Population management is a critical component of an integrated care delivery model. These applications help care management better coordinate patient populations by providing insights into patients' health status, demographic information, and risk factors for chronic diseases. Healthcare organizations can also use population health data to improve administrative workflows and processes such as patient scheduling or billing.
While the benefits of managed care are clear, often organizations encounter challenges translating their data to industry standard formats. The technical experts at Brandywine Consulting Partners (BCP) have experienced working with complicated legacy data and can help you navigate this process.
XML Can Be Difficult, X12 Can Be Time Consuming
One of the biggest hurdles to leveraging population management is the input. The data quality and consistency are often very poor, which can cause issues with claims submissions and payment processing. Mapping schemas for XML can be challenging, especially when you are dealing with a large dataset and multiple data sources.
Using standard formats has helped improve data quality issues, but there is still much more that needs to be done. Most companies will use X12, EDI, or XML, which can be a major hurdle for companies looking to use population management with a user-friendly UI. While these standard formats help promote industry consistency they can be difficult to work with and increase the activation threshold for care management.
With X12, the data quality is the issue and the culprit is human input. Research has found that most providers don't know how to enter their own information into an EMR system. Sometimes they know how to complete this task but they simply lack the resources needed to do so properly (e.g., time).
As an example, provider data is often riddled with errors and missing key information. In many managed care applications, poor provider data can impact and cause load failure for all other file types. Often provider data is a core dependency for all other file types. Inaccurate provider records can prevent attributed member eligibility and claims records from loading.
BCP has experience in overcoming this challenge. Our service leverages the National Plan and Provider Enumeration System (NPPES) to automate the X12 274 provider data mapping process, ensuring that all relevant information is included, properly formatted, and errors are resolved. This technology bridge helps replicate provider information accurately without relying on manual entry methods, which often result in errors due to human error or lack of understanding about how these systems work together across multiple EMRs at once!
Low User Adoption of New Technology is High
Another issue with population health applications relates to user adoption of new technology. It's important that employees understand how they can make use of new technology and are comfortable using it in their daily workflows or processes. We have found that if providers are not familiar with population data requirements, it's more difficult to get them to change their applications to meet your needs. It would be unwise for healthcare organizations to adopt these applications without first addressing staff concerns around user adoption - otherwise, they may find themselves facing challenges on two fronts!
To overcome these challenges, it's critical that your organization conduct the appropriate amount of due diligence before making any decisions around which population health applications will be most beneficial for your organization. This includes understanding how each app fits within the larger picture (your strategic goals) and Identifying potential risks associated with implementing specific solutions.
When BCP is working with your organization to utilize population health applications, your providers and staff will be thoroughly trained and supported. We can help you navigate the challenges of leveraging population health applications through:
Consulting services and workshops on how to use these new technologies effectively
Supporting your team as they work with providers and vendors to develop a solution that meets your needs
Integration solutions to address gaps between your systems and population health applications
Brandywine Consulting Partners is Experienced in Solving These Challenges
BCP has experience with setting up automated means of data translation and loading, as well as curating over time. We’ve also found success utilizing AI and machine learning to identify data risks and errors and make improvements over time. Our technology bridges the gap between historical software, new population health applications, and all the necessary data sources in between. Our clients are experiencing the benefits of fewer human errors, more precise data, and greater patient outcomes due to population health applications. We can help you see the same benefits.
Contact us today for a demo or more information about how we are closing technology gaps in population health management and helping clients achieve better outcomes.
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