Feds at Work: Led the development of digital tools for improving aspects of the Medicare program
The tools provide patients with better access to their health records and change physician payment incentives
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, and her team, have led the development of numerous technological solutions for CMS to translate 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 online platform that contains four years of data on medical appointments, claims, prescriptions, insurance coverage, primary care treatment and cost for 53 million beneficiaries.
This new digital information exchange will enable Medicare beneficiaries to gain easy access to their data, and make it possible to link the information to secure mobile applications, and to services and providers they trust. The portability of the data from the enhanced Blue Button could be a game-changer for practitioners trying to access a patient’s entire medical history, experts said.
“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.
Sartin managed to create technological solutions to maintain patient privacy and ensure security protections, he added. “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.”
Sartin and her team have worked closely with private sector companies to develop the technology and ensure its widespread use. 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 Blue Button iteration 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 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 quantity, of care they provide.
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 their patient care. Not only did this expedite payments, but receiving quicker assessments of their treatments helped physicians improve patient outcomes sooner too.
The team helped with a complete program redesign, 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 now 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,” Brandt said. “Without her leadership, we would be in a very different place.”
Shannon Sartin is one of 26 finalists for the 2019 Samuel J. Heyman Service to America Medals, presented annually by the nonpartisan, nonprofit Partnership for Public Service to celebrate employees who have made significant contributions to our nation’s health, safety and prosperity.
Help share their stories using #Sammies2019, and please help us recognize more inspiring federal employees in 2020 by submitting your nominations now.