https://www.socallinuxexpo.org/scale/20x/presentations/repodiving-open-source-cmsgov
My name is Remy DeCausemaker, my pronouns are he/him, and I'm the Open Source Lead at the Digital Service at the Centers for Medicare & Medicaid Services (CMS.) Before I get started, tho, a few standard disclaimers:
The views presented here today are those of the speaker and do not necessarily represent the views of CMS, it's components, or any other components of the United States Federal Government.
I am not a lawyer or an accountant, and this presentation does not constitute legal or financial advice.
Now then :P
The Digital Service works to transform the U.S. Healthcare system by improving the design of healthcare experiences, delivering value to government, providers, and patients, modernizing systems, and participating in policy development. We accomplish this by deploying small responsive groups of designers, engineers, and product managers within CMS on a 'tour of duty' to work alongside dedicated civil servants. These multidisciplinary teams bring best practices and new approaches to support government modernization efforts, and solve some of the most complex problems facing our healthcare system today.
This video you're seeing is a Gource visualization of CMS Open API source code repositories created by developers at the Centers for Medicare and Medicaid Services (CMS.gov), and maintained by the Office of Enterprise Data and Analytics (OEDA.)
Software projects are displayed by Gource as animated trees, where directories appear as branches, and files appear as leaves of bubbles. Developers are seen working on the trees at the times they contributed to the project, where red lazers are deletions, green lazers are additions, and orange lazers are edits.
I have color-coded each repo, so that each colored tree represents one project.
- Install dependencies
- Create repos directory
- Clone repos
- Generate logs
- Insert parent names
- Colorize logs
- Concatenate and sort logs
- Run Gource
- Export video
We'll dig into the config and rendering pipelines a bit later in the presentation. For now, let's talk about WHAT repos you are looking at ;)
Developer.CMS.gov contains CMS' collection of APIs, datasets, frameworks, and style guides to develop applications that help people get the services and benefits they rely on.
All repos seen in this video can be found via that website (which links to https://github.com/cmsgov when repos are public.)
BFD Server is an internal backend to Medicare beneficiaries' demographic, enrollment, and claims data in FHIR format
FHIR stands for Fast Healthcare Interoperability Resource, and v1 development began in 2012, and current version is up to v4. It is an Open Standard that defines how healthcare information can be exchanged between different computer systems regardless of how it is stored in those systems.
It allows healthcare information, including clinical and administrative data, to be available securely to those who have a need to access it, and to those who have the right to do so for the benefit of a patient receiving care. The standards development organization HL7® (Health Level Seven®) uses a collaborative approach to develop and upgrade FHIR.1
FHIR is RESTful, meaning that it server will respond with the representation of a resource (most often be an HTML, XML or JSON document) and that resource will contain hypermedia links that can be followed to make the state of the system change.2
tl;dr, it allows clinical and administrative data about healthcare records to be encoded into structured data, and wrapped in a RESTful API.
enables ACCOUNTABLE CARE ORGANIZATIONS (ACOs) to retrieve Medicare Part A/B/D claims data for beneficiaries.
tl;dr - BFD is the backend that powers specific APIs that deliver claims and records to different types of users within healthcare.
enables making a patient's Medicare claims data available to HEALTH CARE PROVIDERS for treatment purposes
4) AB2D API Development Begins - https://github.com/CMSgov/ab2d
provides Prescription Drug Sponsors with secure Medicare parts A and B claims data for their plan enrollees
delivers Medicare Part A, B, and D data for over 60 million people with Medicare. Bluebutton is probably our most widely used and longest lived Open API projects.
- May 2015 - Project Begins
- March 2018 - Public Launch
- May 2020 - Interoperability and Patient Access final rule published, with enforcement starting July 2021
- November 2020 - CARIN Blue Button FHIR Implementation Guide v1.0 released
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CMS collaborates with the industry, implements programs, and develops policies to support interoperability in the U.S. health care system with human-centered design in mind.
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Since March 2018, CMS, in collaboration with CARIN (a multi-sector group of stakeholders representing numerous hospitals, thousands of physicians and clinicians, and millions of patients and other consumers and caregivers.), launched FHIR-enabled Blue Button 2.0 which provides Medicare Parts A, B, and D claims and enrollment data for one individual person with Medicare at a time to registered applications with authorization.
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In May 2020, CMS published the Interoperability and Patient Access final rule (CMS-9115-F) which puts patients first by establishing policies that break down barriers in the nation’s health system to enable better patient access to their health information, improve interoperability and unleash innovation, while reducing burden on payers and providers.
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Together, Blue Button 2.0 and the Interoperability and Patient Access final rule establish policies and implement data exchange capabilities aimed at:
- Enabling better patient access to their health information;
- Improving interoperability across the health care system;
- Unleashing innovation, and;
- Reducing administrative burden on payers and providers.
See: https://github.com/decause-gov/cms-gource/blob/main/cms.conf
There are hundreds of repos, thousands of contributors, and millions of lines of code.
There are repos to contribute to, onboarding programs to participate in, and full-time jobs to apply for:
DSAC (the digital service at CMS) is helping to lead SMEQA (Subject Matter Expert Qualification Assessments) hiring actions to place industry experts with Product, Data Science, Engineering, and Design experience into various OpDivs (Operational Divisions) within the agency.
If we're going to address some of the biggest and most complex problems facing healthcare, we're going to need all the help we can get.