Connecting to NC Health Information Exchange by 2018


The North Carolina Health Information Exchange is marching toward its February 1, 2018 deadline that will require all Medicaid providers to connect to the NC HIE if they want to receive payments for the Medicaid services they provide.

That means you need an EHR platform that can connect with HIEs and the upcoming regulations that will dictate how you connect with the NC HIE, as well as what data it will need.

Starting June 1, 2018, the connect requirement will extend to all entities looking to receive any state funds for delivering health services, which would include managed care organizations and management entities or related groups.

It’s an important NC Medicaid provider update, and for the best approach, you should know where the NC HIE has been since its inception, as well as where it’s headed next.

Current Operations

The NC and HIE integration so far has largely focused on creating a policy and developing the required technology to manage the health information exchange, partnering with the North Carolina Department of Information Technology and private groups.

The recently created North Carolina Exchange Authority (NC HIEA), within the state’s Department of Information Technology, is handling current efforts as well as setting future goals and implementation paths.

To date, North Carolina has selected a technical contractor, created an internal team, performed a significant review of the current NC HIE technology and portal, worked with a wide number of health care professionals and started to create new connections for providers who were already attached to the Community Care of North Carolina program.

The largest set of improvements for the NC HIE since September 2015 has been the modernization of the HIE to support greater functionality and enhance network security.

HIE Expansions

The NC Medicaid providers update goes hand-in-hand with the announcement of new undertakings by the state to improve its information exchange. The NC and HIE integration has identified key improvements to implement, which Medicaid providers will likely need to support, including:

  • Connections to the broader eHealth Exchange.
  • Support for clinical notifications through the NC HIE portal.
  • Inclusion of public health data to Medicaid and other providers — this could include the state’s immunization registry, chronic disease and other registries, and support for electronic lab reporting systems.
  • Shifting connections from the CCNC to new NC HIE portals.
  • Integrating single sign-on support for portals as well as direct and secure messaging services.
  • Increasing your options to “simplify breaking the privacy seal.”
  • Creating a statewide directory of providers.

This phase is wrapping up, and the NC HIEA is gearing up for a broader shift to NC Medicaid provider updates and integrations.

North Carolina Medicaid and HIE Future Integration

In March of 2016, providers who were connected to the HIE through the older CCNC were invited to reconnect through the newer NC HIE. More than 300 providers who need North Carolina Medicaid and HIE integration and the connects were expected to be completed by the end of 2016.

These connections are increasingly complex, and support tools are important in your efforts to link and get paid. PsyTech Solutions’ Epitomax® is designed to help North Carolina providers, especially those who work with Medicaid dollars for the majority of their revenue, integrate with the state and federal information systems that you need to get paid and stay compliant.

The NC HIEA is looking to deepen connections with providers and increase the amount of data it uses and analyzes across both exchange participants and EMR vendors. This means we’re being brought into the same set of requirements and reporting, so our systems are being actively designed to address the changes that you’re seeing every day.

Next Steps for Your Business

While the NC Medicaid providers update gives us an opportunity to tell you exactly how robust our platform is and its intentional flexibility to meet future reporting requirements today, it’s also a time to call specific attention to future updates from HIEA NC itself.

The organization is reviewing all of the data they’re processing to ensure that common data is treated the same and is currently in the process of developing training for data as well as other processes that are important to your operations.

The HIEA NC plans to release training materials for Medicaid providers so you can properly implement changes and manage the requirements, addressing technical and finance requirements as well as governance best practices.

The environment is going to become more complex, but also have greater opportunities for integration and automation if you have the right partners in place.

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