Automate Person/Information Matching to Improve Care Quality, Processes, and Outcomes

What’s in a name? For patients, providers, payers, and health information networks, getting identity right is nearly everything. The dangers of associating a name with the wrong information are simply too high.

Patients change home locations, their names, care facilities, and doctors. Providers may retire or change names, locations, organisation affiliations, and insurance networks. Managing and adapting to this constant churn has been a mostly manual, time-consuming, costly process.

For patient safety, for member satisfaction, to improve quality, avoid penalties and save money, provider, payer, and health information network organisations need identity management automation.

Inaccurate provider information has consequences. Wrong telephone numbers and location information limits access to care. Inadvertently choosing an out-of-network provider can result in catastrophic healthcare bills. Health plans have been fined hundreds of thousands of dollars for publishing inaccurate directories.

InterSystems HealthShare Provider Directory automates the process of creating, updating, and publishing accurate provider information as a “golden record.” It enables you to comply with regulations such as CMS 9115-F and the No Surprises Act more easily, enhance customer service, and improve the efficiency of any business process that requires up-to-date and accurate provider information.

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Poor identity management lowers care quality and leaves organisations vulnerable to litigation. HIPAA violations, for example, can lead to millions of dollars lost in settlements, legal fees, and penalties. InterSystems HealthShare Patient Index helps you avoid these risks and improve care.

HealthShare Patient Index is an enterprise master patient index (EMPI) solution that automates the creation of a “single source of truth” for patient and member identity and demographic information.

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Manually identifying the same patient in multiple records from multiple, diverse EMRs, and merging the information, would not be economically viable at the scale Health Information Networks (HINs) need for success. Successful HINs use InterSystems HealthShare solutions to automate the process, at scale. HealthShare also enables HINs to deliver value-added services that can only be built on aggregated, normalised, and accurate longitudinal patient records.

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^{1 - https://www.fortherecordmag.com/archives/0918p10.shtml
2 - https://www.fortherecordmag.com/archives/0918p10.shtml
3 - https://www.kff.org/private-insurance/issue-briefs/surprise-medical-bills
4 - Identity Crisis: An Examination of the costs and Benefits of a unique patient identifier for the U.S. Health Care System, RAND Corporation, 2008 (pg. 16)
5 - "Improving Provider Interoperability Congruently Increasing Patient Record Error Rates, Black Book Survey," Black Book Market Research}