With approximately 43 percent of all Americans using Medicare or Medicaid, the Centers for Medicare and Medicaid Services (CMS), part of the U.S. Department of Human Health and Services (HHS), plays an integral role in today’s healthcare system. Though digital transformation and modernization efforts continue across the government, HHS is focusing on the future of healthcare administration and delivery to improve access to medical care by enhancing how resources, tools, and services are provided across the country. This need for healthcare modernization requires the right approach, and the HHS is guiding the two largest federal healthcare programs through the complexities of this process.
The HHS provides services and information to millions of Americans every day through their 12 operating divisions, including the Administration for Children and Families (ACF) and the Centers for Disease Control and Prevention (CDC). Healthcare modernization requires a unique approach for each agency, but most agencies within the HHS umbrella face similar challenges as they strive to improve user experience (UX) and increase access to healthcare while ensuring the security and integrity of information. Like many agencies within HHS, CMS—its largest operating division—is prioritizing the modernization of legacy systems, many of which date back several decades. “Medicare is a program from the 1960s with technology from the 1960s,” explained CMS Digital Services Director Andrea Fletcher during a recent webcast on modernization also featuring Brandon Shopp, group vice president of product at SolarWinds. “It’s been built and adapted over many decades, and with that comes challenges as new parts are added.” These legacy systems once served their purpose, but as agencies seek to improve UX and security and connect with the 56 states and territories represented by CMS, they’re ill-equipped to do so.
In the webcast, titled “Modern Medicine: Exploring the Future of Health Science Innovation,” Shopp and Fletcher discuss the effective solutions being adopted by CMS and others. Updating and incorporating more modern solutions in place of legacy systems puts CMS into a secure, customer experience (CX)-friendly, and interoperable place. This requires a methodical and measured shift to the cloud to avoid taking on too much too quickly and having functions become unreliable. CMS’s priority is to think about how these improvements can lead to better information security and UX throughout this transition and the healthcare modernization process.
Move to the Cloud
The cloud has expanded capabilities and opened new possibilities since it became publicly available in 2006. Despite the benefits, both Fletcher and Shopp warn about moving to the cloud without a plan. In Shopp’s experience, people think it’s easy to “lift and shift” to the cloud, but when they turn off on-premises hardware, they soon discover how costly transformation can be. Fletcher agreed, saying, “You can’t just pick it up and shift from the mainframe to the cloud. A lot of business process redesign needs to happen, and a lot of new technology has to be put in place for things like cybersecurity.”
Launched in 2020, the CDC’s Data Modernization Initiative (DMI) aims to enhance operations for the future of healthcare administration and delivery. To do this effectively, they’re focusing on the areas with the biggest impact opposed to making all the changes at once. According to the CDC’s cloud strategy, they’re expanding cloud service where “public health programs and partners easily, rapidly, and securely share data and scale solutions in a cloud ecosystem that improves the nation’s health and safety.”
As modernization efforts progress, HHS must focus on information security. It goes without saying healthcare records are highly sought after by hackers because they can contain complete records of personal identifiable information (PII), and they require extra protection. Keeping this information secure is a top priority. The key, Shopp notes, is agencies “can’t treat all data the same from a security perspective.” HHS provides guidelines on how agencies can adhere to HIPAA standards when using cloud computing. Also steering the future of information security is the 2021 Executive Order on Improving the Nation’s Cybersecurity and the roadmap to achieve zero trust the HHS is creating as a result.
A major focus of CMS’s modernization journey is making sure any changes they make are user-friendly and accommodate all constituents, especially as they handle the government’s most trafficked website, healthcare.gov. “With healthcare.gov, you’re dealing with people of all different ages and all different skill sets from a technology perspective, and with that much money and that many transactions flowing, UX is huge,” Shopp said. Fletcher shared how they design with inclusivity top of mind to ensure all systems can work with slow connectivity, apps work on older devices as well as the latest models, and the needs of all users—regardless of ability—are met. For example, CMS puts a heavy emphasis on ensuring all visual and cognitive disabilities are accommodated by using plain language. They write content in an understandable way, use multiple languages, and have multiple avenues—including a phone number—available for support.
The future of healthcare administration and delivery begins with the foundations being laid today. The goal isn’t to upend the entire healthcare system with new technology; it’s to replace legacy systems with technology capable of having the greatest positive impact on the people who rely on it. HHS is committed to improving the information security and UX for millions of Americans in need of care with meaningful and effective healthcare modernization efforts.
To learn more about CMS and the approaches taken within HHS toward healthcare modernization, watch the webcast here.