After spending nearly $800 million on eight seasons of Game of Thrones, many fans were disappointed in the results, and few of the surviving characters were happier or better off by the time the story ended. Don’t let your Medicaid Information Technology Architecture (MITA) end like Game of Thrones.
You may find yourself asking, how does Game of Thrones relate to MITA?
As Tyrion said, it’s about the importance of stories. “What unites people?” Tyrion asks. “Armies? Gold? Flags?” he says. “Stories. There’s nothing in the world more powerful than a good story.”
Your story is important. If you don’t have a cohesive story in your MITA roadmap about the impact of the changes, it’s going to be nearly impossible to modernize your systems and achieve the MITA goals you’ve set for your organization. Goals that will:
- Enable Medicaid managers to improve health care outcomes
- Integrate clinical and public health data with Medicaid claims data
- Mesh with federal health architecture
- Overcome organizational silos to enable a person-centric view of health improvement
- Use common IT and data standards so that data can be easily shared
- Promote interoperability between and within State Medicaid organizations
- Allow web-based access and integration
- Encourage the use of commercial off-the-shelf (COTS) software to promote reusability and lower costs
Why is your story important? Because “The night is dark and full of terrors.”
While that may be a little dramatic, the old Medicaid Management Information Systems (MMIS) are scary and lack cohesion. Medicaid represents one in every six dollars of healthcare spending in the United States, so if we are going to impact healthcare outcomes, Medicaid is a good place to do that.
So, how do you get a better result with MITA? First of all, plan. Don’t be a Stark who rides south unprepared. It didn’t end well for them, and it won’t end well for you. MITA isn’t about the scorecards; it’s about knowing your goals and working across silos to achieve the results that you want.
This will take a lot of planning and telling your story over and over. When you call your Bannermen and women to unite to rebuild your systems using the MITA framework, you need to tell a story about how it will all work together – just like the various armies came together to defeat the Night King.
States will need to work across organizational boundaries and understand their business processes in order to lay out a good plan. The scorecards in the State Self-Assessment (SS-A) are there to rate how well you are doing the detailed work that needs to be done for a cohesive system – such as whether people are equipped with dragonglass daggers (electronic records) or conventional weapons (paper).
The SS-A tracks the details of achieving MITA Maturity Levels, but scorecards do not define the overarching goals. One of the goals of the transition from the old standalone MMIS claims reimbursement system is to build a MITA system framework that allows Medicaid managers to improve healthcare outcomes by integrating with other systems, especially public health and Health Information Exchange. As Daenerys said, “I’m not going to stop the wheel. I’m going to break the wheel.”
You don’t want to end up like her, but the sentiment is the same. If you are only making small or random changes, you can’t have true system modernization. Integration with healthcare providers has the potential to “break the wheel,” and the MITA framework allows all of the states with their disparate systems to have a common framework that provides interoperability and modularity that should lower systems costs and increase efficiency on the system.
So, make sure that you have a solid roadmap and that you are tracking progress towards achieving it. Don’t be like Circe – “Queen of the Short-Term Advantage,” be like Sansa, “Queen of Long-Term Planning and Success.”
As we all know, “Winter is coming.” So, tell your story, unite your forces, break down barriers, and equip your people.