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SSA's commissioner: "We've got to use this money wisely."
The SSA is home to the largest repository of electronic health records in the world, and that volume will grow significantly in the next few years as baby boomers retire and e-health records are standardized. But the agency's nearly 30-year-old data center in Baltimore is running out of space. Terabytes of new data come in daily, and the SSA holds more than a petabyte of information on hard disks and tape backup, including earnings records of more than 200 million people and more extensive data on 56 million recipients of Social Security benefits. The SSA's emergency plan relies on a commercial facility it shares with other agencies that doesn't have sufficient capacity.
Construction already is under way on a $72 million backup facility in Durham, N.C., that will handle the SSA's critical workload, but it won't begin coming online for six months and won't be fully functional for a year and a half.
The agency's solution: Spend $450 million to build a National Computer Center and another $300 million on hardware and software; $500 million of the funds will come from the stimulus bill and the rest from the agency's regular budget. The facility, which will be located within 40 miles of the SSA's Baltimore headquarters, is expected to be completed within five years.
Slaying The Backlog Dragon
The agency will spend another $40 million of stimulus money and likely more from its regular budget on replacing its antiquated disability claims processing system, which is mired in a backlog of 570,000 claims. The number of new cases is expected to jump about 15% this year to 2.9 million, hitting the SSA hard. The 37% of claims that can be processed without an appeal take an average of 100 days to process, and those going through the agency's appeals process take as long as 850 days. The existing system includes a mainframe-based data repository, an electronic claims processing system called eDib, and 54 versions of three legacy Cobol-based workflow management systems that differ by state and territory, and often don't run properly, Astrue says.
The SSA is preparing a request for proposal for a service-oriented architecture that will give its workflow management systems a common underpinning to make maintenance and upgrades easier. "If our core platforms aren't flexible, we're not going to be able to adapt to change," Astrue says. The agency has used IBM's WebSphere for other projects, and that platform will be among those considered.
The SSA also is building hooks into the national health information network that the Department of Health and Human Services is building to connect providers, consumers, and others involved in health care. This network, which will be rapidly expanded with stimulus funds, will let the SSA do away with faxed and mailed medical records that take weeks to process, in favor of electronic ones. The SSA will be the first agency to test the network when it connects with MedVirginia, the first health care provider to put e-health records on the system. That test was scheduled to take place Feb. 28.
The SSA's new workflow system will use artificial intelligence techniques to search e-medical records for diagnoses that support a disability applicant's claim. The system will then coach claims examiners through the steps needed to determine and document eligibility.
With the new system, the SSA should be able to receive patient information in less than a minute and begin analyzing it immediately, Astrue says. That's a huge improvement over the current 26 days to get what often adds up to only half of the records needed to make an eligibility decision, he says.
Ending the claims backlog and coping with data glut are Astrue's immediate challenges. Long term, he knows that the $1 billion in stimulus funds he's putting into these efforts had better be money well spent if his agency is to stay front and center in budget makers' minds. For a long time, the SSA "suffered because there were other agencies that got top priority," he says. "We've got to use this money wisely."