Sunday, May 19, 2024

FedHealthIT 2020 Innovation Award Winners – Centers for Medicare & Medicaid Services

Click the image to view the speeches. Program descriptions are below.

InsightsAI
Centers for Medicare & Medicaid Services
The eRulemaking Program is a cross-agency (340+ agencies) initiative enabling the public to participate in the Governmental rulemaking processes by providing feedback and comments on proposed new rules or changes to existing rules. InsightsAI is an Artificial Intelligence (AI) application using Machine Learning to offer previously unattainable, unbiased views of stakeholders’ comments via a user-friendly Tableau dashboard. Machine Learning models identify the sentiment, themes, recommendations and requests for clarifications based on stakeholder comments on the rule proposal. InsightsAI automates data retrieval from www.regulations.gov and utilizes AI capabilities to contextualize thousands of lines of public comments so they can be assessed and acted upon by policy makers.

Advanced Medicare Provider Systems
Centers for Medicare and Medicaid Services
As part of its support for Medicare providers and beneficiaries, the NGS call center handles between four and five million calls each year. To better serve customers, NGS recently created its own customized CRM that meets strict Government requirements while providing a host of features and flexibility. NGS’ Advanced Medicare Provider Systems (AMPS), was designed and developed entirely inhouse using a low-code platform. This allowed the users to be part of the development process, and allowed for rapid prototyping, reducing traditional development time by as much 75 percent, and producing results not previously considered practical, including a proof-of-concept mobile application.

Enterprise Portal Services
Centers for Medicare and Medicaid Services

The C-HIT team leveraged data analytics and machine data tools to develop tailored solutions based on customer needs, which included tailored Key Performance Indicators (KPI), concise visualizations, and transformative solutions. The environment lacked full-horizon line of sight across multiple dependent environments and included 10+ data centers and 60+ applications. CMS and C-HIT brought the “big-picture” focus by incorporating enterprise machine data into a single view to enhance information sharing and collaboration across teams. Outage prevention is now supported using machine learning through operational patterns and trends. We can predict and prevent outages 20-30 minutes in advance using Artificial Intelligence and Predictive Analytics.

CROWN Data Discrepancy Support 
Centers for Medicare and Medicaid Services
As the CDDS contractor, SoftDev collaborates with ESRD Network contractors and dialysis organizations to analyze data in CMS ESRD systems and their data feeds. The Transplant Wait List report, developed from these data sources and distributed to the dialysis organizations spreads accurate information indicating patients receiving treatment in their dialysis providers and the patients’ corresponding transplant wait list status. Dialysis corporations are integrating information from the Transplant Wait List report to give the dialysis treatment team critical information supporting better decision-making about a patient’s regular dialysis care and future are plan. TheTransplant Wait List report will act as an extremely useful tool to participating providers as they internally assess outcomes and identify patients needing enhanced services.

Data Analytics Coaching Services  
Centers for Medicare and Medicaid Services
CMS established the DACS contract to provide data and analytic coaching services to the newly created Evidence Development Division (EDD) within CCSQ. The DACS contract does not buy or develop any new software solutions or systems. The contract focuses on coaching EDD staff how to leverage existing CMS assets and empowering them to be more efficient and productive. DACS improves Federal knowledge workers ability to be independent and minimizes their reliance any single person’s knowledge. This investment in the development of the EDD workforce leads to lower costs, faster response times, and greater productivity. The DACS team continues to replicate the coaching approach to other aspects of EDD operations.

Grant and Financial System Interface 
Centers for Medicare and Medicaid Services
Two teams collaborated to work on an interface to connect CMS’ Grant writing tool (GrantSolutions) and its Financial system (HIGAS). This interface not only saves the time necessary to obligate and commit funds, but also eliminates the potential manual data entry errors. This is one way for CMS to meet the requirements of DATA and GONE Acts. This is eliminating duplication of efforts and implementing a streamlined workflow process for the award and funding of a Grant action. After a year of develop and testing, an interface was deployed on October 1, 2019.

CPI API Gateway Pilot 
Centers for Medicare and Medicaid Services
The CPI API Gateway initiative aggregates this data from different CPI source systems and shares it directly using APIs. This approach improves system utilization, reduces the cost of operation, and decreases the number of stand-alone point-in-time data extracts that quickly become outdated. Through seamless integration of multiple data centers and source systems, the API Gateway facilitates the creation of a complete Provider profile record by pulling data that is housed in multiple systems and does so in real-time without the need for new standalone data stores. This innovative solution optimizes operational efficiency, significantly reduces development time and is easy to onboard new consumers.

Fraud Prevention System  
Centers for Medicare and Medicaid Services
FPS is an end-to-end platform design to support robust analytics and predictive technologies to support the identification and mitigation of fraud, waste and abuse in program integrity. The system includes industry-trend technologies including integrated advanced machine learning (ML) technologies into the platform, leveraging the capabilities to both identify potential issues and to predict the likelihood that flagged claims will result in administrative action. FPS identifies thousands of potential leads for investigation, making the selection criteria for prioritizing leads key to ensuring efficiency of investigation effort. ML allows FPS to stratify those leads in a way that easily identify the best leads, saving time and effort and positively impacting ROI.

Alignment of Quality and Public Reporting Programs and Websites 
Centers for Medicare and Medicaid Services
CMS will sunset existing compare tools and launch two consumer (beneficiary and researcher) focused tools with well-constructed content and user experience. This program is currently in progress moving towards a Spring 2020 release of the new, fully aligned digitally transformed and consolidated Compare Websites and Summer 2020 sunsetting of the current Compare Website suite. The two new Compare tools, through enhanced digital services, will be user-centric with streamlined content and more intuitive interfaces. Beneficiaries will gain greater insights about available options and researchers will easily target needed data for more meaningful analyses. CMS will move closer to the vision of One CMS through digital transformation and greater collaboration and cohesion between OC and CCSQ.

The Medicare Enrollment and Premium Billing System 
Centers for Medicare and Medicaid Services
The MEPBS team implemented the Beneficiary Information on the Cloud (BIC) Application Programming Interface (API) to provide real time access to data of Medicare’s 62 million active Beneficiaries to partner systems. The MEPBS team implemented the BIC RESTful API on a new AWS platform in just 90 days from concept to completion. The BIC API is a modern RESTful API for dissemination of more than 2.1 TB of data for real time processing and analytics to the many consumers of Medicare Beneficiary information. With this real time access to beneficiary information, partners, including the Beneficiary Experience Data Analytics Platform (BEDAP) program, are now leveraging a “bring your own compute” model for processing and analytics.

Data at the Point of Care
United States Digital Service, Centers for Medicare and Medicaid Services
Data at the Point of Care (DPC) is a product designed to allow physicians to access patient claims history while the patient is visiting their office. This product utilizes the Blue Button API, built by CMS, and integrates directly into the physician’s workflow software. The innovation behind DPC is not only the technology behind the product itself, but the impact of the product and the leadership within the government to stay ahead of the private market. Since the product launched in July 2019, there have been more than 600 sign-ups for the tool, representing 70K+ (and counting) providers. DPC exemplifies the reality of health data interoperability, one of CMS’ key initiatives.

Healthcare Integrated General Ledger Accounting System (HIGLAS)
Centers for Medicare and Medicaid Services
Two teams collaborated to work on an interface to connect CMS’ Grant writing tool (GrantSolutions) and its Financial system (HIGLAS). This interface not only saves the time necessary to obligate and commit funds, but also eliminates the potential manual data entry errors. This is one way for CMS to meet the requirements of DATA and GONE Acts. This is eliminating duplication of efforts and implementing a streamlined workflow process for the award and funding of a Grant action. After a year of development and testing, an interface was deployed on October 1, 2019.

See the video and read about the winners from the Department of Veterans Affairs here.

See the video and read about the winners from the Defense Health Agency here.

See the video and read about the winners from the Department of Health and Human Services here.

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Heather Seftel-Kirk
Heather Seftel-Kirk
A writer for more than a decade, Heather helps hone the voice of FedHealthIT, helping to shape the information we share, working with collaborators and stakeholders to ensure they are delivering the message they intend and that it is the information our readers want to hear. A firm believer that every person has a story to tell and that every story is worth sharing, if told right, she also believes the written word carries power – to inform, to educate, and also to bring people together.

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