Themes from the AFCEA Bethesda Health IT Summit

Published: January 19, 2023


This week thought leaders from throughout government and industry gathered in-person for the first time in three years for AFCEA Bethesda’s Annual Health IT Summit.

Topics of discussion included challenges to modernization and digital transformation, examples of innovative technology implementations, methods for tackling health equity, customer experience enhancements, collaboration within agencies and with the private sector, acquisition innovation, and efforts to modernize data.

During a panel discussion, CXOs emphasized the need for continued collaboration beyond the COVID response, within agencies, across agencies, and with the private sector. They also spoke about breaking down silos for data sharing, but also offered that in many cases policy and legislation are a hindrance. Current data user agreements are cumbersome and time-consuming. Panelists also agreed that modernization is not a technology issue, but a people and cultural matter.  And systems and projects need to align with the agency's mission and produce business outcomes.

The CMS panel discussion touched on the need to include all stakeholders when employing human-centered design practices, not just one set of users. Additionally, panelists said they are implementing new data collection practices to evaluate and improve health equity.  Panelists also stated that technology is secondary to the mission. CMS is also working to construct systems and to identify standards and data to support future agency direction. For example, the Medicare system needs to be able to adopt new models and policies quickly. An 18-month development cycle is not sufficient. CMS is striving to make systems more adaptable, using agile development including people, processes, and technology. 

CMS’ CIO, Rajiv Uppal, stated during a lunch session, that he wants to make it “as easy as possible for people to do the right thing.”  He wants to make it “frictionless.” He’s working to break down silos between organizations. According to Uppal, technology is the easier part.  The people part is more challenging. Uppal also stated that CMS now has 90 out of 200+ systems in the cloud.  Eventually, he expects to achieve 100% of systems in the cloud.  However, some systems will take longer, such as the claims processing system which is 40 years old and run on a mainframe.

During the acquisition panel, speakers expressed interest in embracing COTS where possible, implementing enterprise shared services for applications like finance and HR, and employing innovative acquisition practices such as Statements of Objectives, oral presentations, soft down-selects, and on-the-spot evaluations.

The VA panel discussion further emphasized the value of collaboration between agencies and with industry. Breaking down of internal silos is happening organically driven by MISSION Act implementation and the COVID crisis. VA is also collaborating with other agencies such as CMS regarding identity and access management, and DHS on zero trust planning. And VA leadership also regularly communicates with Silicon Valley leaders to gain knowledge and learn industry best practices.  

The data modernization panel wants to make data a “superpower!” Panelists believe this will require more data liberation, transparency, and secure sharing to form an entire ecosystem between the government, academia, public sector, and private sector. IT leadership from CMS, FDA, NIH, and CDC also talked about the need for systems to work at speed and scale and to also be transparent to the public.  

The COVID pandemic exposed a number of weaknesses in the current U.S. healthcare system and federal health mission agencies for handling a widespread health crisis. However, it spurred much innovation, collaboration, and advancement.  Although much progress has been made in the last three years, agency IT leaders agree, more needs to be accomplished to prepare for the next health crisis and to improve and protect the health of the American people. As federal health mission agencies continue to modernize, contractors should find ample opportunities to assist them in implementing solutions to advance their health missions.