Dara Price-Olsen

Posted on: December 18, 2018

Do you know where your physicians are? Sounds like a ridiculous question, right? They’re here—in our health system, in their offices treating patients, but are they?

Even if you know where your physicians are, where are the physicians outside of your organization that are critical to the care of your patients?

Considering provider demographics change at a rate of more than two percent a month and 30 percent of physicians change affiliations every year*, it’s an important question. But it doesn’t have to be.

If your health system started with 100% perfect provider information today and didn’t maintain it, within 18 months, it would be out of date by an estimated 25-35%, including:

  • Wrong, old or even missing practice addresses, as well as locations where they only rarely see patients
  • Incorrect or missing phone numbers
  • Wrong or missing HIPAA-secure fax numbers
  • Old, wrong, or missing billing relationships
  • Duplicate records
  • Inaccurate or missing National Provider Identifier (NPI) numbers
  • Sanctioned, deceased, and retired providers

So where is this physician and why is his or her correct healthcare data so elusive?

No one disputes the value of quality healthcare data. For health systems and hospitals, provider data drives most business processes. They rely on its accuracy for everything from detecting fraud to validating credentials and managing referrals.

For their patients, provider directories are the means to finding practitioners who meet their needs, ensuring medical record management and accurate billing. There are so many barriers to patient outcomes and improving revenue tied to the governance of this data. So why isn’t it a front and center priority for provider organizations?

One problem is that the collection, management and maintenance of provider information is a specialized area. Generally, no single department within the hospital has complete ownership of its governance. So often the root cause and impact of bad healthcare data is hard to quantify and isolate. The resolution often falls back on overtaxed IT teams whose energy and time is focused on EHR integration and implementation. As hospitals do more with less, this means the governance of provider data falls to the wayside.

But it’s more complex to fix than simply purchasing outside data from a vendor. Data has to be reconciled and then integrated into existing systems and workflows with minimal impact on existing resources. The right data partner has a solution that is consistently updated, fills in data gaps and prioritizes needed changes.

Finding your physicians doesn’t have to be like finding a needle in a haystack.

A proof-of-value trial is the best way for a data management company to demonstrate its capabilities. The trial typically takes a few weeks and should take a minimum of your own staff’s time.

Using your healthcare data, metrics and costs, the vendor should be able to evaluate the current state of your provider information quality and exactly what updates are needed.

A comprehensive provider data solution can ensure simple data governance and accuracy without far-reaching implications on your organization’s resources, costs and most importantly, patient care.

To get your complimentary proof of value report, contact us or to learn more, download our infographic on why “Provider Data Quality is Critical to Health Systems”

*based on LexisNexis data analysis

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