Congress and the Centers for Medicare & Medicaid Services have recently developed policies to dramatically improve patient care, from providing individuals with greater access to their health records to changing physician payment incentives. But for these policies to have an impact, patients and doctors needed new tools and resources to put them to use.
Shannon Sartin, executive director for the U.S. Digital Service at the Department of Health and Human Services, has led the development of numerous technological solutions for CMS that are translating those policies into results.
“I can say, ‘Here’s where I want to go,’ and she has the vision for how to get us there,” said Seema Verma, the CMS administrator. “Now the whole private industry is following us. Shannon enabled us to lead by example.”
One of the agency’s priorities has been to give Medicare beneficiaries more control over their medical records. In March 2018, Sartin led a team that partnered with CMS to launch Blue Button 2.0, a major enhancement to an existing online platform that contains four years of data on medical appointments, claims, prescriptions, insurance coverage, primary care treatment and cost for 53 million Medicare beneficiaries.
This new digital exchange of information created by Sartin’s team not only will allow Medicare beneficiaries to gain easy access to their own data, but will enable them to link this information to secure mobile applications, and to services and providers they trust. Medical records systems often make it hard for practitioners to have access to a patient’s entire medical history, but experts said the portability of the data from the enhanced Blue Button could be a game-changer.
“Shannon’s accomplishments are among the most pioneering in advancing one of the biggest nagging challenges in the health care delivery system: the inability for us to move health care information safely and securely on behalf of our patients,” said Aneesh Chopra, former chief technology officer of the United States.
According to Chopra, Sartin managed to create technological solutions to maintain patient privacy and ensure security protections. “It’s probably the single biggest accomplishment I’ve seen in the public sector in several years, certainly in health care, that relates to modernizing government.”
In creating Blue Button 2.0 and seeking to ensure its widespread use, Sartin and her team have worked closely with private sector companies. So far, more than 1,500 entities—ranging from the largest health care providers and academic institutions to entrepreneurs creating new startups—are developing apps to help Medicare patients and providers tap into the data on their personal devices. The first iteration of Blue Button only allowed participating patients to download claims data via PDFs or text files.
There are currently 18 applications or webpages that rely on the technology to extract patient information. CMS hopes that more than 1 million patients will be using the applications by the end of 2019, and millions more in subsequent years.
A second accomplishment of Sartin and her team revolved around the 2015 Medicare Access and Children’s Health Insurance Program Reauthorization Act, which requires payment to doctors for the quality—not the quantity—of care they provide.
But complying with the law proved difficult. Among other complications, health care providers had to fill out and fax paper forms to CMS and then wait six months or more for feedback on how well they were adhering to these new standards, leading to payment delays.
In April 2017, Sartin and her team launched the Quality Payment Program, an online tool to give doctors instantaneous feedback on the care they provided to their patients. Not only did this expedite payments to doctors, but receiving assessments of their treatments more quickly helped physicians improve patient outcomes sooner as well.
“Shannon’s team came in and helped do a complete redesign of the Quality Payment Program, working with the policy experts to make it easier for people to have a platform to transmit their results,” said Kim Brandt, principal deputy administration for operations at CMS. “They were a SWAT team to help bring private sector, cutting-edge technological perspectives to problems.”
Sartin is currently working to enhance the Blue Button 2.0 initiative by ensuring beneficiary information can be shared broadly from provider to provider so patients don’t have to fill out the same forms every time they visit a new doctor.
“It is really about putting the patient at the center of our health care system and making sure they have access to their data no matter where it is,” Sartin said.
Sartin helped craft “a vision for an interoperable, data-driven health care system,” said Brandt. “Without her leadership, we would be in a very different place.”