Healthcare Data Registry to Support Healthcare Innovation

Introduction

Over 1.6 million people are diagnosed with cancer in the U.S. each year, and 50 percent are Medicare beneficiaries. In accordance with the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) developed the Oncology Care Model (OCM) with the goal of improving quality and lowering the cost of care for Medicare recipients.

OCM is the first of a planned series of studies to identify national treatment guidelines for care under the ACA. Specifically, the model tests the efficacy of appropriately aligned financial incentives to oncology practices and ascertains whether such payments improve care coordination, appropriateness of care, and access to care for beneficiaries undergoing cancer treatment.

To support CMS’ efforts to integrate oncology clinical data from various participating providers, CORMAC developed a cloud-based OCM Data Registry (OCMR), which the company currently maintains for CMS.

Business Benefits/Outcomes

OCMR collects and consolidates data from disparate sources, calculates performance on quality measures, exports raw and aggregate quality and clinical measure data, and allows for the easy exchange and sharing of OCM data to model participants and other entities. With this ability to integrate and analyze clinical data from hundreds of providers, CMS has better insight into which measures ultimately lead to the best patient outcomes.

In this way, OCMR supports ACA’s three primary objectives for OCM, carried out by CMS’ Innovation Center: To deliver patient-centered care, innovate health outcomes and reduce cost of care.

Additionally, OCMR provides data and enables findings that can be leveraged in future care models. As a result, OCM has already laid the groundwork for additional models aimed at improving care under the ACA.

Innovations to Bring Business Value

Agile, Cloud Native and Digital Services

CORMAC built OCMR in AWS cloud and obtained a FedRAMP, FISMA Mod ATO. Additionally, CORMAC implemented best practices from the United States Digital Service (USDS) playbook. OCMR was developed using Agile development methodologies, Human-Centered Design (HCD), DevSecOps, Software as a Service (“SaaS”) and open source software.

Using HCD, CORMAC developed OCMR’s web front-end user interface to improve user experience and increase adoption. To improve cost-efficiency, we leveraged AWS’ commodity hardware (S3 and Glacier) and Elastic MapReduce (AWS EMR) capabilities for in-memory computing and resource optimization. CORMAC leveraged open source stacks such as MongoDB for data storage as well as Python to build APIs and endpoints for interoperability.

Promote Health Interoperability

We designed the OCMR platform to support a broad continuum of data collection methods for both quality and clinical data to assure that users could participate regardless of their place on the health IT spectrum. The OCMR platform was built to accept data directly into the registry from web-based forms (i.e.: chart abstraction), prospective web forms on mobile and fixed devices, patient and peer surveys, automated mapping for file upload, and direct connections (on-demand or continuous cycles for data refresh from fixed pipelines into EHRs, HIEs, etc.). It has the ability to extract EHR data using various standards such as  CDA, QRDA, CCDA, flat file and any custom formats. CORMAC’s registry platform can be set to afford participants multiple methods to populate the registry with their practice data in either an automated or a “self-service” fashion.

Over the course of the program, we have made extensive customizations to the platform based on user feedback. These enhancements include the Data Gap Report and the Duplication Patient Resolution functionality, which were well received by users for helping them easily find and correct data errors, resolve duplicate reporting and ensure accurate attribution.