Digital Modernization - Healthcare Quality Survey

Challenge

The Centers for Medicare & Medicaid Services (CMS) uses a dozen of healthcare quality evaluation and survey applications to collect and validate data from 3.5 million assessments monthly, 42 million assessments yearly received from healthcare providers. To elevate the user experience and meet new needs to improve the quality of care for millions of Americans, the CMS strategizes to redesign and launch a new suite of applications.

Solution

eSimplicity supports our partner in delivering both application development and data pipeline and analytics. Starting with continuous user research and testing, we define user needs and validate designs of the new applications that puts the users and their experience first. The incorporation of modern system design practices such as human-centered design (HCD) and agile development practices, allows for a phased development and delivery approach. Beginning with Long Term Care Hospitals (LTCH), eSimplicity has released the Minimal Viable Product (MVP) and several enhancement releases.

Outcomes

The Long-Term Care Hospitals (LTCH) MVP was released 9 months after the project began. At its peak, users submitted 6,500-7,000 LTCH surveys per day.

Modernization starts with users. To improve the quality and cost-effectiveness of services paid under the Medicare and Medicaid programs, the CMS uses multiple assessment and survey systems to collect and validate data on provider- and beneficiary-specific outcomes of care and performance. Throughout the years, these systems require a series of modernization and redesign to be more reliable, scalable, secure, and accessible; and elevate the user experience.

 

Provider Types

This effort supports more than a dozen provider types, including:

* Nursing Homes
* Home Health Agencies
* Psychiatric Residential Treatment Facilities
* Portable X-Ray Suppliers (supplier)
* Outpatient Physical Therapy / Speech Pathology Services
* End-Stage Renal Disease Facilities
* Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID)
* Rural Health Clinics
* Comprehensive Outpatient Rehabilitation Facilities
* Ambulatory Surgical Centers (supplier)
* Hospices
* Organ Procurement Organizations
* Community Mental Health Centers (CMHCs)
* Federally Qualified Health Centers (FQHCs)
* Clinical Laboratories (supplier)
* Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI)
* Transplant Programs

Outcome Datasets

The redesign effort will eventually cover all the following care quality outcome datasets:

* MDS: Skilled Nursing Facilities assessments
* OASIS: Home Health Agencies assessments
* IRF-PAI: Inpatient Rehab facilities
* LTCH: Long Term Care Hospitals CARE data
* HIS: Hospice Item Set
* ASPEN: Surveyor processing for S&C
* PBJ: Payroll Based Journal
* ePOC: Plans of Correction
* CASPER: S&C Reporting
* QW: QIES Workbench; legacy reporting env
* CLIA: Clinical Laboratory Improvements Amendment