Thursday, June 13, 2024

2021 FedHealthIT Innovation Award Winners Announced

The 7th Annual FedHealthIT Innovation Awards recognizes and honors the Federal Health technology and consulting community by celebrating programs nominated and selected by their peers for DRIVING INNOVATION and RESULTS across the Department of Veterans Affairs, Military Health, Health and Human Services, and Centers for Medicare and Medicaid Services.

Find out more about the event and register here.

Please join us in celebrating our Awardees below:

Centers for Medicare and Medicaid Services 
Health Plan Management System (HPMS) 

The challenge was modernizing a multi-decade old mission critical system that supports Medicare Advantage (MA) and Prescription Drug (Part D) plan access for 33 million beneficiaries. The HPMS team collaborated with human-centered user researchers and engaged modern tools to capture and incorporate feedback from end users to support the establishment of a mature, cloud-based environment, successful conversion of legacy code to new technologies, and the development of application programming interfaces for external partners. Focusing on backend operations, the Agency migrated the entire system to the AWS cloud platform in only 83 days. 16% of the system has been modernized with efforts underway to reach 32% by 2021, resulting in an overall 12% effort reduction in daily system operations.

Centers for Medicare and Medicaid Services
Alignment of Quality and Public Reporting Programs and Websites

Enhancing public reporting necessitated coordination between CMS components and stakeholders involved in publicly reporting quality data. In 12/2020, CMS sunset eight existing Compare tools, completing the final step in the launch of the Provider Data Catalog and Care Compare tools. Through these enhanced digital experiences, beneficiaries, researchers, and others can access needed data. The result equates to an greater soft and hard return for CMS on its investment in HCD, digital modernization, and the productive collaboration/cohesion between OC/CCSQ while also providing positive impacts to Healthcare outcomes nationwide. Leveraging creative management, communication modes, Power BI, and a layered stakeholder alignment strategy, AQPRPW cultivated trusting working partnerships between CMS Components, Contractors, and Stakeholders and ensured mission focus.

Department of Veterans Affairs 
eICU (Telecritical Program) 

eICU is a scalable, centralized solution that extends critical care resources to the bedside via technology, independent of the health facility’s location. This centralized model puts an intensivist-led team in a central monitoring facility where they can be responsible for 50–500 remote ICU beds. With VA managing 1,800 ICU beds nationwide, eICU gives patients access to specialists, and helps VA deliver on the Quadruple Aim: optimizing care costs, enhancing clinician and patient satisfaction and improving outcomes. The pandemic has increased participation in telehealth from 11% in 2019 to 46%, with US Healthcare systems reporting a 50 to 175-fold increase in volume compared to pre-pandemic levels. As part of VA’s telehealth strategy, eICU expansion will support access to care and improving care for Veterans.

Defense Health Agency, Solution Delivery Division, Joint Medical Logistics Functional Development Center 
Department of Veterans Affairs Logistics Redesign (VALOR) 

The idea to implement a joint medical logistics enterprise system across the VA and DHA began in 2012 at the CAPT James A. Lovell Federal Health Care Center (FHCC) and a Joint Incentive Fund project, VALOR, was created. VALOR’s innovative integration processes have vastly improved resource management and patient care efficiency, especially in dealing with electronic health records. The SDD team leveraged the Department of Defense’s off-the-shelf product to modernize and streamline the systems, a process complementary to initiatives from the VA’s Office of Electronic Health Record Modernization – aligning mechanisms across DOD and VA. As a result, the CAPT James A. Lovell Federal Health Care Center maintains fully integrated supply chain, pharmaceutical, equipment, and facilities management capabilities.

Centers for Medicare and Medicaid Services  
Enterprise Identity Management (IDM) System 

The Enterprise Identity Management System (IDM) is CMS’ mission-critical system for ensuring secure access to more than 200 applications. This new IDM provides CMS with the agility to introduce new functionality quickly, while ensuring high availability, reduced downtimes, and cost-effective integration for IDM consumers. The team modernized IDM for better application integration using an API-based architecture, comprised of REST APIs, to support a stateless and loosely coupled system that allowed for easy integration of applications. The cloud-based IDM represents an enterprise asset built upon SAFe, DevSecOps, CI/CD, and COOP principles and practices that has significantly improved development and release agility, customer/user focus, automation, responsiveness, information assurance, applications integration, and overall service.

Defense Health Agency, Program Executive Office for Defense Healthcare Management Systems, Joint Operational Medicine Information Systems
TheaterBlood, a part of the Armed Services Blood Program (ASBP) 

This project supports the wartime missions of the Armed Services Blood Program and Joint Operational Medicine Information System programs to provide blood, blood products, and blood services to US Armed Forces warfighters across the globe. This solution replaces the current, legacy, web-based application, and creates a new theater system capable of performing highly synchronized and complex tasks to ensure the availability, continuous documentation, and visibility of blood products (donor, inventory, and transfusion). Beginning with one prototype, a proof of concept for one of the blood modules, successes and feedback has driven a request to complete the other two modules. Meeting change management head on, training and mentorship through multiple platforms allowed for collaboration on development and promoted communication.

Veterans Affairs, Office of Finance, Financial Services Center 
Veterans Affairs Financial Services Center (FSC) Data Analytics Service (DAS) 

DAS experienced a growing demand for analytic products that leverage large data sets, reconciling data from multiple systems, and integrating over 8 billion rows of data. This modernized technology platform enhanced DAS’ analytic reporting, and artificial intelligence/machine learning capabilities by reducing Extract, Transform, Load (ETL) runtime from 10 days to 3 hours, rendering complex dashboards in under 5 seconds (87% faster) and improving data processing capacity by 2.5 times. DAS developed a rapid proof-of-concept to validate the architecture and demonstrate increased reliability and efficiencies provided to analytics and reporting to inform decision-making. DAS’ modernized analytic platform streamlines data processing and improves performance reliability. It has eliminated 1,000 working hours/week, increasing the data processing speed by 200 times.

Department of Veterans Affairs 
Pharmacogenomic Testing for Veterans (PHASER) 

In 2019, VA teamed up to offer pharmacogenomic (PGx) testing through a program called Pharmacogenomic Testing for Veterans. PGx testing looks at genes to learn how patients may respond to certain drugs and helps doctors decide the best medication for patients. This innovative technique alerts clinicians to drug-gene interactions while they are prescribing medications. To date, over 1500 Veterans have been tested through PHASER and 98% of those Veterans have a genetic test result that impacts the dose or type of medication to be prescribed. The PHASER program stores Veterans’ genetic test results in the electronic medical record and makes them available for all providers for the life of the Veteran. PHASER aims to expand testing to 10,000 Veterans in 2021.

VA Financial Services Center, Financial Technology Service 
VA FSC FTS DevDataSecOps (DDSO) Deployment Capability

This program oversaw managing, updating, and maintaining 100+ applications spanning 36 projects and multiple VA organizations including VHA, VBA, NCA and OIT. Agile Program Increment (PI) Planning facilitated collaborations with security, IT teams, Cloud teams, PMO, scrum teams, service line product owners, and directors. In less than two years, 33 percent of our product mix in the DDSO release pipelines, automated smoke tests, and 8 applications in automated regression testing was achieved. Automated CI/CD deployments now take 46-180 seconds and include automated smoke tests. Manual deployment with 5 deployment members takes three hours to deploy with a cost for the FSC $1,950.00. A DDSO deployment that takes 3 minutes costs the FSC $32.50.

Defense Health Agency 
Medical Community of Interest (Med-COI) Transition Risk Assessment Process (MTRAP) 

DHA is currently migrating Military Treatment Facilities (MTF) into a DOD JIE CSRA compliant Medical Community of Interest (Med-COI) architecture. The MTRAP process provides decision-makers an accurate cyber risk rating and recommendation based on an aggregate of system information and findings. The process utilizes a custom risk assessment tool, methodology mappings, and correlating scan data, asset inventories, and network topologies that provide a comprehensive medical enterprise operational environment risk picture. The process fuels the ability to obtain authorizations, provide continuous monitoring, and allows senior leadership in the medical community to make informed cyber risk-based decisions within the RMF construct, reducing the 9-12 month cycle of introducing medical systems to the enterprise to as little as one month.

Department of Veterans Affairs 
Democratizing Data 

The Democratizing Data project addresses the challenges of leveraging vast amounts of VHA clinical data to better understand, present, and respond to Veteran issues. This project, and the underlying data architecture, addresses data inaccessibility, siloed data, and protecting patient privacy. This tool protects personal health data and allows a limited set of internal users to access patient data, while providing the option to secure synthetic data sets for more generalized audiences. Additionally, Democratizing Data provides advantages in quality improvement, with artificial intelligence/machine learning, and knowledge and model sharing. This tool provides insights in patient care clinical performance, allowing VA to identify and spread high performing practices and build algorithms and models to improve direct patient care.

Department of Health and Human Services 
HHS Protect

HHS Protect integrates and disseminates granular information to a broad base of teams working on the COVID-19 response. HHS Protect unlocked inter-agency collaboration by enabling the Government to actively track and analyze the status of the pandemic, monitor and respond to health-related supply chain missions, and engage in cross-governmental stakeholder data sharing. HHS Protect data enables Government transparency, powering the HHS Protect Public Data Hub and the CDC COVID-19 Data Tracker, allowing the public and the research community a near-real time understanding of COVID. Key Government stakeholders can understand the current state of the COVID-19 pandemic with near real-time alerting; users have a granular, population-wide view of disease spread and community impact; and the Government can better anticipate trends and emerging hot spots throughout the country.

Department of Veterans Affairs, Veterans Benefits Administration, Office of Business Integration 
Using Artificial Intelligence to Help Veterans Get Benefits Faster 

VBA used RPA and machine learning models to automate aspects of mail intake. ML models extract printed and handwritten text from structured and semi-structured Compensation and Pension documents. Enterprise-friendly features, including configuring accuracy thresholds, intelligent quality assurance to measure model accuracy and learning curve slope, and comprehensive analytics dashboards providing a unified view of human and machine performance, VBA’s efforts contributed to reducing processing time for incoming mail from 10 days to one. VBA receives between 15,000 and 20,000 Compensation and Pension benefits related mail packets every day. The AI solution processes more than 1,500,000 documents monthly, has extracted over 5,000,000 fields out of VA forms, and automatically established over 450,000 claims through RPA.

Department of Veterans Affairs, Office of Information & Technology 
VA Enterprise Service Desk, Robotic Process Automation ​

VA’s Enterprise Service Desk (ESD) provides Tier 1 and VIP technology support and employs more than 600 people who have collectively answered more than 7.5 million calls since the contract’s beginning. The adoption of RPA improves the customer experience and enables the team to more accurately route and address incidents. The Queue Manager Assistant (QMA) allows for the intelligent identification and re-routing of incorrectly categorized incidents without human intervention. Pre-determined keyword criteria allow the tool to continuously monitor queues. Immediately, incidents were resolved at a higher level of support with greater than 95% accuracy. The use of intelligent automation for handling non-Tier 1 resolvable incidents improved the customer experience and freed Tier 1 agents to handle more calls and address self-service incidents quicker.

Centers for Medicare and Medicaid Services, Office of Communications 
CMS Medicare Authenticated Experience (MAX) 

The vision for MAX was to provide beneficiaries with a single, secure, personalized, and seamless Medicare experience. MAX focuses on human-centered design methodologies and a modern flexible architecture that ingests and analyzes data, providing insightful information back to other teams and applications via the MAX API. This effort drives technology and business transformation for Medicare services, utilizing data analysis to identify opportunities for improvement. MAX is a voice for embracing change within eMedicare services. Identifying and refining segmented experiences, MAX provides a cohesive seamless experience centered around user and business problems. Additionally, the MAX team has forged a path of continued collaboration with other CMS teams to drive a shared vision for a better eMedicare experience.

Department of Health and Human Services, Program Support Center 

The concept was to leverage a low-code automation platform approach, enterprise-wide, to enable problem solving with emerging technology to deal with the combined challenge of Case Management Standardization and tracking various PSC management tasks. Further adding to the challenge, the Contract Closeout PSC acquisition office had over 11K expired contracts, most affecting Undelivered Orders (UDOs). The solution was the Unified Dynamic Case Management Utilize Appian Accelerator (UDCM) and utilization of RPA to initiate the contract close out process, shifting low value work to automation so staff can focus on higher value efforts.

Centers for Medicare and Medicaid Services, Center for Program Integrity  
Documentation Request and Receipt FHIR Pilot (DRFP) 

Documentation being exchanged via esMD is mostly in unstructured PDF format. CMS expanded esMD to leverage the latest interoperability standards such as HL7 FHIR to exchange structured documentation. DRFP provided services to develop and implement a pilot for exchanging structured documentation using HL7 FHIR standards, specifications, and guides. DRFP supported CMS in transforming paper documentation exchange to an electronic exchange of structured documentation. DRFP remained cognizant that the FHIR specifications will be evolving and took an agile development process to continuously incorporate the updates to maintain a quality deliverable that is compliant to the standards. DRFP was one of the first projects within CPI to be implemented in the CMS AWS environment.

Centers for Medicare and Medicaid Services 
CMS Measures Under Consideration Entry/Review Information Tool (CMS MERIT) 

Section 3014 of the Affordable Care Act requires the Department of Health and Human Services (HHS) establish a Federal pre-rulemaking process for the selection of quality and efficiency measures for HHS use. In support, CMS developed a flexible, user-centered system for the submission and review of quality measure, CMS Measures Under Consideration Entry/Review Information Tool (CMS MERIT). The program offers seamless integration of knowledge management and human-centric design principles with agile methodologies allowing stakeholders to work collaboratively, with less burden, and data integrity. The system supports CMS’ use of this data to inform measure selection that align with agency priorities.

National Institutes of Health, National Center for Advancing Translational Sciences 
National COVID Cohort Collaborative (N3C) 

N3C is an innovative collaboration program across 70 NIH Clinical and Translational Science Award sites to centralize data on COVID-19 for clinical research. N3C’s most innovative aspect is the creation of a secure Data Enclave comprising 1M+ COVID-19 patients from across more than 70 providers and the fostering of a group of more than 1000 researchers using it. N3C has transformed how CTSA sites conduct research, allowing them to form cross-institute research teams accessing much richer datasets. Building the data enclave used industry-leading modern cloud technology, and management of complex organizational change was required to build the community of researchers who are now pursuing training, mentorship, and collaborative science.

Food and Drug Administration, Center for Tobacco Products  
Electronic Submissions (eSubmissions)

The eSubmissions program equipped CTP with modern, scalable data collection tools and cloud-based data management and analysis capabilities to support an increase in regulatory authority and surge in tobacco submission data. The program transformed CTP’s data ingest capabilities to support the unprecedented surge in users and submission data and to address the related capacity and data integrity issues by modernizing the CTP Portal application with a streaming upload architecture, file corruption detection, and automated notification and publishing tools. PMS represented CTP’s first FDA AWS GovCloud application, paving the way for others, and its scalable architecture supported a 318,000% increase in products within the first 6-months of release.

Food and Drug Administration, Office of Business Informatics and Office of Pharmaceutical Quality 
Knowledge-Aided Assessment and Structured Application (KASA) 

FDA is taking advantage of modern technologies like workflow management tools and predictive modeling to build the Knowledge-Aided Assessment and Structured Application (KASA) system, which: 1. Institutes rules and algorithms for risk-management and decision-making 2. Performs intelligent analyses to establish regulatory standards 3. Captures and manages knowledge during the drug product lifecycle 4. Provides a platform for structured regulatory assessments and submissions KASA leverages built-in risk assessment algorithms to auto-evaluate risks objectively and quantitatively within the system. KASA uses structured descriptors with risk control approaches and enables computer-aided analyses for a comparison of regulatory standards and quality risk across the repository of FDA-approved drug products and facilities. KASA rolled out in Q1 2021, and preliminary results are positive.

Centers for Medicare and Medicaid Services
CMS State Health Insurance Exchange (SHIE) Operational Oversight and Monitoring Support (OOMS)

SHIE OOMS provides operational and oversight support for CMS to effectively administer State-Based Exchanges and Section 1332 Waivers. Leveraging human centered design techniques to connect project leads with stakeholders to review meaningful insights that solve root problems for end users the solution: brought efficiency and program integrity to the process of administering State-Based Exchanges and 1332 waivers; significantly reduced email traffic by leveraging SharePoint workflows to improve Open Enrollment Tracking and Readiness Review process; leveraged Tableau to improve the efficiency of validated State-Based Exchange enrollment metrics; reduced the margin of human error; decreased the time spent on quality control; and eliminated the collection of unnecessary data by modernizing the State-based Exchange budget template and related processes.

Centers for Medicare and Medicaid, Office of Communication
CMS Call Center Operations 

The program supports the Medicare and Affordable Care Act contact centers, which averages 40M plus call/touchpoints per year from over 55 million enrolled Medicare beneficiaries and 10 million Marketplace consumers. The program, which historically only worked in dedicated facilities, required the establishment of virtual desktop devices in an approved cloud environment, virtual training of CSRs and deployment of desktop analytics to ensure information integrity and continuity of the citizen experience. The 2021 open enrollment period customer satisfaction (CSAT) for Medicare and Marketplace programs reached all-time highs, while also maintaining no significant impacts to information security, CSR engagement, or operational performance between center-based CSRs and those working from home.

Department of Veterans Affairs, Office of Information Technology
VA Enterprise Testing Service (ETS) Support Services (ETSSS) 

This effort developed new clinical workflows, enhancing testing, and supporting approval for applying a new Critical-Analysis Risk-Assessment (CARA) process: a quantifiable, risk-based requirements analysis providing a comprehensive assessment of all applicable business, design, programmatic, and functional-controls associated with the systems, supporting and continually improving the Testing Intake Assessment (TIA). Applying a disciplined assessment of requirements and design, every application, interface, and workflow is tested to determine whether in-depth verification or validation effort is warranted based on a quantifiable scoring of the risk and criticality under test (SUT). The TIA/CARA process ensures critical components undergo validation and verification to minimize the risk to the VA Health Care program.

Department of Veterans Affairs, Office of Information and Technology
VA Telehealth Scrum Team 

In response to COVID, VA’s Office of Information and Technology (OIT) and the Veterans Health Administration assembled a scrum team of technologists spanning the enterprise to quickly surge telehealth resources to provide novel, seamless information and technology services that VA relied on to fulfill the Department’s mission. Crucially, the OIT-VHA telehealth scrum team worked to rapidly expand VA’s primary telehealth system, VA Video Connect, by upgrading on-premises hardware (tripling pre-COVID capacity) and then, in just five weeks, further expanding the system to the cloud (Care2 Cloud) and quintupling capacity. This dramatic increase in system capacity saw VA Video Connect support approximately 3.9 million visits in FY20, compared to just under 295,000 visits for all of FY19.

Department of Health and Human Services, Administration for Children and Families, Office on Trafficking in Persons
Shepherd Case Management System (SCMS) 

Shepherd provides a secure, streamlined way to request assistance for victims of human trafficking; accelerates connections to victim assistance programs and benefit-issuing agencies; strengthens data privacy, security, and confidentiality; improves analytics to inform evidence-based victim assistance and prevention programs; and fosters public accountability with timely information for Federal reporting and research. The agile development approach allowed collaborating agencies to jointly focus on needs of survivors while fulfilling their respective missions. Shepherd cut case processing time by 50%, enabling OTIP to use new capabilities to identify victims and connect them to services more quickly.

Department of Health and Human Services, Agency for Healthcare Research and Quality
Medical Expenditure Panel Survey – Household Component (MEPS-HC) Health Policy Booklet (HPB) Abstraction 

This represents the development of an efficient data abstraction tool and the support of well-trained, highly skilled abstractors to produce a robust, accurate and actionable data source for AHRQ’s use. To maximize data extraction from the collected HPBs, a cloud-based application abstracted and enhanced data from a highly complex variation of unstandardized documentation using ML, computer vision, and NLP. With a <2% error rate, the tool ensured data quality while also monitoring abstraction progress. This modernized AHRQ’s available toolset by harnessing cognitive services in a way not previously used. By using HCD, the solution strikes a smart balance between automation and human intelligence to best interpret artifacts, empowering AHRQ to leap forward after a twenty year wait for the critical information locked within the HPB documents.

Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of the Chief Information Officer
HHS OASH ServiceNow Implementation 

This effort implements multiple ServiceNow suites including ITSM Incident Management, Change Management, Knowledge Management, Service Portal, ITBM Demand Management and Portfolio and Project Management. Using ServiceNow as the single service platform enabled the automation of highly complex processes throughout the organization to include Service Desk, Asset Management, Change Management, and Project Management, all on the single system of the record, while utilizing common data from the Department level to keep OASH highly integrated with other HHS processes. The whole program lays the foundation for driving automation and innovation, and transforming antiquated ways of doing business while leveraging an HHS wide environment that minimizes time to production through pre-developed functionality and shared data.

Department of Veterans Affairs, Office of Electronic Health Record Modernization
Electronic Health Record Modernization 

VA is transitioning to a new electronic health record system over a 10-year period scheduled to end in 2028, connecting VA medical facilities with the Department of Defense, the U.S. Coast Guard and participating community care providers, allowing clinicians to easily access a Veteran’s full medical history in one location. VA has completed one of the most comprehensive health data migrations in history, moving more than 23 million records to a shared center with DOD. Since March 16, 2020, 116 alerts notified clinicians at one department to reconsider their intended treatment plan due to conflict with orders placed by clinicians at other departments. This insight demonstrates how the new EHR will improve the quality of Veteran health care.

National Institutes of Health, National Institute of Allergy & Infectious Diseases
Coronavirus Prevention Network/CoVPN

As part of Operation Warp Speed, NIH and NIAID, in collaboration with multiple stakeholders, needed to recruit a diverse pool of volunteers for Phase 3 clinical trials for COVID-19 vaccines and monoclonal antibodies (mAbs). The system was built on a collection of reusable digital components vetted and tested for accessibility/508 compliance, usability, and compatibility across browsers and devices. This empowered NIAID to move rapidly, and condensed design and development from months to just five weeks. Since their July 2020 launch, the English and Spanish sites have received more than 12.5 million page views and enrolled nearly 600,000 volunteers. The sites provide education on clinical studies, vaccines, and mAbs, answer questions about COVID-19, and directs visitors to the CoVPN Volunteer Registry.

Food and Drug Administration, Center for Devices and Radiological Health
FDA CDRH Digital Transformation Services Program 

The FDA CDRH Progress Tracker provides industry with a centralized, plain language, and self-service touchpoint for pre-market request status throughout the review process. The portal will replace time-intensive, manual interactions and allow industry stakeholders real-time insight into their application status. To deliver the portal, the Digital Transformation Team is re-envisioning the way CDRH interacts with its customers, leveraging digital products and an agile, user-focused approach to provide an enhanced customer experience. The first version of the progress tracker was launched on March 8, 2021. With the introduction of the industry submission tracking portal and in the larger digital transformation effort, CDRH is incorporating a comprehensive change management philosophy that focuses on two-way communication and stakeholder engagement.

Department of Defense, Naval Information Warfare Center Atlantic 
Enterprise Intelligence and Data Solutions PMO 

Supporting the Enterprise Intelligence and Data Solutions (EIDS) PMO, the NIWC Atlantic Cyber team brings state-of-the-art technology to delivery of data supporting the Military Health System (MHS), such as the MHS Information Platform (MIP). EIDS is an innovator, with impactful leadership, business intelligence, and transformational technology that enable informed decisions for delivery of health services to 9.6 million MHS beneficiaries, including Warfighters and their families. The EIDS/NIWC Atlantic partnership enabled rapid responses to emerging threats such as COVID-19 and solutions for cyber vulnerabilities resulting from aging infrastructure, including a 16-week rapid migration to the cloud and four ATOs in an unprecedented 12 weeks.

Department of Veterans Affairs
Project Resilience 

Project Resilience pairs smartphones and biosensors in wearable designs to support self-care for Veterans affected before, during and after COVID-19 infection. It also offers new ways to study the personal and population health effects of COVID by leveraging tools known to be useful in documenting individual health information. Through Project Resilience, VHA aims to better understand and address the lingering impacts of COVID, and increase access to care, reduce costs in dollars and time, and improve VAMC, specialty care, and system-wide clinical outcomes. Project Resilience will benefit 10,000 Veterans, caregivers, and VA clinical staff who are initially enrolled, but as it expands, could impact 350,000 Veterans who are already using biosensors.

Centers for Medicare and Medicaid Services, Office of Financial Management
CMS CERT C3HUB Application (C3 = Coordination + Collaboration + Communications) 

CMS implemented the Comprehensive Error Rate Testing program to measure improper payments in the Medicare fee-for-service program. The C3HUB tool enables 16 Medicare Administrative Contractors (MAC), CMS, and CERT to share information about claims under-review, track errors, and enhance communications. The hub enables CMS, MACs, and CERT to collaborate in real time and end the endless shuffling of paperwork and cases back and forth. A key innovation of the C3HUB is its fully integrated collaboration capabilities, ensuring that business and collaboration activities are woven together, providing a seamless experience. While most applications are designed in a stand-alone manner, focused on specific business requirements, the C3HUB is a transformational solution because its collaboration capabilities are fully integrated within the application.

Department of Veterans Affairs, Financial Services Center
Financial Services Center Electronic Claims Administration Management System (eCAMS) 

VA-FSC needed to update their administrative support services. This project included replacing its legacy commercial-off-the-shelf system with a centralized processing system and migrating all existing and potential customers. The Agency evaluated and selected a standards-based, configurable platform to increase processing capacity, efficiency, and accuracy. The most innovative aspect of eCAMS 3.0 is its business rule driven, automated, near real-time adjudication, and scalable, configurable architecture, which efficiently and accurately processes the ever-increasing volume of claims. In addition, eCAMS 3.0 accommodates changing policies and business rules for the VA health program while implementing pricing logic in a configurable rules engine. The system is designed to scale up to 125,000 claims daily and up to 30 million claims annually.

Department of Veteran Affairs
Veteran Pension Automation 

This effort modernizes VA pension and burial claims processing with an automation engine orchestrating legacy systems services and manual evaluation steps, augmented by a binary classifier machine learning capability to replace human judgement in determining service connection for burial and dependency indemnity compensation (DIC) benefits. A model-driven design approach established a common understanding between the business SMEs and Agile delivery teams, expediting transition from requirements gathering to implementation and minimizing risk. Over nine months, the team delivered 25 releases into production, substantially decreasing average claim cycle time and backlog. Average claims processing time has been reduced by a third and the associated backlog stands 75% reduced since go-live. For some claims, automation has moved processing from months to minutes.

Department of Veterans Affairs
COVID-19 Surveillance for VA Medical Centers 

This case study showcases the development and rapid deployment of a hospital information system integrated solution for monitoring the test results of patients presenting with symptoms that require screening for COVID-19 to 45 U.S. VA Medical Centers during the pandemic. Seven days prior to the Trump Administration’s declaration of the COVID-19 National Emergency, hospitals with the software platform were able to test, implement and automate the tracking and monitoring of CDC guideline based COVID-19 screening and confirmation test results via a centralized hospital information system integrated solution. The test results were monitored in real-time and patients were flagged to facilitate efficient review by care team members via a single user interface that listed patients who tested negative.

Defense Health Agency
Individual Longitudinal Exposure Record (ILER)

Created using Joint Incentive Funds (DHA & VA), ILER creates a complete record of occupational/ environmental health exposures over a Service Members’ career by integrating exposure data, EHRs, and other medical-encounter information for use by Healthcare providers, researchers, and administrators. It pinpoints Service Members’ locations in theater, times/dates, and associated exposures, thereby enhancing exposure-related medical diagnosis and treatment, medical surveillance, epidemiologic analyses, and disability evaluations. ILER informs and enhances timely medical care, medical surveillance, disability evaluation, and benefits determination processes, supporting complex analyses by medical providers, epidemiologists, and researchers and assessing both individual and population-level exposures and outcomes. The effort could significantly reduce VA claims process which currently takes approximately 1.5 years.

Centers for Medicare and Medicaid Services
CMS Transformed Medicaid State Information System (T-MSIS) 

T-MSIS is a Medicaid IT modernization effort that advanced data processing and storage from costly DB2 data centers to AWS. Using DevSecOps, Agile methodology, and the U.S.  Digital Services Playbook as guiding principles, T-MSIS has strived to “operationalize” data in an enterprise fashion. Partnering with States to submit quality data towards improved Healthcare outcomes, T-MSIS informs data-driven decisions with data on beneficiary eligibility, enrollment, utilization, service delivery, and cost. The team embraced innovations in system and test automation, infrastructure-as-code (IAC), and also reduced costs by maximizing cloud-based and open source solutions.

Centers for Medicare and Medicaid Services, Medicare Enrollment and Appeals Group, Division of Appeals Operations 
Medicare Appeals System (MAS)  

MAS is the system of record for Medicare Appeals used daily by thousands of Government employees and contractors across the country. The team recognized the need for enhanced strategic planning; roadmap creation and execution; and prioritization of new features and operational tasks. CMS integrated the Aha! Roadmap software platform with its existing Atlassian application lifecycle management suite to support the product management and product owner teams’ strategic planning in an Agile, DevSecOps environment. The integration of this toolset proved crucial when the COVID-19 pandemic transformed the project culture to a 100% virtual operation practically overnight. The product management and development teams continued to evolve and execute MAS roadmaps seamlessly. This innovation directly contributed to the continued success and growth of MAS.

Department of Veteran Affairs, Office of Information Security
VA Cybersecurity Operations – Next Generation (CSOC-NG) Program 

CSOC created a custom dashboard to serve as a single pane of glass for enterprise cyber metrics, including attack vectors, NIST compliance, cyber incidents, and critical vulnerabilities. This dashboard utilizes dynamic graphs, charts, and other graphical displays to enhance reporting across the VA Leadership Chain. It also allows leadership to proactively detect and mitigate impacts to the VA enterprise and align people, processes, and technology for cyber initiatives that improve VA’s ability to detect and remediate cyber threats while maintaining a secure and effective operational environment. The initiative serves as a key enabler in transforming the VA CSOC from a reactive cyber entity to a proactive, intelligence-driven entity.

Department of Veterans Affairs
Medical Care Collections Funds (MCCF) Electronic Data Interchange (EDI) Transactions Application Suite (TAS)  

The MCCF EDI TAS product portfolio is comprised of software products supporting medical insurance reimbursement of over $3.2B yearly and resides within the Veterans Information Systems and Technology Architecture (VistA). To support the transition to a modern EHR, VA deployed MCCF EDI capabilities to Microsoft Azure Government (MAG) cloud – the first project to do so in VA. Utilizing MAG-enabled infrastructure-as-code and modern DevSecOps, VA implemented the modern FHIR protocol for 837 EDI transaction processing, standardizing data exchange for electronic submission of claims information. Standardizing on FHIR lays the groundwork for additional interoperability efforts, including the implementation of the Veterans Data Integration and Federation (VDIF) enterprise platform, a federated FHIR server that supports health information exchange within VA and other partners.

Centers for Medicare and Medicaid Services
CMS Cloud SecOps 

CMS created the Cloud SecOps program to enable cost-effective and scalable cloud services that are secure, user-centric, and scalable as demand for services increases. The Cloud SecOps program is modernizing CMS’ security posture by promoting extreme automation, self-service tools, and an embedded security culture. In 2021, CMS implemented AWS Security Hub. The platform automatically aggregates security findings data from AWS accounts, services, and supported products, enabling ADOs to view and manage noncompliance alerts and automate security checks across the environment. With the integration of automated security tools like AWS Security Hub, CMS is significantly reducing the effort to collect, prioritize, and remediate security findings across the enterprise while enabling ADOs to make informed decisions based on their risk profiles.

Centers for Medicare and Medicaid Services
CMS Innovation Payment Contractor Portal “IPC Portal”

CMS’ Innovation Payment Contractor (IPC) program processes non-claim based payments and provides related financial and IT services for the Agency’s Innovation Center Models. The program relies on paper, sent via mail to CMS for review, scanning and transmission for processing. The IPC Portal takes a burdensome paper process and moves it online to reduce effort, risk, and time. The IPC Portal is used as an important digital information channel for CMS to reach providers, providing real-time information, and allowing reconciliation of accounts more quickly. Within the first months, the IPC Portal is now a standard component and is actively used to make payments. The Portal has been adopted by three CMS Innovation Center Models, with more expected.

Department of Health and Human Services, Office of Inspector General
HHS OIG Business and Mission Systems Modernization

This program forged partnerships across HHS OIG offices and leveraged a shared, low code platform to build a suite of modernized applications which improve all aspects of how HHS OIG executes its mission. The modernized applications automate and digitize manual processes, enable outbound engagement with mission partners and citizens, and help investigators manage case information, improving their ability to conduct investigations. The modernization of OIG’s public-facing tip line enables the collection, routing, and investigation of more than 9,000 tips about potential criminal activity each month, tying together hundreds of agents and specialized task forces in offices across the country and allows all 27 HHS operational divisions to directly collaborate in a unified investigation process.

Defense Health Agency, Naval Hospital Jacksonville
Navy Care

Navy Care serves as Naval Hospital Jacksonville’s virtual health platform. The use of the secure Navy Care platform for on-demand and scheduled visits has supported fleet readiness and enabled NH Jacksonville to maintain and expand patients’ access to care as COVID-19 evolved. From March to July 2020, average visits increased from 10 to 200 per day. In response, NH Jacksonville expanded platform functionality to allow eligible patients to self-register for Navy Care, built on-demand virtual care with new virtual waiting rooms, transitioned additional providers to the platform to conduct virtual health visits from multiple locations, and created a protocol to enable patients to self-schedule vaccine appointments.

National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
NICHD Data and Specimen Hub (DASH)

DASH is a data sharing resource established by NICHD to address the many challenges that have historically limited data sharing. DASH is a centralized resource for researchers to store, access, and analyze individual-level participant data from NICHD-funded research studies for use in secondary analyses. DASH maximizes NICHD’s investment in research. Establishing DASH as a centralized resource has enabled NICHD to shift the culture of data sharing from a ‘one-off sharing’ between investigators to a broader ‘public sharing’ with any researcher who accesses DASH. This data sharing ecosystem is driven by science, policy, analytics, and technology to facilitate new discoveries and biomedical breakthroughs. DASH has had an extraordinary impact by shifting the data sharing culture within NICHD and the biomedical research community.

Food and Drug Administration, Center for Drug Evaluation and Research
FDA MedDRA-based Adverse Event Diagnostics (MAED)

The MAED application allows FDA reviewers to explore adverse-event data for trends in safety signals in clinical trial and post-marketing reports. To further explore clinical trial data, the new Time-to-Event feature allows FDA to reliably and quickly evaluate the time elapsed until a drug trial participant experiences an adverse event. The Office of Computational Science developed a cost-effective, enterprise SAS-based solution that does not require new licenses and uses existing tools to address the time-sensitive needs of FDA. MAED uses drug sponsor/manufacturer provided data to produce meaningful, accurate results about adverse event frequency quickly and supports FDA’s mission to ensure drugs, biologics, and vaccines are safe through the innovative use of health IT.

Department of Veterans Affairs
VA Office of Technical Integration Interoperability

VA OTI leads a coordinated leadership body focused on ensuring the Veteran journey is seamlessly enabled through interoperability of the systems that support them. This requires a robust, comprehensive notion of interoperability to encompass: Business, Data and Information, and Systems and Technology. An Interoperability Maturity Model (IMM) provides for measurement of the intangible concept of “Interoperability” between business entities and processes within VA. The program approach engages VA stakeholders at all levels from top-level leadership to boots-on-the-ground experts to advocate for Interoperability in all phases of VA execution. Adoption of the ideas and concepts advocated by this program are enacting a change, that is managed, that will improve how VA operates, evaluates cost benefit, and plans expenditure.

Department of Veterans Affairs
VA Community Care Referral and Authorization (CCRA)

CCRA is an enterprise-wide program that is used by Veterans Affairs to generate patient referrals/authorizations for Veterans receiving community care. Through HealthShare Referral Manager (HSRM), VA has transitioned from a manual process to one that generates automated standardized referrals and authorizations. HSRM provides prompt referrals to a community provider of choice. The system decreases administrative burdens on VA staff by establishing clinical pathways reflecting best practices, consistent outcomes, and reduced turnaround times, through an innovative automation solution. CCRA has processed over 9M referrals, over 1M of which involve emergency care episodes. Care for more than 3M Veterans has been improved through expedited referrals and authorizations.

United States Department of Defense, DTRA (Defense Threat Reduction Agency)
RATE (Rapid Analysis of Threat Exposure)

RATE is the first large-scale empirical exploration into the prediction of pre-symptomatic infection in humans and is part of efforts to improve military readiness and community health. The solution acts as an early warning system facilitating faster diagnosis and treatment of infection to reduce individual downtime and aid in containing the spread of a communicable disease by isolating exposed individuals earlier. RATE uses large-scale data machine learning and trade-space analyses across 165 different biomarkers. The RATE algorithm is currently integrated into wearable devices such as smart watches and Oura rings, allowing a soldier’s health to be non-invasively monitored and delivering earlier alerts to potential infection up to 48 hours prior to the onset of symptoms. The technology could further be applied in a civilian capacity by helping to monitor the general population and hospital patients for infection.

Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau (HAB)
HRSA HAB Health IT Performance Monitoring and ROI Analyses

HAB lacked a coordinated strategy for managing IT projects or leveraging outputs from ROIs to inform decisions. Through this ROI-centric program, HAB developed a collection of measurements for IT investments and created ever-growing circular benefits for employees to engage with IT systems. HAB learned the value creative participation in IT projects has on employee empowerment and engagement and is incorporating it in planning and decision-making. The ROI on HAB’s IT investments allowed stakeholders to measure the impact of investment on their organization, discover how it drove internal efficiencies, and its overall effectiveness for grantees. The ROI outputs gave HAB a baseline for the status of the investment and information to influence future decision-making.

Centers for Medicare and Medicaid Services, Office of Strategy, Performance and Results
CMS COVID-19 Impact Dashboard

CMS leadership launched a “COVID-19 Taskforce.” Agency executives and directors needed to identify current and potential impacts of COVID-19 on the Agency, its mission, and the public. Initial work involved identifying data assets that could be collected, analyzed, and developed into visualization dashboards focusing on COVID-19 impacts to the Agency. The dashboard solution technology drove a transformation in the way impact was viewed across the entire enterprise using visualizations that represented nine CMS component areas and included information on topics such as organizational continuity, cyber security, legislation, budget, acquisition, and program impacts.This dashboard has simplified the data reporting process for CMS leadership and given them tools to understand which parts of the organization are most impacted by COVID-19.

Defense Health Agency
Cyber Operations Center

JFHQ DODIN recognized the CyOC as the highest standard in which other agencies are compared against and its cyber compliancy efforts have been heralded as a litmus test across the DODIN. The CyOC has taken the task of its changing mission and issuance process and redefined how traditional issuances are released within the enterprise, implementing a standard practice of releasing immediately upon receipt from the higher-level entities. The CyOC tracks the release down to the program level to ensure proper steps are followed for accurate and timely reporting. The CyOC has increased compliancy across the board for issuance management, Scorecard reporting, Vulnerability Disclosure Program (VDP) Management, and Public Key Infrastructure identification.

Department of Veterans Affairs, Office of Information Technology
VistA Audit Solution – Protecting Veterans’ Data

Congress mandated and funded development of a new capability for the VistA system known as the VistA Audit Solution. VAS will provide a nationwide HIPAA audit tracking solution to track and report access to VA patient PII/PHI data across 171 medical centers and over 1000 clinics. Using the VA Enterprise Cloud, the VAS team leveraged three untapped Amazon Web Services tools resulting in a cost-effective solution to meet fluctuating storage demands and allowing data to be moved from higher-cost storage tiers to lower-cost storage as it ages. The new technology system can retrieve targeted audit records from the archive storage instead of accessing all records simultaneously, resulting in significant cost reductions and decreased processing time, and an improved user experience.

Department of Veterans Affairs, Board of Veterans Appeals and Office of Information and Technology
Caseflow – Virtual Tele-Hearings

Caseflow is a series of tools that provide a solution to allow Lawyers, Judges, and other staff within the Department of Veterans Affairs (VA) to electronically submit and process appeals for benefits and services that are due to Veterans. In response to COVID-19, the Caseflow team released into production the Virtual Tele-Hearings capability. This new capability allows Veterans to coordinate with the Hearings Coordinator to schedule their Virtual Tele-Hearing, as well as attend the meeting from home. In 2019 and 2020, the Board held 22,743 and 15,669 hearings respectively while also deciding approximately 100,000 appeals each year. The pandemic demanded a technological solution. To date, the Board has held over 17,000 virtual hearings enabling the Board to set stretch goals of 50,000 hearings annually. Currently, over 97 percent of all Board hearings are conducted virtually.

Centers for Medicare and Medicaid Services, Center for Clinical Standards and Quality
The Health Care Quality Information Systems, Information and Data Center Support (HCQIS HIDS): Implementation and Transition to the Cloud

The CMS CCSQ/ISG leadership established the ISG Playbook to create a vision and strategy to achieve cost savings and rapid development and to engage all stakeholders to embrace change and adopt the new delivery model. The development of a new governance model for the cloud environment streamlined approval processes, minimized touchpoints, maximized automation, and granted application developers exceptional levels of autonomy. Dramatic increases in development velocity and cost reductions were achieved throughout the enterprise (~21% of the four year infrastructure and security budget alone) as well as additional savings for developers, maintainers, PMO, and the Government workforce due to reduced meetings, touchpoints, and tracking needed for project delivery and operations.

Centers for Medicare and Medicaid Services, Office of Information Technology
CMS Enterprise Data Encryption (CEDE)

CMS required a recommendation of an optimal data-in-transit and data-at-rest encryption solution that could serve over 200 systems across 55 data centers and multiple cloud environments. This corrective action plan under an Agency-wide POA&M provided a clear path for business owners and a consistent approach for the Agency that could be readily monitored via existing programs. Detailed security analysis was based upon threat posture and decisions were driven through Data Analytics and Insights. Data analytics and visualizations helped define the problem and provided a means to engage business owners. Approaching the encryption challenge from a security posture and risk mitigation approach, empowered Agency leadership to transform and modernize encryption strategies through a greater level of insight into their security posture.

Department of Veterans Affairs
Veteran Signals (VSignals)

VSignals is a continuation of the award-winning VOICE Veteran Experience program and uses multi-channel feedback mechanisms to gather continuous Veteran and employee feedback, identify Veterans in crisis, and ultimately improve Veteran experience across the spectrum of interactions that occur between Veterans, employees, and VA. As a result of VSignals, VA has surveyed over 38 million Veterans [HG] and received feedback from over 6 Million Veterans on topics ranging from Disability Compensation to Outpatient treatment services. VA caregivers have also provided support to over 6,000 Veterans identified to be at risk for suicide and/or homelessness using the innovative Crisis Alert system. COVID showcased the value of the VSignals program as an essential tool that helps VA shape its emergency response to a global pandemic.

Department of Veterans Affairs, VA OIT Data & Analytics Product Line
“Rockies”  – Part of the VA Data & Analytics Ecosystem

“Rockies,” project was started to develop and implement a cloud native enterprise data analytics platform with scalable computing resources and knowledge management service for VA operations and external collaborators. Using the latest cloud-native tools, natural language processing (NLP), and predictive analytics, Rockies is unlocking the power of VA data and improving predictive models. By reducing compute time and accelerating delivery of actionable insights to clinicians and other critical decision makers, Rockies enables VA to improve responses to health crises. VA is now looking to use Rockies capabilities to support a wider variety of use cases across VA, such as cancer management to improve Veteran health outcomes and virtual care tracking to provide a holistic view for patient care decisions.

Centers for Medicare and Medicaid Services, Office of Financial Management
BCRC Intelligent Virtual Assistant (IVA)

The Benefits Coordination and Recovery Center program handles 10+ million calls annually from a diverse group of stakeholders. The IVA utilizes AI and ML to assist the CSR in handling complex calls, acting as the Interactive Assistant (IA) partner to obtain current and accurate data to answer the caller efficiently. Focused on business transformation and modernization, BCRC’s IVA streamlines how CSRs receive information by automatically providing keyword information based on what the caller says, improving quality and consistency. The IVA leverages several capabilities to assist CSRs including freeform conversational chat – allowing CSRs to type in questions and receive learned answers, quick reference matrix tools – improving information retrieval and a call notes panel for quick reference.

Telemedicine & Advanced Technology Research Center, Digital Health Innovation Center 
National Emergency Tele-Critical Care Network (NETCCN)

The National Emergency Tele-Critical Care Network (NETCCN) addresses a specific disaster health care problem: patients with severe COVID-19 infections were overwhelming critical care resources. TATRC rapidly developed a digital health ecosystem which virtually extended critical care capabilities and expanded care capacity significantly. While the necessary technology existed previously, TATRC experts adapted the systems for use in a disaster setting. In addition to supporting tele-critical care for COVID-19, the capabilities created and lessons learned from this project will address similar challenges posed by dispersed operations and prolonged field care expected in future military operations. The initial phase of NETCCN consisted of system configuration, testing, rapid development, and deployment. The project garnered partnership, endorsement, and follow-on funding from HHS ASPR.

Department of Veterans Affairs, Office of the Chief Technology Officer
VA COVID-19 Patient Manager & SMART on FHIR Platform 

The VA COVID-19 Patient Manager application, leveraging the SMART on FHIR Platform, launches from CPRS with a VistA integration and was developed in four months. At the time of this submission, live clinical pilot testing is ready to begin in three VA medical centers, pending final work to complete VistA data integration. VA clinical subject experts from three medical centers were actively engaged throughout the development lifecycle. The application’s clinician facing experience has received praise from the VA clinical users. Multiple VA clinical and business champions have expressed interest in leveraging the innovative foundations created by this team.

Department of Veterans Affairs, Office of Information and Technology
VA Virtual Hearing Platform

This three-way communication tele-hearing platform was created by a joint effort between the Board and the IOT at the VA and was designed to connect judges, Veterans, and Veteran representatives together regardless of physical location. By allowing Veterans to schedule and attend hearings virtually, VA is bringing a pivotal service to Veterans. Doing so has resulted in fewer hearing cancellations, more scheduling opportunities, and less wait times. Prior to the launch of virtual tele-hearings, approximately 50 hearings per week were being scheduled. Since the platform’s launch 1,000 hearings have been scheduled weekly. To date, the Board has held over 13,000 virtual tele-hearings since the start of COVID-19.

Department of Veterans Affairs
VA Nurse Advice Line (VA NAL)

The COVID-19 surge challenged VA to expand high-quality, virtual health care. VA quickly mobilized operations to support existing nurse advice lines (NAL) at VA medical centers through the provision of additional registered nurses to support Veterans who needed care. The Office of Veterans Access to Care (OVAC) initiated a NAL to manage call volumes, increase access to same day nurse triage and assist in care delivery. VA NAL was initiated in May 2020 and will continue until this fall as the Clinical Contact Center modernization is also occurring. This modernization will ultimately provide 24/7 virtual care throughout VA’s network.

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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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