Market forces are compelling – and inspiring – health insurance providers to acquire digital clinical data and make it available to members and usable across the enterprise. CMS mandates require government-sponsored plans to provide members access to their health data using the FHIR standard. Risk adjustment is more accurate with access to diagnoses and other clinical factors that don’t appear on claims. HEDIS scores and Star ratings depend on clinical data such as test results and vital signs to identify and address care gaps.
Despite the need for and availability of clinical information in digital form, the reality is that raw data collected from EHRs, HIEs, labs and other sources can’t be seamlessly incorporated into analytics or real-time transactions. Poor data quality and the need to integrate data from multiple sources to complete each member’s health picture pose enormous challenges. And traditional approaches to normalizing and integrating data are resource-intensive and don’t scale.
Fusion best-of-breed technology integrates via API with enterprise infrastructure for clinical data acquisition and management, protecting your technology investment while generating a shared data asset to improve clinical outcomes, financial results and operational efficiency. Compliant with security, privacy and regulatory requirements.
Real-time, high-volume data processing supports use of timely clinical data for proactive care management and care gap identification as well as downstream quality reporting and analytics. Fusion is purpose built for enterprise data management needs, scalable to process millions of data elements.
FHIR-enabled for deployment of solutions to meet CMS requirements and Da Vinci use cases such as Patient Access and Payer to Payer Exchange. Includes automated legacy data to FHIR conversion, while addressing data quality issues.
Health plans are deploying Diameter Health as a core component of their enterprise data strategies. Fusion ensures that data acquired from multiple sources can be compiled into a centralized member-centric data asset to support multiple workflows from a single hub. This approach eliminates the redundant costs of chart retrieval and departmental data silos.
Use Fusion to surface timely member health details such as prescribed medications, test results and vital signs that are not available in claims data. Fusion delivers these details in codesets such as LOINC, ICD-10 and SNOMED and standards such as FHIR or CCD so they can be easily ingested by risk targeting tools, and used in chronic disease and utilization management programs.
A leader in digital quality measurement, Diameter Health supports health plans with HEDIS/Star reporting and ongoing assessment of network provider quality. Fusion calculates member compliance with ambulatory clinical measures such as total diabetes control, and outputs supplemental data for use in HEDIS engines.
Senior executives from Centene Corporation and UnitedHealth Group share insights on making the case for Enterprise Clinical Data Integration.
We invested in Diameter Health because their ability to automatically integrate and normalize clinical data will play an important role as we look to accelerate innovation and digitization across our company.
Mark Brooks, EVP and CIO, Centene Corporation
With up to 5 billion exchanges of digital health information annually, the tide of clinical data keeps rising. Start upcycling your data into a clean, concentrated, usable force today.