Facilitating rapid adoption and meaningful use of electronic health records for healthcare and public health

Background: Northrop Grumman supports CMS' EHR Incentive Payment Program which promotes the adoption and meaningful use of electronic health records (EHRs) via incentive payments to select Medicare and Medicaid Providers. Companion public health programs provide data via communication exchanges to facilitate broader scope of meaningful use in both clinical and population settings. For the purpose of EHR incentive payments, we have designed, developed, and fielded the National Level Repository (NLR) and manage the operations support contract for the program. Objectives/Purpose: This presentation discusses the technology solution of the data repository and how the solution leverages service-oriented architecture (SOA) concepts to integrate with the many other systems required to manage the incentive program.

Methods: The solution incorporates several components and strategies. A business rules engine (IBM iLOG) was configured to enable flexibility for implementing complex attestation and payment rules. Spring-Batch open source framework was leveraged to develop a “receipt and control” component for managing file-based integration jobs. SOA concepts were applied to both internal and external components of X. And a spiral/agile development methodology was used to address schedule constraints in a volatile requirements environment. For business operations, an information center was established in addition to production support, data quality, and reporting teams.

Results: The initial system to support registration requirements was developed and fielded in under 8 months. A subsequent release was also accomplished just 3 months later to enable more complicated attestation and payment functionality to be available in April 2011 also per mandate. : as of December 2011, the solution holds registrations for over 175,000 eligible providers and payment records for over $2.5 Billion in incentive payments from the program's first year. Discussion/Conclusion By providing consistent, reinforcing incentives for the adoption and meaningful use of EHRs, the program has hastened EHR application across the nation, enhancing both clinical and public health community efforts.