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From evidence-based guidelines and clinician workflows to measure definitions and value sets, a lot of time and planning goes into monitoring, managing, and improving the quality of health care. The rapid evolution of technology has changed the way health care is delivered, and it’s more than just the use of EHRs. While there’s still ground to cover, advancements in interoperability have created an opportunity for data aggregators to be tomorrow’s game changers.
Data aggregators—HIEs, health systems, ACOs and others—can now demonstrate the power of their data, thanks to NCQA’s new Data Aggregator Validation program. Once an aggregator demonstrates that its processes maintain data integrity from the original source (or sources) to a health plan, data can be used as HEDIS® standard supplemental data, thereby eliminating the need for primary source verification. This is a profound change in how electronic data can be used and exchanged to support quality measurement, but this is far from the only use case it can support.
Beyond the anticipated reduced burden of HEDIS reporting, there is speculation about the additional benefits of DAV-validated data:
· Better Population Health Management. Using DAV-validated data to support population health activities may soon become the norm rather than the exception. Right now, despite sizable internal data sets, care managers and quality teams face data gaps that hinder their ability to understand the health and activity of their members. Care managers may not have historical health information on a new member who enrolls
in a plan or switches to a new provider. Or they could end up making repeated phone calls to local hospitals and other facilities to find out if a patient has been discharged.
· More Efficient Processes. The conversation about DAV-validated data has centered on how to use it for quality measurement and population health efforts—and rightly so. Yet, this data could also support other health plan departments and processes, such as reducing data burden associated with prior authorization and utilization management concurrent reviews.
· Stronger Provider-Payer Relationships. The topic of health data seems to divide providers and payers more than any other. Although some providers have close ties with their health plans, there is usually a discernible separation between the two. The DAV program might be the opportunity for stronger provider-payer relationships.
· Shared Data Quality Ownership. Data quality has been a hot-button topic since providers started documenting in EHRs. As new standards and programs—such as DAV—come to market, the focus on data quality will continue to challenge the industry. What’s exciting is that the question, “Who owns data quality?” is evolving to be, “What roles do different stakeholders play in ensuring data quality?” This is how change happens. It’s how meaningful progress is made.
· Expand the Value Proposition. How can the DAV program impact other health care settings? Hospitals that need valid data to for urgent treatment fit nicely into this value proposition, as do behavioral health providers, long-term post-acute care facilities—and many more. In fact, it's hard to think of even a single health care stakeholder that would not benefit from DAV-validated data.
· Spark Innovation. We’re still in the “what if?” stage of the value of aggregator data. If DAV-validated data proves to reduce the reporting burden, imagine what can happen when we look at other data sets, like unstructured data with Natural Language Processing or remote patient monitoring data. DAV sets the standard for data quality, and electronic data that comes from aggregators is just the beginning
of what is possible when new data sets are deemed valid.
DAV is all about data exchange, transformation and ensuring that data maintains its integrity through an in-depth analysis of policies and procedures. Burdensome manual data process can be alleviated through the evolving digital landscape of health care and new programs like DAV. Reduction of waste frees up capacity. What will you do with your extra time?
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Renee Towne | Director of Quality Programs | KPI Ninja
Renee Towne is the Director of Quality Programs at KPI Ninja where she empowers clinicians and teams to draw on the power of data to improve outcomes. She has experience driving performance excellence across a variety of healthcare settings through people and process improvement methodologies. Renee holds a Doctor of Education degree as well as a Master of Occupational Therapy degree.