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利用大数据革命:医疗保险和医疗补助服务中心正在拓展能力以推动卫生系统转型。

Leveraging the big-data revolution: CMS is expanding capabilities to spur health system transformation.

作者信息

Brennan Niall, Oelschlaeger Allison, Cox Christine, Tavenner Marilyn

机构信息

Niall Brennan (

Allison Oelschlaeger is a special assistant in the Office of Information Products and Data Analytics, Offices of Enterprise Management, CMS.

出版信息

Health Aff (Millwood). 2014 Jul;33(7):1195-202. doi: 10.1377/hlthaff.2014.0130.

Abstract

As the largest single payer for health care in the United States, the Centers for Medicare and Medicaid Services (CMS) generates enormous amounts of data. Historically, CMS has faced technological challenges in storing, analyzing, and disseminating this information because of its volume and privacy concerns. However, rapid progress in the fields of data architecture, storage, and analysis--the big-data revolution--over the past several years has given CMS the capabilities to use data in new and innovative ways. We describe the different types of CMS data being used both internally and externally, and we highlight a selection of innovative ways in which big-data techniques are being used to generate actionable information from CMS data more effectively. These include the use of real-time analytics for program monitoring and detecting fraud and abuse and the increased provision of data to providers, researchers, beneficiaries, and other stakeholders.

摘要

作为美国最大的单一医疗保健支付方,医疗保险和医疗补助服务中心(CMS)生成了海量数据。从历史上看,由于数据量庞大以及隐私问题,CMS在存储、分析和传播这些信息方面面临技术挑战。然而,过去几年数据架构、存储和分析领域——大数据革命——的快速发展,使CMS有能力以全新的创新方式使用数据。我们描述了CMS内部和外部正在使用的不同类型数据,并重点介绍了一些创新方法,通过这些方法,大数据技术正被用于更有效地从CMS数据中生成可操作的信息。这些方法包括使用实时分析进行项目监测以及检测欺诈和滥用行为,以及增加向医疗服务提供者、研究人员、受益人和其他利益相关者提供数据。

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