How advanced data exchange facilitates efficient care delivery

With diverse types of data now available to providers, there’s the potential to revolutionize patient and provider experiences and improve care.

In today’s regulatory environment — one in which there’s an ever-increasing demand for data — acquisition and delivery is not enough. Providers and payers need data that is enriched and activated for immediate use in clinical and payer environments. This is data that delivers insights that will positively shape the patient and provider experience, and optimize how health plans function.

Healthcare stakeholders need an expansive network and robust platform of capabilities that work together to create an exchange that drives meaningful and efficient collaboration across the ecosystem.

Beyond data delivery

Network and platform are equally important parts of this approach. Both must continue to evolve and expand to satisfy new use cases for the benefit of providers and payers with an eye towards creating a world where every U.S. resident has access to affordable healthcare.

To enable exchange to bring the most value to stakeholders, expanding the network plays a key role. The more data acquired and available, the more value delivered to users across the healthcare ecosystem.

It’s not only critical to seamlessly connect with data from the top EHRs, but to also ingest data from other sources, such as national health data networks like CommonWell and statewide health information exchanges. As a network grows in these ways, it can become a one-stop data shop for users. The neutrality, depth and breadth of the network is one piece of the puzzle that will unlock the potential of clinical data for smarter, more efficient healthcare operations.

A solid, yet flexible foundation

While a deep and increasingly broad network enables the ingestion of as much data as possible, a platform approach to activate the data and deliver meaningful insights is equally important.

As data becomes easier to access — thanks to regulations like TEFCA — simply being a data supplier is not enough. It’s one thing to get data; it’s entirely different to interpret and act on that data.

At its core, an effective platform acquires, manages and activates data. This means that by integrating with diverse data sources, the platform can find, regulate and consume data, refining and packaging it to the desired specifications of both the supplier and receiver. In this way, the repository of enriched data can address the growing list of healthcare use cases.

In addition, this approach offers solutions that activate data, increasing its value to solve complex healthcare problems. For example, bidirectional data exchange solutions may be able to deliver meaningful insights at the point of care. By converting data into insights, the platform helps stakeholders both interpret and take action at scale. It also enables advanced reporting and analytics for use cases, such as prospective and retrospective risk adjustment, quality, managed care and payment integrity.

What makes an effective exchange?

There are four things that differentiate an effective exchange of data.

Neutrality. Most payers need data from providers operating on different EHRs. The exchange must connect to multiple EHRs and enable expansion of the network, so that payers can use the exchange as their one-stop-data shop — or at least vastly cut down on the number of shops they need to visit to get the data they need.

Strict access controls. Many providers are understandably hesitant to connect to platforms that take an open pipeline approach. The exchange must be privacy-minded and patient-centric. Data shared through the exchange must go through dynamic filtering logic, ensuring only the minimum necessary data is shared. You don’t have to sacrifice control for connectivity.

Flexibility to tailor solutions. The exchange must be built so that it can continue to evolve to satisfy additional use cases as users’ needs and market demands evolve.

Customer service. A good exchange must strive to exceed all customer expectations, with a focus on responsiveness and customer support. Customers should feel the relationship is more of a partnership than a vendor relationship.

Why the exchange matters

Combining both a broad network and robust platform of capabilities, the exchange can inform smarter, more streamlined healthcare. Payers can save administrative time and money, reduce provider friction, and improve clinical and financial outcomes.

Providers can increase efficiency, enable control and management of patient data and reduce the cost of care. Better served providers and payers become more efficient through the delivery of actionable insights at the point of care, ultimately improving care quality.

As an effective exchange grows, the focus must be on increasing the value and portability of data and further integrating it into clinical workflows — where it is best positioned to impact providers and their patients.

Alex Vannoni is the chief product officer at Moxe Health.

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