Medicare needs more than digitization – it needs unification


As a new generation ages in Medicare, more participants than ever are enrolling. The agency is at a pivotal moment and must find a way to innovate systems that incorporate new regulations from the Centers for Medicare and Medicaid Services (CMS) that improve the interoperability of data platforms, while meeting the demands of updated technology request for this new, more technological Medicare. generation.

Healthcare providers are embracing digitalization as a way to empower older people. However, it is not enough to store data on a digital platform – for data to be valuable to patients and providers, it must be unified, deduplicated and scaled to deliver insights like rates. patient engagement, indicators of patients at risk, etc. . CMS compliant health data platforms that facilitate patient and population health management are the answer. A Quality Health Data Platform (HDP) can ingest patient data from multiple systems and data silos and unify it into consolidated 360-degree patient records, which means improved quality and safety of patients. health care for beneficiaries. This type of platform not only allows providers and patients to access key medical information in one place, but also empowers patients by giving them increased visibility into their records, while streamlining provider workflows. and giving clinicians more time to focus on patient-centered care.

Current state of health data

Traditionally, patient health care information has been almost universally siled. Digital data stores remain separate and inaccessible, in large part due to the challenges associated with integrating and managing data at scale. Doctors’ offices constantly run the risk of using outdated and incomplete patient charts, or having multiple charts with different information for individual patients, creating the potential for unsafe care. In addition, the lack of coordination of healthcare teams between providers remains a major challenge in the US healthcare system. Because Medicare beneficiaries often see more than one clinician, it is important that each provider is aware of the care an older person receives from other providers, and not just in their own office. However, there has not been a common way to do this, as different medical practices use different Electronic Health Records (EHRs) and systems may not be able to communicate with each other.

Today, the new federal interoperability rules are driving a technological revolution. In addition, the aging population currently in Medicare is technologically savvy and more engaged in their own care. This means that there is an increased demand for technology-related policies that improve the healthcare experience for Medicare beneficiaries, as well as an opportunity to address the data fragmentation issues that plague the system.

However, for these rule implementations to be truly successful, we need a platform that can unify digital data from multiple data silos and combine it into a single, accurate and comprehensive patient profile, providing access and accountability. 360 degree view of medical condition for both. provider and patient. But providers will then need to ensure that the patient is recognized in all systems and that their profile is constantly updated and protected. It is not enough to have the data in one place; providers need to be confident that the data they are using is accurate in order to make informed decisions.

How digitization impacts health actors

The possible outcomes of unifying data for health stakeholders can be best understood by examining our current state and federal data systems. Many government departments have gone online, as has the digitization of health records, but all information is siled – there is not one place to see a 360 degree view of information that all agencies have. government have captured an individual. While we can log in and view information about our individual tax returns or government benefits, we can’t see everything in one convenient place; we need a different login for each portal – just as hospitals and outpatient clinics often require separate login information and tap into separate data silos. Imagine if there was a unified portal for “US residents” – which would provide visibility into your overall relationship with the government and, conversely, provide the government with a better understanding of its people. This is the type of patient view that an HDP provides.

This unification of patient data is even more important in healthcare, where the quality and safety of care depend on accurate and complete patient data. This is especially true when patients see multiple providers, which increases the risk to the patient if each clinician is not fully aware of the drug therapies that the others have prescribed, for example. Two different doctors could prescribe drugs that interact poorly with each other without being aware of a potential impending adverse drug reaction, because they did not have access to a unified patient profile – instead, they had separate FSDs that can’t talk to everyone. other. A unified patient profile not only enables the patient because they can see and understand all of their information in one place, but providers can also be more confident in the quality and safety of their care plans and can more easily coordinate care plans. care between teams.

Patients are consumers, and alongside new CMS rules, the aging generation in Medicare is driving demand for access to health records and integrated care options. Not only will a data platform engage and empower patients, it will ultimately reduce the burden on providers, giving them more time to focus on what they do best.

How HDPs unleash the potential of health data

An HDP can make data unification and interoperability a reality and enable data to benefit everyone involved in a patient’s care. HDPs allow the provider to view not only the patient’s history within their own physician’s office, but the entire patient view – providing a profile that contains relevant information from all of the patient’s physicians and enabling a more comprehensive care plan. unified, safer and better quality. The needs of Medicare beneficiaries change, and a flexible and scalable data platform can provide the solution they need to stay safe and healthy.

HDPs can go beyond CMS standards and provide true interoperability. For example, an HDP is able to support machine learning, overcome the difficult hurdle of patient matching, and ensure that all patient data is up to date. The data is then compiled into a flexible, secure and well-managed 360 patient view, enabling healthcare brands to see the needs of the people they care for and deliver patient-centered care by identifying gaps in health care delivery that need to be addressed. HDPs can also use AI to predict future patient needs, which is essential for controlling healthcare costs and preventing disease.

High-quality HDPs will support standards, such as CMS and FHIR, to facilitate compliance and give patients confidence that their data is secure. These standards allow for scalability of clinical and patient data and supplier directory requirements. Additionally, quality HDPs support an open and extensible architecture that allows brands to easily and cost-effectively innovate new experiences and workflows in addition to the patient database. While protecting patient privacy, provider organizations can create applications that “call up” anonymized patient data to better support patient planning and tracking, prescription management, and more.

It’s time for Medicare to move beyond legacy data storage and embrace the incorporation of health data platforms that give beneficiaries direct, unified access to their data and a way for providers to get the full picture. of their patients. By incorporating technologies such as artificial intelligence and increasing interoperability through HDPs, providers gain access to comprehensive and organized patient profiles that increase the safety and quality of care, and patients will benefit from better outcomes. for health.

Photo: alexsl, Getty Images


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