**[HHS FY 2007 E-Government Act Report]{.underline}**

**[Section 1 -- Implementation of Electronic Government Initiatives
Section]{.underline}**

A. Describe how the initiative is transforming agency operations

-   The Hospital Compare tool (via
    [www.hospitalcompare.hhs.gov](http://www.hospitalcompare.hhs.gov/)
    is "A quality tool for adults, including people with Medicare".
    Hospitals can vary in the quality of care they provide. This website
    was created to help consumers see how well the hospitals in their
    area care for their patients and to compare the quality of care
    hospitals provide. The Centers for Medicare & Medicaid Services
    (CMS) launched Hospital Compare March 31, 2005, with seventeen
    processes of care quality measures in three clinical conditions:
    heart attack, heart failure and pneumonia; and, surgical infection
    prevention. As of June 2007, CMS increased the number of quality
    measures, reporting 22 process measures and two outcome measures.
    CMS will add Patient Satisfaction measures in early 2008 to provide
    even more detail to help make available the information consumers
    need for health care decision making.

-   The Hospital Compare tool allows consumers to see the recommended
    care that an adult should receive if being treated for a heart
    attack, heart failure, or pneumonia or having surgery. The
    performance rates for this website reflect care provided to all
    adults, not just people with Medicare. Psychiatric, children\'s,
    rehabilitation and long-term care hospitals currently are not
    reported on this website, although many have agreed in principle to
    provide data using standard quality measures. This is due to the
    fact that the conditions currently measured \-- care of adults with
    a heart attack, heart failure, or pneumonia \-- are less commonly
    treated in these settings.

> The quality of care information comes from hospitals that submit their
> data voluntarily from their patient records. The information is
> converted to rates that measure how well the hospitals care for their
> patients. In addition to reporting quality measures, Hospital Compare
> includes tools consumers can use to start a conversation with their
> physician or hospital about what the information means and how they
> can best get the care they need.
>
> In September 2003, the "National Voluntary Hospital Reporting
> Initiative", the predecessor of Hospital Compare, had only 415
> hospitals that voluntarily reported information for one or more
> quality measures. In less than four years, the number of hospitals
> that voluntarily report quality measure data in September 2007
> Hospital Compare tool increased to 4,416.
>
> Hospital Compare is one of six compare tools that CMS provides to
> consumers to locate and compare quality of care information through
> its beneficiary-centered website
> [www.medicare.gov](http://www.medicare.gov/). The other tools are
> Dialysis Facility Compare, Home Health Compare, Nursing Home Compare,
> Medicare Options Compare (Medicare Managed Care Plans) and the
> Medicare Prescription Drug Plan Finder. In March 2008, the Hospital
> Compare tool will provide patient experience (Hospital-CAPHS) data.
> CMS staff are also meeting to develop meaningful methods to providing
> the cost and volume information for the commonly performed procedures.
>
> The Hospital Compare Website enables CMS to transform agency
> operations by implementing the principles of a value-based system in
> the Medicare program. Hospital Compare empowers consumer choice and
> gives consumers a better insight into the quality of care provided by
> their local hospitals. The Hospital Compare initiative supports CMS'
> commitment to the four cornerstones of value-driven healthcare:
> ensuring transparent quality and price information, interoperable
> health information technology and incentives for high-quality,
> efficient health care delivery. These quality compare tools position
> CMS to achieve the HHS Health Transparency and e-Government priorities
> by providing easy electronic access to helpful comparative information
> on health care quality. CMS is also working with the Agency for
> Healthcare Research and Quality to develop a patient experience tool
> for home health agencies which will also be provided online.

B. Explain how your agency maintains an ongoing dialogue with interested
parties to find innovative ways to use information technology for the
initiative; AND

C. Identify external partners (e.g., Federal, State or local agencies,
industry) who collaborate with your agency on the initiative;

-   CMS works with its partners in the Hospital Quality Alliance (HQA),
    a public-private collaboration established to promote reporting on
    hospital quality of care and to increase the number of measures and
    the types of conditions and treatments on which the hospitals will
    report over time. The HQA consists of organizations that represent
    consumers, hospitals, doctors, employers, accrediting organizations,
    and Federal agencies. The HQA effort is intended to make it easier
    for the consumer to make informed healthcare decisions, and to
    support efforts to improve quality in U.S. hospitals. The major
    vehicle for achieving this goal is the Hospital Compare website. The
    HQA provides CMS with suggestions to improve the ease of use and
    displays in the tool. They also encourage hospitals to report on and
    improve their quality of care. HQA members include:

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-   AARP

-   AFL/CIO

-   Agency for Healthcare Research and Quality

-   American Hospital Association

-   American Medical Association

-   American Nurses Association

-   Association of American Medical Colleges

-   Blue Cross and Blue Shield Association

-   Centers for Medicare & Medicaid Services

-   Consumer-Purchaser Disclosure Project

-   Federation of American Hospitals

-   General Electric

-   National Association of Children's Hospitals and Related
    Organizations

-   National Business Coalition on Health

-   National Quality Forum

-   U.S. Chamber of Commerce

> Since its inception in December 2002, the HQA has worked to increase
> hospitals' voluntary participation in public reporting and expand the
> set of reported quality measures to provide information to the public
> on hospital quality. The highest executive member of each organization
> (the HQA Principals) meet in-person on a quarterly basis to discuss
> hospital data collection, data submission to the Quality Improvement
> Organization (QIO) Clinical Data Warehouse, and public reporting on
> Hospital Compare of both current and future hospital (including
> outpatient department) measures. These meetings are open to the
> public. CMS also participates in the weekly HQA conference call.
> Website content and design are frequently discussed and reviewed to
> collaborate on areas for improvement.

D. Identify improved performance (e.g., outcome measures) by tracking
performance measures supporting agency objectives and strategic goals;

-   The Hospital Quality Initiative (HQI), like other CMS quality
    initiatives, consists of many facets. Its goals are to improve the
    care provided by the nation's hospitals and to provide quality
    information to consumers and others to use for informed
    decision-making. CMS has several activities in progress to provide
    hospital quality information to consumers and others, and improve
    the care provided by the nation's hospitals. These activities build
    upon previous CMS and QIO efforts on behalf of Medicare
    beneficiaries and other adults to promote the best medical practices
    associated with certain clinical conditions.

> During the 12 month period July 2006 through June 2007, there were 22
> quality measures reported on Hospital Compare. All but two of these
> measures had overall improvement rates of 1 to 13% at the National
> level.
>
> CMS is supporting this priority by developing quality alliances to
> obtain and disseminate consistent quality measures of health care,
> allowing consumers to make better informed choices. With these
> alliances in place, CMS will provide easy-to-access information about
> health care quality, patient experience, and pricing to consumers. CMS
> will include comparative information on providers and other key
> stakeholders including hospitals, ambulatory care centers, cancer and
> kidney care centers, pharmacies and nursing homes. CMS is on track to
> establish demonstrations and pilots which include performance-based
> payments. The public reporting aspect of various pay-for-performance
> initiatives will also generate data that can be used to support
> transparency.
>
> Annually, CMS considers the initiative to be successful as it
> continues to expand the quality information available to people with
> Medicare to make informed decisions about their healthcare choices. In
> terms of a measurable outcome, Hospital Compare continues to be
> refreshed and/or enhanced without interruption or significant lapse in
> availability to the public. Additionally, current and future website
> navigation, design, enhancements, and additional measures are consumer
> tested and usability tested to implement improvements based on
> user-feedback to offer accurate, timely, and relevant quality
> information in an easy-to-understand consistent web format that
> supports multiple agency and departmental initiatives for improving
> public access to quality information for informed decision-making.

E. Quantify the cost savings and cost avoidance achieved through
implementing the initiative (e.g., by reducing or eliminating other
investments in information technology);

-   This initiative provides a consolidated, easy to access place for a
    variety of audiences to seek and find important Government
    information through a relatively inexpensive channel and provides
    for cost avoidance in other investments. Without this investment in
    Hospital Compare, which provides a one-stop shop for hospital
    quality information for consumers, Medicare beneficiaries, and
    external stakeholders, alternatives would have to be developed to
    provide this information to the public through other channels in
    order to meet mandated reporting requirements. 1-800 MEDICARE would
    need to develop print-based packages that are customized to
    beneficiaries on demographic information and physically mail
    booklets at the request of beneficiaries and other audiences and be
    able to update this information frequently with new measures and
    accurate data. Also, IT investment dollars would need to be directed
    to incorporate this set of data into a different technology that is
    not accessible to the public so that 1-800 MEDICARE can find and
    answer questions electronically for beneficiaries who call seeking
    information on hospital quality in order to make informed decisions
    about their health and quality of care. This would be exceedingly
    more expensive and less efficient in meeting the goals of multiple
    quality and e-gov initiatives.

F. Explain how this initiative ensures the availability of Government
information and services for those without access to the Internet and
for those with disabilities;

-   For those who do not have access to the Internet, CMS provides
    access to the same level of information through 1-800 MEDICARE. The
    1-800-MEDICARE call center provides an alternate channel for
    communication and information dissemination for beneficiaries 24
    hours a day, seven days a week.

> Additionally, Hospital Compare, as a component of the
> [www.medicare.gov](http://www.medicare.gov/) website, complies fully
> with Section 508 requirements. CMS strives to continue to improve its
> resources for persons with disabilities and annually reviews the
> website for opportunities for improvements both in general usability
> and site navigation as well as targeted enhancements for increasing
> access for those with disabilities to government information.

G. Explain how the project applies effective capital planning and
investment control procedures.

-   Hospital Compare is a component of CMS' www.medicare.gov website
    system. The Hospital Compare tool falls within
    [www.medicare.gov](http://www.medicare.gov/) processes and
    procedures that follow all aspects of the Capital Planning and
    Investment Control (CPIC) procedures and requirements. It is managed
    as part of an Exhibit 300, Beneficiary e-Services, and also follows
    Earned Value Management reporting procedures as a part of the larger
    Agency IT investment. Through these processes, the website is in
    compliance with Enterprise Architecture procedures and actively
    updates and maintains respective Performance Reference Model,
    Business Reference Model, Service Reference Model and Technical
    Reference Models. Performance information is captured and reported
    to the Department on a monthly basis and currently this investment
    is performing within acceptable thresholds and is meeting clear
    goals, milestones, and defined performance improvements each year.
    Hospitalcompare.hhs.gov is part of the CMS Enterprise Data Center
    (EDC) at the Cherokee Data Center (CDC) in Tulsa, Oklahoma. Hospital
    Compare goes through rigorous testing and review and as a part of
    this investment.

> CMS strives and meets all requirements of the HHS IT Investment
> Management (ITIM) process including all components that are a part of
> the CPIC procedures for the Medicare.gov applications including
> Hospital Compare. Compare undergoes annual security and penetration
> testing by an independent contractor as well as certification and
> accreditation (C&A) as part of Medicare.gov. CMS implements plans of
> action to address any findings and ensure the site is secure and meets
> Agency, Department, and Government security requirements. It is also
> included under CMS' Privacy Impact Assessment (PIA) for the Customer
> Service Systems family and follows and meets all FISMA reporting
> requirements including annually updating appropriate Risk Assessments
> (RA) and Secure System Plans (SSP). CMS actively monitors contractor
> compliance with regulations and policy and performs on-site audits of
> contractor facilities.
>
> Hospital Compare strongly aligns with multiple strategic plans and
> initiatives including Health Transparency, Health Information
> Technology (HIT), Value-Driven Health Care (VDHC), and E-Government by
> providing easy access to helpful comparative information on health
> care quality for consumers, partners, and Medicare beneficiaries to
> use to make informed decisions and to increase access to and
> transparency of Government information.

**[Section 2 -- Agency Information Management Activities]{.underline}**

Please provide the link(s) to your agency's website where the following
information is located:

A.  Your agency's Information Resources Management (IRM) Strategic Plan:

-   The Department of Health and Human Services Information Resources
    Management (IRM) Strategic Plan is located at:
    <http://www.hhs.gov/ocio/plans/itstrategicplan.html>

B.  Final determinations, priorities, and schedules. Also include your
    agency's information dissemination product catalogs, directories,
    inventories, and any other management tools used to improve the
    dissemination of and access to your agency's information by the
    public:

-   As required by Section 207 (f) (2) of the E-Government Act of 2002
    and OMB Memorandum M-05-04 "Policies for Federal Agency Public Web
    Sites" HHS developed a comprehensive inventory located at:
    <http://www.hhs.gov/webinventory/>

-   Examples of specific information products available from HHS and its
    agencies are available at the HHS Information Quality Web site at
    <http://aspe.hhs.gov/infoquality/>

C.  Your agency's FOIA handbook:

-   The HHS FOIA handbook is available at:
    <http://www.hhs.gov/about/infoguid.html#foia>

> The link of your agency's primary FOIA website:

-   The primary HHS FOIA website is: <http://www.hhs.gov/foia/>

> Frequent requests for records are made available to the public:

-   Frequent requests for HHS records may be found on the primary FOIA
    page <http://www.hhs.gov/foia/> filed under the Frequently Requested
    Materials section

D.  A list of your agency's public websites disseminating research and
    development (R&D) information to the public, describing for each
    whether the website provides the public information about federally
    funded R&D activities and/or provides the results of Federal
    research:

-   To comply with Section 207(g), "Access to Federally Funded Research
    and Development," HHS makes available through Science.gov a database
    of federally funded Research and Development (R&D) activities.
    Information about these activities is found on the CRISP (Computer
    Retrieval of Information on Scientific Projects) database at
    <http://crisp.cit.nih.gov/>

-   The CRISP searchable database website provides information on
    federally funded biomedical research projects conducted at
    universities, hospitals, and other research institutions. The
    database, maintained by the Office of Extramural Research at the
    National Institutes of Health (NIH), includes projects funded by
    NIH, the Substance Abuse and Mental Health Services Administration
    (SAMHSA), the Health Resources and Services Administration (HRSA),
    the Food and Drug Administration (FDA), the Centers for Disease
    Control and Prevention (CDC), and the Agency for Health Care
    Research and Quality (AHRQ).

E.  An inventory describing formal agency agreements (e.g., contracts,
    memorandum of understanding) with external entities (e.g.,
    partnerships with State and local governments, public libraries,
    industry and commercial search engines) complementing your agency's
    information dissemination program, briefly explaining how each
    agreement improves the access to and dissemination of government
    information to the public;

-   The HHS Reference Collections website
    (<http://www.hhs.gov/reference/>) complements HHS information
    dissemination as it provides links to health-related dictionaries
    and glossaries; catalogs and indices of health information; and
    various other health resources, such as consumer health libraries,
    clinical trials databases, published medical articles, and medical
    encyclopedias. The website provides links to health, human services,
    and general statistics and links to HHS Secretary reports, HHS
    performance and accountability reports, and HHS health publications
    and reports.

-   MEDLINE® (<http://www.nlm.nih.gov/databases/databases_medline.html>)
    is the National Library of Medicine\'s bibliographic database that
    contains over 16 million references to journal articles in life
    sciences with a concentration on biomedicine. The majority of
    journals selected for MEDLINE® are based on the recommendation of
    the Literature Selection Technical Review Committee (LSTRC), an
    NIH-chartered advisory committee of external experts similar to the
    committees that review NIH grant applications. Some additional
    journals and newsletters are selected based on NLM-initiated
    reviews, e.g., history of medicine, health services research, AIDS,
    toxicology and environmental health, molecular biology, and
    complementary medicine, that are special priorities for NLM or other
    NIH components. These reviews generally also involve consultation
    with an array of NIH and outside experts or, in some cases, external
    organizations with which NLM has special collaborative arrangements.

-   MedlinePlus (<http://medlineplus.gov/>) is the National Library of
    Medicine\'s web site for consumer health information. MedlinePlus
    includes extensive information on health topics with links to health
    information from NIH and other authoritative sources. It includes a
    medical encyclopedia, interactive health tutorials, information on
    drugs, supplements, and herbal information, current health news,
    health dictionaries and local health care professional directories.

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-   The HHS Data Council Gateway to Data and Statistics
    (<http://www.hhs-stat.net/>) is a web-based tool that brings
    together key health and human services data and statistics. It is
    designed to complement other government resources such as FirstGov
    and FedStats and covers federal, state and local government
    sponsored information.

F. An inventory that describes your agency's NARA-approved records
schedules(s) or the link to the publicly-posted records schedules(s),
and a brief explanation of your agency's progress to implement NARA
Bulletin 2006-02. For the brief explanation please report the number of
systems for which a record schedule was submitted to NARA in FY 2007 and
the number of systems still requiring records schedules.

-   HHS posts records management information on its website at
    <http://www.hhs.gov/ocio/policy/recordsmanagement/management.html>.
    HHS does not currently have an online inventory describing HHS
    records' schedules and is currently developing plans to meet the
    NARA Bulletin 2006-02, NARA Guidance for Implementing Section 207(e)
    of the E-Government Act of 2002, deadline of September 2009.