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Rhode Island Quality Institute Tackles the Challenge of Managing Provider Data
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Rhode Island Quality Institute Tackles the Challenge of Managing Provider Data

Healthcare costs continue to rise each year. According to the 2016 Milliman Medical Index, an employer-sponsored plan for the average family of four costs over $25,000 a year. Across the US healthcare marketplace, healthcare organizations continue to look for ways to reduce medical costs, deliver better care, improve patient experience, and build operational efficiencies.

One of the many challenges of healthcare surrounds managing provider data. Providers have multiple, complex and changing relationships, which leads to frequent changes in their location, insurance participation, and affiliations with health systems. Recent surveys report that roughly 20% of provider data, such as demographics and credentials, changes annually. Health plans, provider organizations, and public health organizations struggle to keep up with this constantly changing provider data, each using valuable resources to update similar records. Furthermore, provider data is collected, but not consistent, across disparate systems in a typical health system or health plan. In fact, on average, 30 to 40 percent of provider records in US health systems have missing or inaccurate information.

Incorrect or incomplete provider information can especially be frustrating when providers are trying to refer their patients to a specialist, or when patients are searching for a new provider and trying to determine which ones accept their insurance. So how do organizations tackle the challenge of providing accurate, complete information to its many stakeholders in an efficient way? The Rhode Island Quality Institute (RIQI) has found a solution.

RIQI is setting a new standard for the nation with its statewide provider directory, a key feature of RIQI’s CurrentCare – Rhode Island’s state health information exchange (HIE). CurrentCare is based on InterSystems HealthShare, a software platform that goes beyond basic information exchange requirements to enable the sharing of enriched information, the integration of analytics, and the building of engaged online communities.

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Rhode Island Quality Institute Tackles the Challenge of Managing Provider Data