The American Speech Language Hearing Association’s (ASHA) National Outcomes Measurement System (NOMS) is a voluntary data collection system that demonstrates the value of speech-language pathology and audiology services. ASHA came to us to redesign and significantly expand the capabilities of the system. NOMS serves as a critical tool in accomplishing ASHA’s mission of empowering and supporting speech-language pathologists and audiologists by fostering excellence in professional practice, and advocating for their members and those they serve.




  • - Data Collection and Survey Implementation
  • - Business Intelligence and Dashboard Implementation
  • - Discovery and Business Analysis
  • - Cloud-Native Development
  • - User Research
  • - UX Design
  • - Agile-based Technical Project Management
  • - Microservices-based Dev Ops


The NOMS project had an array of critical success factors, including flexibility, to customize, and then create specific data collection instruments, reduce response burden significantly, improve ease of reporting and analysis, support additional data collection mechanisms and interfaces, and implement the ability to scale to match increased member demand.

Through our user-centered design and targeted technical approach, we ensured that we were implementing a solution that would serve these goals.



Discovery and UX Design

We conducted extensive discovery sessions with the business team (consisting of SLPs, audiologists, and data analysts) to dig into the nuances of the business and user requirements. We then designed interactive prototypes to demonstrate business functionality. Working from the user representatives, we were able to get early confirmation that the application met the users’ needs.

Cloud-Native Development and Microservices-based DevOps

We performed cloud-based development by leveraging Kubernetes as the cloud-native platform and by packaging the application into microservices. Thus, we were able to derive efficiencies in development and, additionally, develop and deploy in an incremental manner. The system architecture allows for future expansion built within Kubernetes. By leveraging a cloud hosting platform and implementing autoscaling, the number of resources needed can scale up when there is an increased load of data expected to match member demand.

Data Collection and Survey Implementation

NOMS allows clinicians and organizations to submit their data in multiple ways, including web-based data entry, CSV file upload generated from data from the EMR, JSON transmission, Secure FTP, and HL7-based SMART on FHIR data transmission protocol integration with the EMR. Additionally, we implemented Survey JS to address the need for flexibility and customization. By embedding the survey tool within NOMS, ASHA is now able to easily make changes to the data collection questions and integrate them within the application. All data can be viewed at an aggregate level through an extensive Power BI interface so that each user can view and work with the data.



The first release of the updated NOMS application was launched on October 15, 2020. Since then, there have been no reported issues within the application. ASHA has shared how pleased they are with how things are working within the new application and that they have no issues or concerns moving forward. ASHA will be able to use the data collected to better understand service delivery across patient populations.

  • - User-centered design and brand alignment
  • - Flexible Data Collection via multiple mechanisms
  • - EMR integration with SMART on FHIR
  • - Integrated Data Reports Dashboards using Power BI Embedded
  • - System orchestration using Kubernetes

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