototype
Based on an existing Eligibility system in production The front end application was modified to call the
CORE Service for connectivity The CORE Service calls the Eligibility Adapter
Translates the 270 request into MITA compliant request Translates MITA compliant response into a 271 response
The Eligibility Adapter calls the MITA compliant Eligibility Service
The Eligibility Service retrieves that data from the eligibility database or legacy system.
IME Activity Diagram
Gateway 5010 – Next Steps
Complete the interface specification for Inquire Member Eligibility
Create a package of IME artifacts for the TARB review
TAC members to implement the published IME interface
Show a demo of IME at the MMIS conference in August 2009
Gateway 5010 - Questions