Uniform Assessment System (UAS)
Background Information: A large state’s long term care system had a wide range of inter-connected services and programs. To provide appropriate long-term care to its citizens, the state health department needed to uniformly assess the level of care needed across settings. The state’s existing home and community-based programs garnered client, quality, and provider performance information from many different screening and assessment instruments. The existing tools lacked standardization and a common language, which complicated an already fragmented and uncoordinated system of long term care and did not best serve the needs of its recipients, service providers, or payers. The Governor and Legislature recognized this problem and appropriated funds in the State budget for services and expenses related to the implementation of an electronic, uniform assessment system.
The overall goals of uniform assessment for the Medicaid program were to provide:
- assessment of functional needs through empirically tested and validated means,
- an electronic system and uniformity of data across programs,
- access to programs and services with minimum duplication and maximum consistency,
- and a basis for allocation of resources, standardization of care delivery, and quality outcomes.
For individuals in need of long term care services, navigating the State’s existing long term care system could be challenging. The assessment processes for services and programs in the State vary and rely on many tools to determine a person’s needs and eligibility for program services. The electronic assessment software was needed to support eight Medicaid programs, covering areas such as adult day health care, traumatic brain injuries, assisted living, and managed long-term care.
The Obstacles: Highly sensitive data and security was the prime objective. New implementation for assessment tracking. Complicity included eight Medicaid programs, 20+ different forms for each program, 2500+ field elements, 5000+ validations depends on combination of service category and related forms. The system implementations deadline were based on contractual period. The reporting requirements were very complex and user interface was listed as prime concerned.
How GCOM Assisted: Considering complexity for analyzing different service categories and forms, GCOM team created bottom up approach by analyzing total forms elements vs. form element used by individual service categories. GCOM developed robust security architecture where all security controls were implemented and thoroughly tested. GCOM’s Project Manager developed a very robust project plan, and obtained customer buy in, which allowed the team to meet deadlines. As part of the requirement analysis, the GCOM identified a set of UI components (such as form elements, demographic information, etc.) which were repeated on multiple screens. These custom components were designed and developed only once, as part of common services development. This approach not only reduced the development cost but development time too.
End Results: A Layered Architectural Model which not only satisfied the existing needs of the customer but also met their future enterprise-level long-term requirements. Key features of the system include:
- Application is flexible, web based and utilizes Oracle database.
- Application was written in a modern, widely used Java language.
- Framework and application architecture utilized to develop the application follow industry accepted design patterns. This reduces the effort required to maintain the developed code.
- Application is secure and utilizes agency Single Sign on (SSO) using agency Portal for internal and external users.
- Communication between browser and IIS Server is through HTTPS using 128 bit encryption.
- Application has thorough reporting features in the form of data extract and canned reports.
- Application outcomes are compliant with InterRAI algorithms.
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