Case Study

Modernizing Healthcare IT Systems

A Case Study on Quality Payment Program Foundational Components

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The client

Centers For Medicare and Medicaid Quality Payment Program

Quality Payment Program Foundational Components

Challenge

In 2016, the U.S. government faced significant challenges in modernizing its healthcare IT infrastructure, particularly after the Affordable Care Act (Obamacare) website failed to handle the expected user load. The Quality Payment Program (QPP), aimed at assessing the quality of care provided by clinicians and healthcare facilities, needed a robust and efficient IT system to manage data, ensure security, and improve operational efficiency. The initial setup involved multiple teams from different vendors, leading to communication issues and redundant efforts.

Our approach

To address these challenges, the government engaged with the U.S. Digital Service (USDS) to lead the modernization efforts. In 2018, Flexion’s foundational components team (FC) was tasked with creating standardized, scalable, and secure solutions for the QPP. The FC embedded team members within various QPP product teams to foster collaboration and identify improvement areas.
Key initiatives undertaken by the FC included:

  1. Cost Reduction and Efficiency: The FC developed tools to automate processes and optimize resource use, achieving a 40% cost reduction for the QPP program.
  2. Security Enhancements: Implemented a robust vulnerability management process and addressed critical security issues related to the Healthcare Authentication and Role-based Access Control (HARP) system.
  3. Data Management and Testing: Created Data Faker, a tool that generates synthetic test data from actual patient data, ensuring compliance with privacy regulations while allowing effective system testing.
  4. Standardization and Automation: Developed standardized disaster recovery plans and centralized documentation processes to ensure consistency and reliability across all teams.
  5. Infrastructure Inventory: Implemented a centralized tool to manage and track hardware and software versions, facilitating quick identification and resolution of vulnerabilities.

Technology stack

Frontend Development

Javascript(React)

Backend Development

Python
Javascript
Go

Testing

Pytest

API development

Javascript
AWS
API Gateway

Serverless Computing

AWS Lambda
Serverless Framework

Data Processing, Warehousing and Analytics

Python
Go

Infrastructure and Deployment

AWS EC2
AWS Lambda
AWS ECS
AWS RDS
CI/CD Pipelines

Cloud Services

AWS EC2
AWS Lambda
AWS ECS
AWS VPC
AWS Cloudwatch
AWS Cloudtrail
AWS RDS
AWS SNS
AWS SES

Continuous Integration/Continuous Deployment (CI/CD)

Jenkins
Codebuild
Github Actions

Infrastructure as code (IaC)

Terraform
Cloudformation
Serverless

Containerization and Orchestration

Docker
ECS

Monitoring and Operations

In House Solutions
AWS Cloudwatch/Cloudtrail
Splunk
NewRelic

Automation and Scripting

Go
Python

Application Development

Infrastructure Monitoring, Synthetic Test Data Creation
Inventory Management
Security Vulnerability Management

Version Control and Collaboration

Github

Code Quality and Security

Sonarcube

Outcomes

Flexion’s foundational components team successfully modernized the QPP’s IT infrastructure, significantly improving cost efficiency, security, and operational reliability. By embedding team members within various product teams, they fostered collaboration and ensured the seamless integration of new tools and processes. The team’s innovative solutions, such as the Data Faker and infrastructure inventory tool, have set new standards for data management and security within the CMS.
Their efforts not only enhanced the QPP but also influenced broader CMS practices, demonstrating the value of proactive and creative approaches to IT modernization in government healthcare programs. The FC continues to identify and implement improvements, contributing to the overall goal of delivering high-quality, efficient, and secure healthcare services.

Ready to change the way you’re doing business?

Contact us to talk about how Flexion can help your organization to streamline the development process.

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