HITECH, PPACA Call for Revised CMS IT Infrastructure, Report Says

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Recent laws calling for widespread adoption of health information technology and payment reforms necessitate changes in the Centers for Medicare & Medicaid Services' IT infrastructure and capabilities, according to a report released Nov. 14 by the National Research Council.

The report, Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services, recommended that CMS move from viewing IT as “simply an operational necessity” to embracing it as a “critical strategic element.”

Both the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Patient Protection and Affordable Care Act (PPACA) have given CMS new and expanded responsibilities for driving national improvements.

These improvements are needed in areas such as greater efficiency of health care services; elimination of health disparities; support of health care quality; adoption of health information technology; value-based purchasing; and collection and analysis of data to promote health and wellness, according to the report.

Additionally, CMS is now responsible for testing innovative care and payment models, and overseeing and supporting state-based insurance exchanges, the report said.

The report was authored by NRC's Committee on Future Information Architectures, Processes, and Strategies for the Centers for Medicare & Medicaid Services.

CMS Needs New IT Strategic Plan

According to the committee's analysis, CMS's ongoing operational requirements are currently being met with a very large and complex set of hardware, software, and communications systems that vary considerably in age, capability, and sophistication.

“The ability of these systems to continue to keep up with the ongoing changes and new missions demanded of them is an understandable source of concern,” it said.

According to the committee's recommendations, CMS should:

• develop a comprehensive strategic technology plan;

• determine an appropriate methodology to guide an iterative, incremental, and phased transition of business and information systems;

• address the implications of extensive IT renovations on its internal organization and culture; and

• recognize the increasing importance of data and analytical efforts to stakeholders inside and outside CMS.

CMS must also provide secure IT services to maintain patient and provider privacy, and remain flexible for future innovative technologies, the report said.

The NRC report is available for post-publication purchase and pre-publication download at https://download.nap.edu/catalog.php?record_id=13281 .