Health information technology can play an important role in helping to achieve the aims of the Americans with Disabilities Act (ADA). This year marks the 30^th anniversary of the passage of the ADA – a major milestone in our Nation’s history that has helped increase access and opportunity for individuals with disabilities. The ADA prohibits discrimination and is intended to guarantee that people with disabilities have equal opportunities to fully participate in mainstream American life, including state and local programs and services. Missouri’s use of health IT is an example of one state’s approach to advance access to care through the use of technology.

In Missouri, the Division of Developmental Disabilities serves over 14,000 residents with intellectual and developmental disabilities (IDDs). The state offers services and support centered on empowering individuals and families as valued members of their communities. This allows Missourians with disabilities to pursue their life goals where they live, work, play, and learn.

Missouri’s Division of Developmental Disabilities focused on partnering with stakeholders across the state, including the state’s health information exchanges (HIEs). The state recognized that a standards-based, interoperable health IT infrastructure is critical to supporting the person-centered planning process. (This point is particularly important during public health emergencies like the COVID-19 pandemic.) The Division of Developmental Disabilities and the state’s HIEs developed taskforces to advance the work. A focus on this health IT infrastructure was made possible by:

• Moving from a largely manual, paper-based process to an online platform. This case management solution allows staff to electronically conduct assessments, develop care plans, coordinate and plan services, and support cross-state agency data sharing as needed.
• Mapping their state-based Individual Service Plan (ISP) to the Health Level 7 (HL7) electronic Long-Term Services and Supports (eLTSS) standard. The ISP to eLTSS mapping in Missouri will better enable all health and human service providers, along with individuals and their families, to seamlessly exchange critical information. (The eLTSS standard, a joint project between the ONC and the Centers for Medicare and Medicaid Services, focuses on the identification and harmonization of health IT standards that enable the creation, exchange, and re-use of interoperable service plans by health care and community-based long-term service support providers, payers and the individuals they serve.)
• Participating in an HL7® Fast Healthcare Interoperability Resources (FHIR®) Connect-a-thon in May 2020. The care coordination track during the event demonstrated person-level information exchange across an acute, ambulatory, post-acute care, community-based organization, as well as the patient’s mobile devices.

Missouri is also developing and implementing a robust value-based purchasing model to promote services that support individuals with IDDs. Through securing and maintaining competitive, integrated employment in their communities, the state hopes to further promote adoption and use of health IT by providers and individuals for care and support of disabled individuals in their homes and communities.

While there is still much work for our nation in addressing the dreams, goals, and needs of individuals with disabilities, health IT-based tools, approaches, and methods have become an important part of this journey. ONC is encouraged by this work and looks forward to helping other stakeholders learn how these initiatives can help benefit others in implementing health IT enabled models for inclusive, accessible, community-based, person-centered health delivery.

More information on the ADA >