The existing electronic data interchange networks of claims clearinghouses could serve as the foundation of a nationwide health information network and exchange clinical data as well as financial information, Julie Klapstein, CEO at clearinghouse vendor Availity LLC testified today in Washington.

"Deployment and adoption efforts for a new network are time consuming and costly," Klapstein told the HIT Policy Committee, an advisory body to the Office of the National Coordinator for Health Information Technology. "I recommend that the existing administrative networks used today for claims transactions be utilized for clinical exchange, as well. The new standards for clinical exchange would be utilized as well as the existing HIPAA standards on the administrative transactions. It will be easier later to combine clinical and financial data on the same patient record if the same infrastructure was utilized for both."

Klapstein also said the forthcoming definition of "meaningful use" of electronic health records should include claims data "as a necessary and valuable source of clinical information."

She explained an Availity service to give physicians a summary of patient care using relevant claims data. The service, called Availity CareProfile, includes such information as diagnoses, tests performed, lab results, medications prescribed, ambulatory visits and inpatient events. Providers can view the information via a Web browser, or download the summary to supplement a patient's electronic health record.

"The information is valuable because it is current, supplements the information the patient reports and gives the provider a much broader history and knowledge base to support meaningful use," Klapstein said in written testimony. "The provider knows what happened to their patient in the hospital or other doctors' offices across town. They can avoid duplicate orders and have a medication history, saving time and improving quality."

Further, clearinghouses have a sustainable business model, Klapstein said. "We don't charge payers or providers for the Availity CareProfile. The financial and administrative transactions pay for the clinical exchange. Claims data is just one source of valuable data but should not be left out of the definition of meaningful use."

Full testimony from Klapstein and others is available at Click on Federal Advisory Committees, then Health IT Policy Committee, then Meetings.

--Joseph Goedert

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