National Capitol Area Chapter of HIMSS October 21, 2010

2. Disclaimer Perspective provided by Phil Surine, and is not an official presentation by CMS

3. CMS Data Center Experience CMS implemented its Enterprise Data Center Program in 2006 Started with Medicare claim processing system consolidation from 20+ data centers to 2 CMS systems moved into its EDCs: Hospital claim processing system Physician claim processing system Medical supplier claim processing system Medicare eligibility and secondary payer system 1-800-Medicare Data Warehouse CMS web sites HIT Provider Incentive Payment System

4. Contract Models GOCO / GOGO More control over details of technical environment, but perhaps less focus on business objectives Can bog an agency down in the �how� instead of the �what� COCO CMS EDC model / CMS pays fixed amount per claim processed -- �as a service� Technology refresh built in, no cyclical IT upgrade costs More aligned with current trend towards cloud computing

5. Number of Data Centers Too many data centers� Less efficient Expanded security perimeter Variation in systems Too few data centers� �all of your eggs in one basket� Reduced competition

6. Transition Forklift or Data-based No HW was moved during CMS� transition of systems that process 1 billion claims / year Cost-effective, but requires parallel system operations and very structured procedures, good documentation, and extensive testing How to organize the transition By Application By Site By User Groups Hybrid (CMS chose by application, then by site)

7. Critical Success Factors Federal PMO Model Executive Leadership Business buy-in Contractor teaming environment Client Services

8. Lessons Learned Standard systems may not be very standard Don�t forget about peripheral support systems and processes! Look at Entire Architecture (not just TRM)

9. Disaster Recovery / COOP High availability Costly (could be almost 100% increase in resources) Hot site Moderate cost, how �hot� Cold site Used for Medicare and TRICARE claims processing (Sunguard) Lowest cost DR solution Production data centers for DR/COOP Control your own destiny, cost implications are complex

10. Analytics and HIT Integration Data center optimization in health space is about much more than efficiency and reduced energy demand -- the true power is better business outcomes through lower health care costs and better health care quality Enables cloud / virtualization / thin client solutions More integrated health systems by sharing data sources and application components New analytics