The following is an article and video from Transparency Matters, an e-newsletter produced and distributed by the Center for Healthcare Transparency.
Our Work: Integrating Clinical and Claims Data for Quality Improvement
To test solutions to several pressing transparency issues, CHT funded three innovation pilots. One of those was led by The Health Collaborative, which used clinical and claims data provided by a Cincinnati-area integrated healthcare system to design a scalable technical solution to integrate claims and clinical information at the patient-level. The Health Collborative collected over 400,000 Continuity of Care Documents (CCDs) from providers. These included a broad set of data types such as laboratory tests (including values), medications, and care plan goals across many types of encounters including hospitalizations, home visits, and office visits. Claims data arrived in flat file format and was transmitted from the health plan to The Health Collaborative via sFTP. The Health Collaborative matched the clinical to the claims records using IBM’s Master Data Management (MDM) and used popHealth® to import CCDs, electronic clinical quality measures (eCQM), definitions, and to calculate several diabetes care quality measures.
Read more on our website and watch an interview with Jason W. Buckner, SVP of Informatics for The Health Collaborative, below: