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The focus on interoperability has been under discussion for years, yet providers still work with paper records. A few years ago, many New Year Top 10 Goals included “death of the provider office FAX machine.” Unfortunately, there are still FAX machines in many provider offices today—in fact, providers continue to rely on the FAX machine for many day-to-day operations, especially for exchanging medical records.
I hope the advent of digital measures will help the transition away from the FAX machine—and this is happening, to a degree, but it isn’t happening fast enough. I’m amazed at how many providers continue to FAX charts in support of HEDIS, even when they have the option to participate in EMR data exchange.
Providers tell us about the burden of HEDIS—the resources needed, the challenges that result from short (and strict) timelines, the numerous requests from health plans and their retrieval vendor partners. Providers also tell us, however, that the burden to move to digital data exchange is heavy, which hampers the transition.
I’d categorize provider concerns into the following groups:
1. System/EMR configuration: Is the EMR configured to easily extract data?
2. Cost: Is there a cost to participate with an aggregator or EMR vendor parent company?
3. Variation: Each payer has its own file format or specifications for accepting data.
4. HIPAA: Is it okay to share data (for example, historical data)?
These concerns aren’t trivial, and they require conversation, trust and time to resolve. Barring a universal data exchange extract, variation across payer ingestion requirements and concerns about sharing patient-level data will be discussed for some time.
What we can address are configuration and cost questions. Managing these will depend on resources available in an organization. For example, can you accept any file type or layout, or are you limited by type and layout? Do you have resources to support provider cost for configuring or extracting data? If so, at what cadence and cost per provider?
Vandna Pandita | Vice President of HEDIS® Strategy and Analytics | AmeriHealth Caritas
Vandna Pandita, MPH is the Vice President of HEDIS® Strategy and Analytics for the AmeriHealth Caritas Family of Companies [ACFC]. In her role, Vandna oversees the full continuum of performance measurement from the acquisition of data to reporting and analytics for the enterprise, the Medicaid Risk Adjustment program and Clinical Solutions. Vandna works collaboratively with internal and external partners to ensure that the AmeriHealth Caritas Family of Companies is best positioned within the marketplace at the state and national level.
Vandna has moved from coast to coast, and although she has spent the last 20+ years working on her southern drawl in Atlanta, these days you will find her running the streets of her new hometown, Philadelphia.