Gathering data to use it to improve care delivery is easier said than done, explained Charles Saunders, MD, CEO of Integra Connect.
Gathering data to use it to improve care delivery is easier said than done, explained Charles Saunders, MD, CEO of Integra Connect.
Transcript
Technology has led to greater data collection: how can practices ensure they are gathering data and using it in a meaningful way?
Well, the first part is gathering it. And that’s not as easy as it might seem. It’s not just a matter of reporting measures out of the electronic health record (EHR). In many cases, measures that are important—either for calculating quality measures or MIPS [Merit-based Incentive Payment System] measures—may not even be in the electronic health record in a structured format. So, they need to be somehow captured, either through natural language processing or through manual data abstraction. So, the data curation part of it can be very tricky.
In addition to that, if they have holistic responsibilities for patients with the Oncology Care Model, they also need to have claims. They need to integrate claims from CMS and understand those claims and link those to the clinical information from the EHR and other sources of pharmacy, lab, etc. And that requires integrative technology.
How is technology being used to identify inefficiencies?
Well, one of the most useful things that can be done is to take the CMS claims and to identify cost and utilization of services. So, that means acute care days, SNF [skilled nursing facility] days, avoidable emergency department visits, as well as hospice use and other high-cost, high-tech services, and specialty drugs. And the use of those and the units of service can be determined from the CMS claims data and compared against benchmarks to determine whether or not there are savings opportunities, and whether they’re efficient and not efficient and the use of those services.
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