Clinical Data Acquisition
How to leverage technology to retrieve patient information
Clinical information documented in medical records – including physician narratives in progress notes, lab results, radiology reports, discharge summaries, etc. – contains valuable insights about patients’ health. Risk-bearing entities must have access to this clinical data for risk adjustment and quality management. Yet, too frequently, poor access to clinical data hurts revenue integrity and limits the analytical insights available.
It begs the question, “Why is it so difficult for organizations to acquire and take advantage of clinical data?”
The challenges of acquiring clinical data
Clinical data used for risk adjustment resides within electronic health record (EHR) systems or paper charts, usually at the physician’s office. Because clinical data sits with providers, it’s difficult for payers to obtain, especially in non-integrated healthcare settings. Despite increases in EHR adoption, true interoperability across disparate systems has yet to be realized.
Consequently, medical record collection is usually done manually via fax, mail, or by sending chart abstractors in person to provider offices; a process that is costly and time consuming, especially if locations are geographically dispersed. As organizations scale, so too do the costs associated with manual chart retrieval. These data requests also pose an administrative burden to providers and disrupt their workflow, resulting in provider abrasion. In addition, scanned or faxed documents often have quality issues that impact readability (e.g., pages are cut off, printer ink is spotty). This makes legibility difficult for chart reviewers and limits the effectiveness of technology in processing the data.
Using technology to capture data
Integrating directly into providers’ EHR data feeds is an emerging tactic in the industry. Doing so allows organizations to fetch data continuously – soon after patient encounters take place – rather than on a periodic basis (e.g., in advance of submission deadlines). The results are better predictive analytics, more timely identification of care gaps, more effective capture of member risk, and more accurate risk-adjusted payments. However, while EHR integrations do provide timely and high quality data, they still require a major investment and can be difficult to set up, especially if the right resources are not available on the provider side.
Lighter-touch technologies that can automate the retrieval of EHR data are also beginning to surface. An example of this is Automated Chart Extraction, where – after remotely logging in to the EHR – a software program locates and abstracts the appropriate medical records without additional human intervention. With a simple upload of a member roster, the program automatically navigates the EHR and captures and transmits the records’ contents and associated metadata into a specified secure location. Such a solution helps to efficiently extract high quality chart data with minimal disruption to providers. It requires very limited resource commitments from both payers and providers, and it allows organizations to significantly decrease their costs associated with manual chart retrieval.
Vast amounts of clinical data are generated daily, but traditional methods of collecting and making use of it are inadequate. Risk-bearing entities would be wise to invest in solutions that decrease the need for manual retrieval by implementing technology-enabled solutions that require minimal maintenance. In the long run, it will generate cost savings and lead to improved clinical and financial outcomes.
For more information about Health Fidelity’s data acquisition capabilities, please refer to the HF360 Data Acquisition Solution Brief.