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New Priorities for Provider Data Management

Our partner, IMT, has been helping organizations manage data across the healthcare ecosystem for more than three decades. Through it all, they’ve helped our clients navigate each wave of change. Patient registries have expanded to provider registries with relationships connecting the two entities for accountable care assignments, encounter history, and PCP assignments. Fully harnessing and optimizing provider data given the complex and distributed ownership, governance, and usage needs demands a more sophisticated approach.

Provider Data Requires Special Handling

Expanded Data Domains: Provider data management requires expanded domains and unique matching algorithms from patients – incorporating domains for organizations, locations, networks, and contracts.

Complex Governance: Provider data governance policies require collaboration that reaches across credentialing, marketing, RCM, IT, and the provider relations teams, to name a few of many and it is often necessary and appropriate for shared authorship of a provider directory record.

Data Quality & Enrichment: Incorporating reference data from outside sources against your provider directory is especially beneficial for NPPES specialization, and local or federal Sanctions or exclusions lists. Address standardization and maps integration helps to fortify patient-facing “find a doctor” portals. Data quality profiling and standardization are beneficial to improve the consistency and completeness of data used for referrals and orders.

Analytics: Analytics measurements of provider data quality and establishing regular verification processes, etc. are critical to the No Surprises Mandate as well as to ensure the right and most up to provider data is where it needs to be across the organization. Being able to measure when data requires re-verification is crucial.

Today, IMT is taking provider data management to the next level – introducing IMT Health:iDM for Provider Data Management, an agile, innovative foundation to deliver value to all stakeholders and systems.

Built upon Semarchy’s Unified Data Platform and optimized for provider data, we can help you create a comprehensive directory of providers, affiliated organizations, and related details from across a health network. That single, consolidated view enables your most pressing strategic, operational, and regulatory initiatives. 

How intelligent provider data management changes the game

Intelligent provider data management gives you a more comprehensive view of your information that empowers you to: 

  • Establish a single view of each practitioner that includes the source data lineage you need for an audit trail
  • Reduce manual updates with flexible, fast integration that populates changes across other systems while enabling direct access via active integration
  • Access and deliver consistent, accurate data to patients and referring providers with such crucial details as specializations and network coverage to avoid billing surprises
  • Gain enhanced insights into relationships between patients and providers, including attribution 
  • Boost provider satisfaction by distributing updates (in real-time or batch) to every department that needs accurate, current information
  • Improve compliance with ever-changing regulations such as the No Surprises Act and anti-information blocking 

How Health:iDM Enables Intelligent Provider Data Management

To deliver a solution optimized for provider data management, first, we started with IMT Health:iDM, which is built on Semarchy’s Unified Data Platform. Then we built on our years of experience to optimize the platform for provider data domains and matching algorithms that are best suited for provider demographics, locations, licensing, and credentials. We defined the most important relationships in the data model to understand and use linked organizations, locations, networks, contracts, and patients for transactional or operational use cases using Semarchy’s flexible and unique multi-vector architecture.

We can help you implement intelligent cross-departmental workflows that compliment your existing processes. This enables credentialing, marketing, RCM, IT, provider relations, and other internal and external teams to collaborate — all while adhering to your existing data governance policies.

You can establish an enterprise-wide data dictionary with shared definitions in a single glossary to help with more consistent use of provider-related data across processes, systems, and users.

With Health:iDM for Provider Management, you can create a permanent provider ID that can be shared with downstream operational and analytical systems. This ID can bolster aggregate reporting and insights on provider data quality, verification, and other initiatives.

Finally, to help you comply with an ever-evolving regulatory landscape, Health:iDM gives you the agility to easily capture new data elements or share data with new places through open APIs, HL7, FHIR, or new custom methods. Whether you’re building a strategy for the No Surprises Act, anti-information blocking and access mandates, or other changing regulations, the flexible Health:iDM platform helps you adapt. 

Download our fact sheet to learn more about how IMT Health:iDM for Provider Data Management can help you achieve your strategic initiatives.