Modernizing how the nation measures healthcare quality
Summary
The Internet Quality Improvement and Evaluation System (iQIES) is a nationwide platform that thousands of healthcare providers and surveyors use daily. They submit patient assessment data and evaluate quality of care for Medicare and Medicaid beneficiaries. As a subcontractor to Ventera, we helped modernize iQIES from a legacy desktop application into a cloud-based, user-centered system — improving the user experience, establishing a scalable design system, and delivering key parts of the modern front end.
The challenge
The Centers for Medicare & Medicaid Services (CMS) relies on quality reporting systems to monitor and improve care across the country’s healthcare providers — from long-term care hospitals and skilled nursing facilities to home health agencies and hospices. For years, this work ran through a set of legacy desktop applications: the Quality Improvement and Evaluation System (QIES), the Certification and Survey Provider Enhanced Reports (CASPER) system, and the Automated Survey Processing Environment (ASPEN). Together, these systems collected patient assessment data, generated quality measures, and supported the survey and certification process that determines whether providers meet federal standards.
But the legacy architecture had become a barrier. Providers could only access the systems through a virtual private network or the CMS network. That limited when and where they could submit data or review reports. The interfaces had grown complex and inconsistent over time, making routine tasks harder to complete. And because each system had evolved independently, there was no shared design language or consistent user experience across them.
The modernization effort — consolidating these systems into iQIES — was already underway when Skylight joined. The challenge wasn’t just rebuilding the technology. It was making sure the new system actually worked better for the people using it. Interfaces had to be intuitive. Design decisions had to be grounded in research rather than assumptions. And the front-end engineering had to scale as iQIES expanded to cover more provider types.
The solution
As a subcontractor to Ventera, we joined the iQIES modernization with a focus on three areas where the effort needed the most help: user-centered design practices, a scalable design system, and modern front-end engineering. The biggest gap wasn’t technical — research, design, and engineering each worked in isolation. We embedded researchers alongside designers and developers, so insights from user interviews translated directly into interface improvements. The practices we introduced kept user needs front-and-center rather than letting findings get lost between teams.
From that foundation, we built a collaborative design system that gave teams a shared vocabulary for building consistent, accessible interfaces. Before the design system, each team made independent choices about layout, interaction patterns, and component styling. The design system gave teams a shared vocabulary — and stopped each team from reinventing every component. Reusable components and clear guidelines let teams ship maintainable interfaces without reinventing decisions on every screen.
The front-end work wasn’t about features — it established patterns iQIES would extend across every future provider type. We engineered key parts of the application’s front end using React, Redux, and the U.S. Web Design System. By aligning front-end architecture with the design system, we ensured new modules could be built consistently. The application stayed accessible and performant as it grew.
The result was a modernization effort that improved not only what users saw, but how the teams behind the system worked together. Embedding user-centered practices directly into the delivery process meant design quality wouldn’t depend on any single team’s involvement. The methods were part of how iQIES got built.
The results
- Delivered a modern front-end experience for a nationwide healthcare quality reporting system, replacing legacy desktop interfaces with a cloud-based, accessible web application
- Built a reusable design system that helped teams produce consistent, accessible interfaces across provider types and modules
- Embedded user-centered design practices into the development process, strengthening collaboration between research, design, and engineering teams
- Supported iQIES’s phased rollout across multiple provider types, including long-term care hospitals, home health agencies, and hospices