• The Challenge: Help the Centers for Medicare & Medicaid Services make all assessment data collected in post-acute care settings standardized and interoperable by 2019.
  • The Task: Promote interoperability in post-acute care by deploying The Data Element Library, CMS’ first cloud-based project using Amazon Web Services.

A Cloud Customer Success Story 

It’s been called the “boomerang effect:” patients discharged from the hospital who bounce right back for readmission. One in five discharged Medicare patients are readmitted within 30 days at an annual cost of $26 billion. This makes communication and data sharing between hospitals and post-acute care (PAC) facilities (e.g., nursing home, home health, long-term care, inpatient rehab) a critical Medicare initiative.

This is especially challenging for PAC facilities, which lag behind other healthcare settings in EHR adoption and health data exchange.


Following the approval of the IMPACT Act, CMS needed to design, build, and implement a database that assists with standardizing the thousands of data elements used across multiple assessment instruments by post-acute care facilities.


CMS originally attempted the work with another contractor, but the project never materialized. The project was re-bid, and Telligen and Nguyen Information Consulting were selected by CMS to meet a 15-month deadline.

Data Element Library Roles:

  • Telligen: Development, programming, server maintenance, deployments, coding, health information technology and PAC subject-matter expertise.
  • NIC: Program management and quality assurance testing.


Today, the Data Element Library is a free public resource that’s moving CMS closer to the government-wide goal of enabling the availability of electronic health information when and where it’s needed.

 “The DEL supports the use and sharing of data, and aligns with MyHealthEData, a government-wide effort strengthening the interoperability of health information. It also closely aligns with CMS’ Patients Over Paperwork initiative focused on reducing administrative burden and costs while improving care coordination, outcomes and patients’ ability to make decisions about their own care.”  – Seema Verma, CMS Administrator


“. . .We were able to adapt and come together as a team to accomplish goals on time.”

Meet Changing Requirements: Several months into the project, the development methodology was changed from Waterfall to Agile. “There was a lot of conversation and coaching taking place, but we were able to adapt and come together as a team to accomplish CMS’ goals on-time,” says Jana Linthicum, Telligen’s Data Element Library Program Lead.

“We were the guinea pigs . . . Now we’re fielding questions from other contractors moving applications to the cloud.”

Navigate a New Platform: The Data Element Library was CMS’ first cloud-based project using Amazon Web Services to go live. “We were the guinea pigs so there was no one to call on when we got stuck,” says Jana Linthicum. This resulted in intensive collaboration with CMS to work through the problems. “Now we’re fielding questions from other CMS contractors working in the cloud,” she says.