U.S. Department of Health and Human Services

The Federal Health Architecture (FHA) Program was established to support federal activities related to the development and adoption of Health IT (HIT) standards, ensuring that agencies seamlessly and securely exchange health data with other agencies, other government entities (state, local, and tribal), and with other public and private organizations. To be successful in its mission, FHA is establishing a framework that allows Federal health leaders to assess the effectiveness of HIT investments against both internal and industry benchmarks. The framework will serve as the basis for a common understanding across the member agencies of what FHA is trying to accomplish, how we are going to accomplish it, and how we will measure success. Through their coordinated efforts, FHA member organizations will improve health operations by promoting interoperability and collaboration and by enabling better decisions.

Why This Matters To You

Consider that in one person’s lifetime, they may be enrolled in over a dozen different health plans, both public and private. Changing plans, or being enrolled in multiple plans at one time, makes keeping track of the coverage a challenge for the patient, provider, and payer alike.

How does the health system keep track of an individual’s medical history? Who determines what they are covered for at any given time, and who pays for their care? A person may be eligible for several different plans at once – which one applies for a given treatment? These questions and others arise millions of times every day across the country. Information technology alone won't solve the problem, but it is part of the answer. Common processes, shared standards, and policies supporting information sharing are also part of the solution.

Today, the questions are typically answered by filling out forms, making phone calls, and waiting for a determination to be made. Standardized data exchange packages that collect and maintain all the information needed to determine a patient’s eligibility status will help to speed and simplify the process. The data exchange package will be in a format recognized and understood by any payer or provider’s system, and have a set of logical rules to determine eligibility status quickly and efficiently.

How We Helped

Phase One was brought into the FHA program to provide expertise in business transformation, strategic planning, and the Federal Segment Architecture Methodology (FSAM) in order to improve the FHA’s ability to establish a structured, repeatable approach to solving the nation’s health challenges and develop solutions that enhance information sharing, interoperability, and re-use. Phase One is assisting the FHA TRANSFORM initiative to implement a process to engage government and private health providers and payers in a collaborative effort to address the information challenges that face our nation.

While this effort is still in its early stage, there has been a great deal of success in bringing various health agencies at the federal, state, and local levels together to identify and prioritize shared business challenges and to begin solving them using a common approach. The TRANSFORMATION team is currently addressing immediate challenges that include: solving the paper record problem, tracking enrollment information, improving services to children, and addressing provider management issues across state and federal programs. As these and other new initiatives progress, Phase One will continue to provide invaluable assistance in analyzing the business challenges facing our nation’s health enterprise.