Medicare Details IT Modernization Plan

Agency aims to transform into an information-centric organization to improve its delivery of healthcare services and manage new programs and requirements outlined in federal law.
Slideshow: Who's Who In Healthcare IT
Slideshow: Who's Who In Healthcare IT
To improve the organization's management of data to help meet its objectives, CMS will implement changes, including the following:

-- The EDE will establish Operational Business Intelligence Repositories (OBIR), a category of data stores that will serve as the authoritative source of near-real time and/or historic data for individual CMS programs.

-- CMS' healthcare role is changing from a passive payer of claims to a purchaser of quality healthcare outcomes. CMS is implementing programs for assuring healthcare quality and is progressing toward new payment models based on the quality of care.

-- The data in the EDE exists in raw form, and does not reveal the trends and comparisons that CMS needs to make mission-critical decisions. To meet these and other vital data access needs, CMS is implementing an enterprise-wide business intelligence environment (BIE) that provides essential operational analytics and reports that will help CMS use its data to inform important decisions and offer greater confidence in those decisions.

-- The establishment of data governance to address standards, organizational readiness, budgetary capitalization of shared enterprise data assets, enterprise data engineering and planning, and business transformation.

According to CMS, it will take 5 to 10 years to implement the plan in incremental development cycles. CMS also predicts that its data governance and enterprise data management policies will spawn significant cost savings. Among the areas identified as benefiting from potential administrative cost savings/cost avoidance are:

-- Reduced risk of systemic failure due to overly complex, customized systems;

-- Simplified infrastructure through the retirement of hardware, applications, and databases;

-- Retirement of systems reducing the burden of maintaining product licenses and support costs (monitoring, upgrades, and patches) of retired systems;

-- Reduced labor activities related to the legacy hardware, applications, and databases (acquisition, storage, analysis, enhancement, maintenance, troubleshooting, archival, and distribution); and

-- Negotiation of better rates for resources that do not require special domain knowledge or expertise, which is presently required for complicated infrastructure or legacy assets.

"There should be significant administrative savings beyond FY 2015 once the core infrastructure capabilities are established. As the enterprise technology systems are integrated and the data services mature during the initial phases, the agency will realize modest savings," the report concluded.