Public comment is sought regarding consulting services available to support development of a business approach to using current and emerging standards and products to locate, request, receive and utilize medical evidence in support of SSA’s disability determination functions. SSA requires efficient access to medical information for disability claimants and sees great potential in utilizing standards-based practices and systems already under development in the health care industry. SSA seeks information regarding consulting services familiar with current and emerging standard transactions such as Health Level Seven Clinical Document Architecture (HL7/CDA), and HIPAA claims attachment transactions 277 (Requests) and 275 (Responses). These consulting services should also be familiar with the standardized clinical codesets and structures in use and proposed for medical settings to capture the medical information, such as LOINC, SNOMED, and ICD-10-CM. These consulting services should also be knowledgeable in the management and utilization of information receiving using such transactions and codesets. BACKGROUND: The Social Security Administration makes approximately 15 million requests for medical records annually as part of the processing of claims of disability under Titles II and XVI of the Social Security Act. Currently, both the requests from SSA and the responses from medical providers are made using a multitude of formats including conventional mail, fax, and electronic uploads. SSA now has in place a national electronic folder for storing and accessing claims-related information. Most of the information is converted from paper using scanning, but in the interest of speed and efficiency for both SSA and providers, SSA desires to obtain as much information in electronic standards based formats as possible. SSA currently uses images to process claims, but wants to realize the potential of obtaining and using medical information as data that can eventually be used in decision support business processes and systems. The President’s Federal Health Architecture (FHA) initiative requires SSA to make changes in its business process and capabilities to interoperate with individuals and entities who have implemented the FHA standards. On a broader scale, the Office of the National Coordinator for Health Information Technology (ONCHIT) has been charged with coordinating an industry-wide drive for interoperable health information exchange, based on standards for transactions, codesets, and clinical architecture. SSA desires to integrate its business processes as closely as possible with related business processes being deployed in the general health care community. However, SSA is not a healthcare provider, so its business processes must consider features not present in transaction between payers and providers in the healthcare context. SSA must provide information to locate and identify the appropriate medical information, SSA must provide a release for the medical record, and SSA must pay for the information received. What are the availability, capability and experience of consulting services that would enable SSA to find information and products necessary to develop and migrate to a business process that utilizes standards-based transactions for locating, requesting, receiving and utilizing medical information? Are these consulting services available to provide responses to the following questions: • How can SSA best accomplish building the framework for the new business process? • How should a new business process be best aligned with comparable business processes in the general health care environment? • How could the transition effect the current environment at SSA? • What services, products and processes exist for maximizing the utility of the medical information once it is received in the future as both structured and unstructured data? We are interested in consulting services that may be of value to any part of the process of obtaining and using medical records, not just end-to-end solutions. Please provide enough documentation to address the needs described and permit an initial assessment of the potential. DATES: Responses should be submitted to the Social Security Administration, Office of Disability Programs, Office of Process Policy, Health Informatics Branch, before 5:00 p.m. EDT on May 31, 2006. ADDRESSES: Electronic responses are preferred and should be addressed to
[email protected] include the title of this RFI in the subject line. Non-electronic responses will also be accepted. Please send to: Social Security Administration Office of Disability and Income Support Programs Office of Disability Programs Office of Process Policy Health Informatics Branch Annex Building Room 4620 6401 Security Blvd. Baltimore, MD 21235-0001 FOR FURTHER INFORMATION: Contact Bob Hastings at 410-965-7675 or Chuck Urban at 410-965-9029