Self Service Government Spring 2015 Conference The Leap from Legacy - UBTI A Case Study

1. THE LEAP FROM LEGACY
A Framework for Low Risk and High Return
For Cambria Solutions and
California Department of Health Care Services
PASRR Case Study
April 29th, 2015
Prem Daniel
Lesley Jones

2. 4/29/2015
Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
2
Todays Agenda
 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A

3. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
3
 Headquartered in Anaheim, California
 C Corporation, incorporated in the State of California
 Provide specialized Systems Architecture, Systems Design, Development
and Implementation Services
 Coupled technical expertise and business domain expertise to provide
customized solutions
 Provide application development, enhancements, maintenance,
operations and conversion support
 Enterprise Application Integration (EAI) using leading edge web and
Mobile user interfaces (.NET, J2EE, PHP)
 Microsoft Gold Certified Partner for Business Intelligence
 3-time Supplier Excellence Award Winner
UBTI Corporate Profile
Technology Services for SLG
4/29/2015

4. Copyright © 2015 UB Technology Innovations, Inc.
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 Significant platform integration experience with legacy platforms.
 Significant experience in handing electronic health care records and interfaces
including,
 Proprietary Systems, SAP, Oracle, legacy mainframes
 Significant experience with BizTalk, ANSI X12 and industry adapters for BizTalk.
 Trinity Framework provides a low risk, quick delivery approach.
• Microsoft Practice
 .NET, SQL Server
 BizTalk, Exchange
 Reporting Services, Analysis Services
 Visual Studio, TFS
 Visual C# / C++
 MVC, Entity Framework, Dapper
• Java Practice
 J2EE, JSF, JSP, Spring, Hibernate, iBATIS
 WebLogic, WebSphere, JBoss, Apache
 WPS, WebSphere, Vignette, Liferay, eXo
 Oracle, MySQL, MongoDB, NoSQL
 Web services - REST, SOAP
Integration Experience
The Key: Integration services with Quick turn-around
4/29/2015

5. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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Where are we ?
 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A
4/29/2015

6. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
6
Cambria Solutions
 Leading IT and management consulting firm.
 Prime contractor with solid track record in public sector
 Nationally recognized by Inc. Magazine as one of the fastest growing companies
Department of Healthcare Services (DHCS)
 Backbone of California public Healthcare
 30% of CA population serviced by DHCS
 Over 34 Divisions including IMD, ITSD and MHSD
Mental Health Services Division (MHSD)
 Medical related Mental Health Services were transferred to DHCS in 2011
 Responsibility to administer Early Periodic Screening, Diagnosis and Treatment
(EPSDT) for Community-based mental Health Services
 Increasing case load with over 20 different programs
Source: http://www.inc.com/inc5000/ ; Governors Budget 2015,
Assembly Bill 102 – Chapter 29 – Section 14700. (a) (1); http://www.dhcs.ca.gov/services/MH/Pages/PASRR.aspx
Cambria & DHCS Overview
4/29/2015

7. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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• Pre Admission Screening and Resident Review
• Mandatory Federal Health care program
• Supreme Court ruling and Olmstead Act 1999
• Screening for All Medi-Cal patients entering NF
• Further Evaluation required for some patients
What is PASRR
Online Evaluation for
appropriate treatment
Resident at
Nursing Facility
Evaluation Approval
Community
Placement
4/29/2015

8. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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• Federal Compliance
• CMS Mandates for State MH Agencies
• Case Disposition takes over 45 days
• Manual Processes
• Man-power intensive, paper and Fax based
• Outdated Technology
• Mainframe systems > 25 years running Z/OS
• Adabas DB / NATURAL screens
• Quality of Healthcare for Citizens
Why PASRR IT Project
Issues with Legacy Platform
#1 Business Problem – Failing Federally mandated timelines
4/29/2015

9. Copyright © 2015 UB Technology Innovations, Inc.
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• Web based internet portal
• COTS or Custom solution accepted
• Fixed Price, fixed schedule
• Compliance to standards
• Info Sec, HIPAA, SAM, SIMM, HAM
• Medicaid Information Architecture Standards (MITA)
PASRR IT Project
Critical Requirements
Reliable, Secure, Scalable, Maintainable
4/29/2015

10. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A
Where are we ?
4/29/2015

11. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
11
Why UBTI Trinity Framework
• Use of pre-built software components
• Rapid Prototyping and POC Development
• Responsive and Intuitive UX
• Built-in Work Flow Management
• Security components for Authentication
• Reports and Dashboards
• Audit Logging and Error Handling
Section Criteria on RFO focused on Quality and Understanding
4/29/2015

12. Copyright © 2015 UB Technology Innovations, Inc.
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Comparison of some alternates
Comparison Implementation
Risk
Intuitive&
ResponsiveUX
Workflow
Management
Dashboards&
Reporting
Knowledge
Transfer
Custom
Development
High X X
COTS (Dynamics) High X X
Trinity Framework Low
Framework- based solution scored at the top
4/29/2015

13. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
13
PASSR IT Project Timeline
Software build - only 6 months in 4 iterations
2012
IFSR
2013
Funding
Procurement
RFO
Award
3 Year Roadmap
2015
Phase II
2016
Mobile
2017
Integration
4/29/2015

14. Copyright © 2015 UB Technology Innovations, Inc.
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Key Users
Nursing Staff Clinicians State StaffEvaluators
Key Functional
Components
Level 1
Screening
Level 2
Evaluation
Level 3
Determination
System
Administration
Level 4
Reconsideration
Dashboards
Reports
PASRR Application Building Blocks – Functional components
PASRR Business Architecture
4/29/2015

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Framework
Capabilities
Authentication Authorization
Organization Structure
Error Logging Audit Logging
Workflow Management
Prebuilt components – A foundation for PASRR Building blocks
Security Layer
Foundation Layer
Trinity Technical Architecture
4/29/2015

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Compliance to MITA Architecture Reference Model
Key Users
Nursing Staff Clinicians State StaffEvaluators
Key Functional
Components
Level 1 Screening Level 2 Evaluation
Level 3
Determination
System
Administration
Level 4
Reconsideration
Dashboards
Reports
Framework
Capabilities
Authorization
Audit Logging
Authentication
Organization Structure
Error Logging
Workflow Management
Security Layer
Organization Structure
MITA Compliant Layers
Business and Technical Architecture
4/29/2015

17. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A
Where are we ?
4/29/2015

18. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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Patient admitted
To Nursing Facility
Resident at
Facility
Evaluated for
certain
Change in MH
conditions
Resident
Screening
done by
Nursing Staff
Forms are Faxed
Legacy Process (At Nursing Facility)
Level I Screening
4/29/2015

19. Copyright © 2015 UB Technology Innovations, Inc.
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Manual Review
Process
Faxes Received Case Created Document with
Case List
Assigned to
Evaluator
Legacy Process (At DHCS)
Level I Screening (Continued)
4/29/2015

20. Copyright © 2015 UB Technology Innovations, Inc.
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7 days
Patient admitted
To Nursing Facility
Resident at
Facility
Evaluated for
certain
Change in MH
conditions
Resident
Screening
done by
Nursing Staff
Forms are Faxed Case Created
Legacy Process
Level I Screening
4/29/2015

21. Copyright © 2015 UB Technology Innovations, Inc.
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Online Resident
Review done by
Nursing Staff
Case CreatedDuplicate Check
Cases for review are
identified by the system
Online
Contractor/Evaluator
Assignment
1 Day
DHCS does online case
review
Patient admitted
To Nursing Facility
Current Process
Level I Screening
4/29/2015

22. Copyright © 2015 UB Technology Innovations, Inc.
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10 days
Evaluator on
visit
Resident at
Facility
Clinical
Evaluation
filled in paper
Evaluator back
to Home
Office
Manual Data Entry into
Mainframe System
Submitted to
DHCS
Legacy Process
Level II Evaluation
4/29/2015

23. Copyright © 2015 UB Technology Innovations, Inc.
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Online Evaluation
completed bed-side
5 Days
Evaluator on
visit
Resident at
Facility
Submitted to
DHCS
Evaluation Approval
Process
Current Process
Level II Evaluation
4/29/2015

24. Copyright © 2015 UB Technology Innovations, Inc.
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14 days
Clinician
Old Mainframe System
Clinician screens
Manual data entry and
limited copy/paste of
data
Letter Template
Selection
Batch Printing Letters Mailed
Legacy Process
Level III Determination
4/29/2015

25. Copyright © 2015 UB Technology Innovations, Inc.
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25
Clinician Online Review of
Determination Letters
Workflow and
Consultation with
Evaluator
3 Days
PDF version of
Determination Letter is
Generated
Online copy sent to
Resident
Online copy sent to
Nursing Facility
Current Process
Level III Determination
4/29/2015

26. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
26
 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A
Where are we ?
4/29/2015

27. Sample PASRR Features
Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
27
Role specific
Menus and
Dashboard
Widgets
Action oriented
Alerts
4/29/2015

28. Sample PASRR Features
Copyright © 2015 UB Technology Innovations, Inc.
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28
Sections with logic that decides if
case is positive or negative
Wizard progress bar to identify
current and completed steps
4/29/2015

29. Sample PASRR
Workflow
Copyright © 2015 UB Technology Innovations, Inc.
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29
Workflow
Approval
Workflow Steps
Electronic Approval
4/29/2015

30. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
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 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A
Where are we ?
4/29/2015

31. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
31
• Did project meet objectives and goals
• Compliance and timeliness
• Costs
• Implemented new automated IT system
• Project Schedule to meet CMS Requirements
Sharing Success
Project Objectives
4/29/2015

32. Copyright © 2015 UB Technology Innovations, Inc.
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32
PASRR
From
45+ days
To
9 days
Overall Time Reduced by 80%
Reduced Costs
Savings in Cycle Time
4/29/2015

33. Copyright © 2015 UB Technology Innovations, Inc.
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Legacy System Retired - New Automated IT System Live
Implemented
New Automated IT Systems
Old Mainframe System
Letter Template
Selection
Manual Data Entry into
Mainframe System
Clinical
Evaluation
filled in paper
Faxes Received
Manual Review
Process
Online Evaluation
completed bed-side
Evaluation Approval
Process
Online Form
Online Review of
Determination Letters
PDF version of
Determination Letter is
Generated
Manual
Process
Automated
IT System
4/29/2015

34. Copyright © 2015 UB Technology Innovations, Inc.
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34
Schedule
Dec 2013 Jan 2014 Feb 2014 Mar 2014 Apr 2014 May 2014 Jun 2014 July 2014 Aug 2014 Sept 2014 Oct 2014 Nov 2014 Dec 2014 Jan 2015
Requirements Phase
Design, Analysis Phase UAT & Roll Out
Design, Build, Test
Post Production
Release
Release 1
Release 2
Release 3
Release 4
Planned Schedule
Dec 2013 Jan 2014 Feb 2014 Mar 2014 Apr 2014 May 2014 Jun 2014 July 2014 Aug 2014 Sept 2014 Oct 2014 Nov 2014 Dec 2014 Jan 2015
Requirements Phase
Design, Analysis Phase
UAT & Roll Out
Design, Build, Test
Post Production
Release
Release 1
Release 2
Release 3
Release 4
Actual Schedule
Planned Start
Dec 2013
Actual Start
March 17, 2014
Planned End
Jan 2015
Actual Go-Live
Jan 2 2015
4/29/2015
Implementation Schedule compressed with no cost increase

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Overcame the Triple Constraint successfully
Triple Constraint
Planned
Scope
Delivered
Planned
Time
Actual
Planned
Costs
Actual
Delivered more
than scoped
Delivered sooner
than planned
Delivered within the
budgeted cost
4/29/2015

36. Copyright © 2015 UB Technology Innovations, Inc.
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• User Interface Design Challenges
• Modern themes, Step-by-step Wizards Dashboards
• Decision by committee or take risks
• Responsive UX Design for users who were not used to
automated Web applications
• Commitments
• Meet milestones and deadlines at all cost
• Listen to the customer first and think before reacting
• Build trust to gain customer confidence
Lessons Learned
Success is measured not only in achievements, but in lessons
learned, lives touched and moments shared along the way.
4/29/2015

37. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
37
 Company Overview
 What is PASRR
 Why UBTI Trinity Framework
 Legacy Versus New Processes
 Application Features and Benefits
 Lessons Learned
 Q & A
Where are we ?
4/29/2015

38. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
38
 UBTI Differentiators
 Summary
 Q& A
 Lunch
Q & A
4/29/2015

39. Copyright © 2015 UB Technology Innovations, Inc.
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39
UBTI and Trinity Framework
Differentiators
Low Low
High High
High High
UBTI UBTI
Business Domain
Expertise
Leveraging
Legacy Systems
Technology
Expertise
Business
Value
• Very strong track record with our customers
• Excellent technical and business domain expertise
• Compelling solutions that provide value to you and your
organizations by leveraging existing legacy systems
High value proposition for leveraging Technology in business
4/29/2015

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 Learning experience for all
 The Fun and Challenge
 Opportunity to grow and mature
 Excited with the future
 Lunch and Learn for those interested
Summary
Enjoy the lunch  We are here for you !
4/29/2015

41. Copyright © 2015 UB Technology Innovations, Inc.
Information contained in this presentation is confidential and may not be used or disclosed without the written consent of UB Technology Innovations, Inc.
41
Contact
Lesley Jones
Office: 714.912.1608
Lesley.Jones@ubtiinc.com
Prem Daniel
Office: 714.912.1637
Prem.Daniel@ubtiinc.com
UB Technology Innovations, Inc.
2400 E Katella Ave, Suite 570
Anaheim, CA 92806
4/29/2015