State of Maryland Systems Interoperability and Integration Project


Project Summary

Maryland chose to use its Health Insurance Exchanges (HIX) as the client and worker portal that allows for a single point of entry to apply for health programs and needs-based social services programs such as Temporary Assistance to Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and energy assistance, establishing the foundation for interoperability.  This project broadened this integration to other programs and systems such as Child Welfare, homeless services, behavioral and public health.

Needs Addressed

Maryland recognized that many of the residents it serves utilize more than one service, and is committed to ensuring a “no wrong door” approach that minimizes the complexity and burden of service access to its residents - regardless of the administering agency.


The planning grant was used to identify opportunities to improve process efficiency and effectiveness, and describe a future state for the improved system, articulate a path and level-of-effort to achieve the future state, and design tools to enable other states to apply Maryland’s experience to their contexts.  The state is committed to ensuring that the technology it develops is reusable and transferable.  Maryland approached the planning of interoperability components and deliverables in three areas:

  • Technology - Identified core information flows, created an integration definition for interoperability, and created a draft integrated case management information system design.
  • Data Exchange and Governance Standards - Determined how existing interoperability standards can be extended and leveraged into repeatable artifacts that can be used by other states, including data architectures that leverage Service-Oriented Architecture (SOA) for maximum integration, governance structures and data exchange standards. The focus was on leveraging the National Human Services Interoperability Architecture (NHSIA).
  • The Practice of Integrating Health and Human Services - The integrated case management practice model informed system design considerations, and created a return on investment framework to estimate the overall impact of an interoperability on service delivery, efficiency, error, integrity, and outcomes.

Deliverables (click on each deliverable below for more information) 

  • Core Information Flows (FINAL)
    The purpose of the Core Information Flow is to support rules-driven information sharing among multiple case contributors in real time, allowing those contributors to make better-informed decisions about how to serve their clients and to work more efficiently and effectively with one another.
  • Integration Definition (FINAL)
    This report primarily describes the proposed approach for the Montgomery County Enterprise Integrated Case Management System (eICM) to operate with necessary state systems and provides an overview of the intersystem functions.
  • Interoperability Data Exchange and Governance Standards Architecture
    These documents identify data exchange standards, governance structures, and best practices in cross-organizational security architecture to support interoperability projects to states and other jurisdictions.
  • Interoperability Return on Investment Models and Calculator
    These documents provide a model that states can leverage to demonstrate and measure efficient and effective use of taxpayer money and social outcomes produced through interoperability
  • Enterprise Integrated Case Managemnt Information System Design Technology
    These documents identify core information flows at process and data levels across programs and an integrated Case Management model for integrated case management
  • Final Report
    This comprehensive final report provides a summary of Montgomery County’s efforts to examine the impact of interoperability on client outcomes, and establish a blueprint and operating model that can be used by states and other jurisdiction
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