Case Study
Modernizing Healthcare IT Systems
A Case Study on Quality Payment Program Foundational Components
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:
- Cost Reduction and Efficiency: The FC developed tools to automate processes and optimize resource use, achieving a 40% cost reduction for the QPP program.
- 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.
- 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.
- Standardization and Automation: Developed standardized disaster recovery plans and centralized documentation processes to ensure consistency and reliability across all teams.
- Infrastructure Inventory: Implemented a centralized tool to manage and track hardware and software versions, facilitating quick identification and resolution of vulnerabilities.
Technology stack
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.
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