Government Technology - September 2008 - (Page 34) social services those behavioral health and physical health providers know their counterparts. That’s one piece that’s unique.” A foster child may also have state-required assessment forms in areas such as behavior and dental health. Each child’s Health Passport includes a screen listing the assessment forms, which give detailed information doctors can’t glean from other areas of the system. Medicaid claims, immunization records, prescriptions filled, office visits, lab results and vital signs — such as height, weight and blood pressure — are all additional passport modules. when handling patient health entered, which makes it possible records — whether physical or they’ll be incomplete. “Hopefully electronic. Normally an indiproviders have someone entervidual must sign off on every ing it every time they discover an release of their medical inforallergy, but it does take some time mation, but Cody said because to enter those,” Pogue said. “Even the DFPS is legally responsible if they don’t, it’s a lot better than for all Texas foster children, the what they had before. I think it department is responsible for will be a really great tool.” access to the Health Passport. While the HHSC studies passIn addition, Superior and port-user satisfaction, it’ll also the HHSC track usage and flag be preparing a report for the unusual activity. “I have staff Texas Legislature on the feasibilfully dedicated to auditing and Fast Fact ity of expanding the program to doing security measures, and Texas’ foster child Health all Medicaid users. Some of the we send the HHSC weekly and Passport combines data Health Passport’s features are daily reports on usage,” Cody from insurance claims, unique to foster children — i.e., said. Superior has guidelines for physicians’ offices and information about caseworkother sources, giving normal activity on the system ers and some health assessment new foster parents and and checks the actual usage doctors access to the forms — but most of the medical against them. “Our criteria set child’s medical history. data would be the same. “The for that is actually pretty low, so application itself, and the platwe haven’t had any breaches that turned out form it resides on, could certainly support a lot to be real,” Cody said. more end-users,” Cody said. “The challenge there would be multiplying by 100 times the number of different information sources.” Passport Security Addressed Controlling access to the passports was another major undertaking, Cody said. Superior recognized that as children move from one home and set of guardians and doctors to another, it becomes difficult to secure frontend access. Front-end system security is handled by a login process with a unique PIN. The DFPS gives each authorized individual a unique identifier, and larger providers are allotted a certain number of staff members who can access the Health Passport. Another step in the security-building SLOANE CODY process was to assign Smooth Rollout The Health Passport came online stocked with two years of insurance claims and medical data for more than 30,000 foster children. Officials said problems have been minor and were to be expected. “We’ve had a really successful implementation,” said Marisa Luera, project manager of the HHSC. “Providers, in particular, are pleased with it because before, when children moved, we The Health Passport covers more than 30,000 foster children in the state. “This is one way we can clearly document who is involved with these children’s lives across the board.” Sloane Cody, program manager, Superior Health Passport SEPT_08 various access levels to 19 distinct user roles, to keep, for example, foster parents from changing data on a child’s office visit history. Each time users log into the system, Cody said, their identity is checked against Superior’s daily updated list of people who have access to the system. All that is just to log on to Superior’s secure, private site — users must supply another login and password to reach the passport itself. Cody said the security measures comply with the Health Insurance Portability and Accountability Act, which requires discretion really didn’t have any medical history. The Health Passport does that with two years of claims data to start with.” At the Center for Public Policy Priorities, an Austin, Texas-based nonprofit policy watchdog, Policy Analyst Stacey Pogue said they’re “cautiously optimistic” about the Health Passport. Access and security issues are potential concerns, she said, if they aren’t flagged by Superior’s usage reports. In addition, while state records feed most of the data automatically, some inputs — including allergies and vital signs — must be manually The HHSC’s Sanchez said a number of states are looking at electronic health records driven by medical claims, though none have implemented a system for foster children like Texas. Cody said Superior’s parent company, Centene Corp., is looking into adapting Texas’ Health Passport to its second-largest network, Georgia’s Peach State Health Plan. “There is no other Health Passport like this in the U.S. at this point. We were the first ones to do something of this scale for an entire Medicaid population,” Cody said. PATRICK MICHELS IS A WRITER BASED IN AUSTIN AND SAN FRANCISCO. 34 http://www.govtech.com
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