3 Ways to Decrease Administrative Headaches by Improving Clinical Data Exchange
Written by: Cheryl Reifsnyder, PhD
Clinical data exchange (CDE) is the method used to transfer data so that information can be easily exchanged in the healthcare industry, whether that exchange is between providers, between providers and payers, between payers, or between other players in the healthcare industry. Traditionally, CDE has often taken place manually: Checking patient data might require answering emails, answering phone calls, downloading chart drafts, faxing, uploading data to a patient portal, or—at times—even feet on the ground to deliver patient information or retrieve a patient’s chart from a practice.
These challenges can place a significant burden on staff. Manual data exchange costs time and energy, creates administrative headaches, and has a higher likelihood of error during information transfer.
But CDE is critical for the transfer of patient health information for numerous purposes. The need for accurate, timely, and efficient information exchange between providers is obvious, required for patient care coordination or supporting a patient’s move between caregivers. CDE between payers and providers is important for purposes such as claims processing, risk adjustment, and evaluating requested services to determine whether they are necessary and appropriate. It’s important for identifying gaps in care and potential gap closure opportunities. Research has shown that care gaps can be both harmful and costly. Resolving gaps in care isn’t just important to payers, but also to providers and patients, because it can:
- Positively influence patient health
- Lead to improvements in quality scores
- Lead to improvements in reimbursements under risk-sharing arrangements such as Medicare
CDE related to prior authorization, estimation of benefits, and cost estimates information can help arm providers with payer details when dealing with patients.
There are numerous reasons we need CDE to take place in a more timely and efficient manner—and fortunately, CDE no longer has to occur via manual pathways. Keep reading for strategies you can use to move away from manual workflows to streamline CDE and, in the process, diminish the administrative headaches it might be causing.
Focus on data standardization
One strategy for streamlining CDE is to focus on data standardization when recording clinical and administrative data. Standardization makes it easier to exchange data between payers, between payers and providers, between healthcare practices, and so on. Jay Bercher from Solutions by Design II, an IT system modernization company, told Healthcare IT News that the healthcare industry “cannot optimize interoperability without creating data and adhering to data standards.”
The HL7® Fast Healthcare Interoperability Resource (FHIR®) standard defines how healthcare information can be exchanged between different computer systems, no matter how the data might be stored in those systems. It allows healthcare information to be available securely to those needing access to benefit patients receiving care.
FHIR’s development began in response to market needs for faster, easier, and better means to exchange the rapidly growing volumes of health care information. Based on internet standards widely used outside healthcare, FHIR has become one of the critical standards enabling efficient and secure interoperability.
eChart Integration and Analytics (formerly Integr8™)
Veradigm’s eChart Integration and Analytics solution can help streamline payer-provider CDE by standardizing data from multiple electronic health record (EHR) sources, facilitating payer-provider collaboration and the medical record retrieval (MRR) process. eChart Integration and Analytics uses the current standard for healthcare data exchange, FHIR, enabling seamless information exchange with all other FHIR-compliant EHRs. It also sends all patient information in encrypted format to ensure data security.1
Automate the data exchange process
Another important strategy for streamlining CDE is to automate as much of the process as possible.
Traditionally, payer-provider data exchange relied primarily on time-consuming manual processes to track down lab results, clinical data, and other patient health information manually is costly, time-consuming, labor-intensive, and error-prone—yet despite these drawbacks, more than 100 million medical record requests sent to healthcare providers (HCPs) each year are exchanged via manual methods such as paper or analog fax.
Veradigm® eChart Courier™
Veradigm® eChart Courier™ is an easy-to-use solution that can help streamline CDE by automating the medical chart retrieval process—in the process, saving time, office resources, and expense.
Typically, medical charts are retrieved individually. Each is then driven or mailed to the requesting health plan, where they are reviewed manually. This process is repeated for about 160,000,000 medical charts each year. Medical practices need to designate staff to sort through patients’ charts to respond to requests, diverting resources away from supporting patients and providers and introducing errors.
Veradigm eChart Courier increases the efficiency of medical chart retrieval by automating the process. It operates through the EHR so users can access and supply requested charts through the existing workflow. All information is sent in an encrypted format, helping to ensure security.
Carequality
Carequality is another tool supporting streamlined CDE. Carequality is a national-level, consensus-built interoperability framework created to enable data exchange between and among health information networks and service platforms.
Carequality was created to help ensure healthcare data is exchanged successfully throughout the U.S. Most healthcare data-sharing networks only offer HCPs connectivity within their membership, and that membership is often based on geographic or technology vendor lines. Carequality delivers a solution that bypasses these limitations, unlocking previously unseen levels of connectivity in the healthcare ecosystem.
As of October 31, 2022, Carequality is available with the Veradigm EHR (formerly Professional EHR.) It is available to all Veradigm EHR clients without the purchase of additional software or subscriptions; your practice pays only for configuring your EHR system to connect to the network for sending and receiving data.
Shift to using modern, internet-based tools for communication
You can also help streamline your CDE process by shifting your data exchange to modern, internet-based communication tools. Although manual means of information exchange, such as fax machines and exchanging hard copies of patient charts, used to be the primary means of exchanging pertinent patient information, most of the rest of society has progressed to faster and more efficient methods of communication—and it’s time for healthcare to follow their lead.
Modern, internet-based tools such as application programming interfaces (APIs) allow quick and easy access to health information. They enable information systems to communicate and transfer data, closing the gap with respect to how information is sent, retrieved, and processed.
Depending on how it’s configured, an API can accomplish many types of tasks, including:
- Enable a system to send or retrieve data to update an individual’s medical record
- Provide collective data for use in creating reports
- Send information from one system to another
- Automatically communicate between HCP organizations and payers to determine patients’ coverage for specific procedures or medications
Simplifying CDE
CDE is a powerful tool in the healthcare ecosystem and one with a myriad of different roles. Its growing importance makes it increasingly critical to streamline healthcare. Contact Veradigm today to learn more about how Veradigm can help you to improve the implementation of CDE in your organization.
References:
- Veradigm 2022, Internal Data on File.