Exploring the role of Patient-Centered Data Design in HHS Transformation
Tom Byrne, VP Government Solutions, sat down with Healthcare IT Connect’s Rob Waters to discuss how the emergence of patient-centered data design and what this means for states as they explore modular modernization strategies.
RW: The opening session for Track 3 (Enterprise Systems, H&HS Integration) introduces the concept of person-centered data design and how this approach enables states to integrate new data sources and advance community engagement, what should states be thinking about as they embark on such initiatives?
MS: Person-centered data design is predicated on rapidly integrating new sources of data and making it more easily accessible, and states should be thinking about how to accomplish this most easily. How do we build a 360 degree view of the person/member.? Traditional approaches require a significant amount of effort to both organize and fuse data together. This is primarily because data is persisted in legacy technology, often relational databases, where the structure and indexing of the data needs to be known prior to using it. Maintaining these rigid structures can be challenging as unforeseen business needs arise.
A modern approach is to leverage an integration platform that forgoes these challenges by leveraging a modern enterprise NoSQL database that easily accommodates unforeseen changes without sacrificing enterprise capabilities mission critical applications expect. It also enables the ability to query integrated data without needing to know the underlying structure or indexing, resulting in agility when querying, fusing, and reporting.
MS: It is this type of agility that has enhanced citizen services at the Maryland Department of Human Service. The Maryland Total Human-services Information Network, or MD THINK, is a cloud-based modernization initiative that breaks down traditional silos and data barriers between state agencies and provides integrated access to administered programs. MarkLogic serves as the foundation of the Shared Data Repository that supports data from legacy systems and new programs and applications being developed as part of their modernization effort. The ability to rapidly onboard and fuse new, unforeseen data sets is vital to this program.
RW: At the same time many states are exploring modular modernization strategies that will enable them to be more agile and cost-effective in supporting programmatic goals. How does this data model translate to supporting these goals, and what are some of the data architecture considerations in meeting them?
MS: Leveraging a modern integration platform supports the goals of modularity in a number of ways. The ability to load data sets “as-is” without upfront data modeling provides significant time (and thus cost) savings. Further, to be able to meaningfully query data without any prior knowledge of the structure or indexing of the underlying design is a powerful tool that promotes unparalleled agility; module developers are more quickly able to create applications without needing to be experts on the architecture of the database itself. Some of the architectural goals that should be considered would be to support data integration platforms that are trusted to run the business and that contain truly enterprise capabilities. Top of mind is security – states have a responsibility to protect citizen data from adverse access and use. Ensuring that all reasonable precautions are taken to prevent adverse access and exploitation of data and that government-grade and certified solutions are leveraged is key. This includes such features as being secure by default, access control profiles, advanced encryption, and redaction/anonymization. Beyond security, states should be considering enterprise-readiness such as complete disaster recovery and high availability options, cloud-neutrality, and multiple storage options.
RW: What are some of the common applications where states are realizing some of these benefits?
MS: We’re seeing a lot of success and interest in MMIS projects that leverage both our data integration and Master Data Management capabilities. For instance, as a part of the Systems Integration contract in a southwestern state, MarkLogic was selected as a system migration repository. This state saw migrating data from one system into another not just as a core challenge for its modernization effort, but rather as a key capability that would be frequently needed to facilitate data integration while adhering to MITA principles.
As another example, a southeastern state selected MarkLogic to be the data hub of their Enterprise Data Services (EDS) and serves as the Raw Data Lake and Operational Data Store for mastered citizen data, Medicaid members, Providers and other important entities. MarkLogic reduces manual data integration by providing 360° views that allow for faster and more accurate eligibility determinations, more complete and accurate enrollment and eligibility reporting and a lower TCO by reducing duplication of data across silos.
RW: – Scalability has been a common fail point for large scale integration projects, what is MarkLogic doing differently to meet with these challenges?
MS: MarkLogic was built for scale and it does so linearly on commodity hardware and in cloud environments. Yet while we most certainly benefit from great engineering innovation in our product, what sets MarkLogic apart on these projects is also our approach to actual integration. A great scalability example of this is the work we did for HealthCare.gov. Following the approval of the Affordable Care Act, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) needed to design, build, and implement a technology platform capable of enrolling millions of Americans in new healthcare plans. CMS attempted to achieve this with a relational database, but the project failed, so CMS selected MarkLogic to meet its 18-month deadline. Today, CMS runs on MarkLogic as the largest personal data integration project in the government’s history.
RW: Looking to the future, how do you see the integration platform supporting state HHS transformation efforts in 5 years from now?
MS: Many states have now begun their IT modernization efforts, and this trend will continue to increase and the benefits will be more fully realized both in terms of meeting citizen needs and cost savings. I also believe that we will see a transition from traditional approaches for data design towards ones that favor greater innovation, agility, and simplified architectures.
Mark Logic is the 2019 TRACK 3 Sponsor
Enterprise Systems Planning, Health & Human Services Integration | Attend Mark Logics’s industry session Enterprise Data Hub as the New Medicaid Data Integration Pattern
Tuesday, March 19th • 2:45pm – 3:45pm
View 2019 State Healthcare IT Connect Final Agenda