Electronic Health Resources, LLC: Ensuring Compliance through Automation

Wayne Cooper, Executive Director
“In 2009 we began to lay the foundation for our new software firm. I thought it would be a good time to introduce a commercial off-the-shelf (COTS) product that could help States and vendors navigate the complex requirements associated with the administration of a Medicaid enterprise,” begins Wayne Cooper, Co-Founder and Executive Director, Electronic Health Resources, LLC (EHR). Having started two previous successful IT firms based on innovative products, Cooper and his team began the design of a compliance solution that could incorporate all the Federal requirements associated with the successful operation of a State Medicaid Agency. Starting with the Medicaid Information Technology Architecture’s (MITA) 10 business areas, 80 business processes, and thousands of edits, EHR developed ReadyCert, the first software capable of performing multiple assessment types without reprogramming. “We believe that it makes more sense to use multi-purpose software designs to replace the single-use spreadsheets that are so common in the compliance industry,” says Cooper.

The Medicaid IT world is struggling to replace the expensive legacy systems specifically designed for use in one state with modern, component driven solutions that can be shared. Service Oriented Architecture is driving this trend. “In today’s world, where we analyze, configure, and deploy solutions, business should drive technology. I believe in moving states toward component driven enterprises configured using COTS products,” cites Cooper. “Our solution helps states pick and choose the ideal COTS products for their enterprise and helps ensure a clear path to modernization.”

The first step in MITA compliance is the assessment of existing business processes—both today’s processes and the processes envisioned for the future. The Centers for Medicare and Medicaid Services (CMS) has termed it the As-Is and To- Be conditions. The business processes are rated for maturity using a scale of one to five—one meaning a manual step and five meaning completely electronic. Tracking the progress of maturity enables states to maximize the federal financial participation.

EHR is dedicated to the evolution and application of the standards associated with MITA

With ReadyCert, States can compare their To- Be goals to the features of any given software (down to the actual edits the solution will perform). This makes the selection of components a much less risky proposition. GAPS between the State’s requirements and the vendor’s component can be easily identified. Once the GAPS are eliminated, the solution is ready for production. ReadyCert supports this entire process of modernization.

For standardization, ReadyCert is hosted in the cloud, is scalable, and runs on multiple platforms. “Through our solution, states can share ideas and document both the pros and cons of their enterprise so that others may benefit or avoid pitfalls,” explains Cooper. States use ReadyCert to perform their self-assessments, create advanced planning documents, issue requests for proposals, vendor selection, tracking deployment status, and obtaining federal certification. Vendors use ReadyCert to assess the maturity of their solutions, track future releases, write proposals, and gain better ROI for their clients. It is estimated that ReadyCert saves over 40 percent of time taken to perform these tasks manually.

As a software firm, EHR develops tools for re-sell that save time and money for its clients. While his marketing team looks for the proper distribution partners for ReadyCert, EHR is in the process of developing new technology that will empower organizations to track the efficiencies of the work environment. “There’s always a better mousetrap. We believe ReadyCert is one of those,” says Cooper.

Electronic Health Resources, LLC

Tallahassee, FL

Wayne Cooper, Executive Director

Specializes in the strategic application of MITA principles throughout all six CMS certification milestones

Electronic Health Resources, LLC