Interoperability: Advance the Convergence of Clinical and Claims Data in support of Value-Based Care

Interoperability: Advance the Convergence of Clinical and Claims Data in support of Value-Based Care

Inovalon’s interoperability platform provides for a two-way exchange of patient-level clinical data with Electronic Health Record (EHRs), and state and regional Health Information Exchanges (HIEs) in order to both improve the speed and efficiency of clinical data review and as well to create a more complete, accurate and current patient profile. By extracting clinical data through the platform, Inovalon is able to aggregate this with claims data to calculate more accurate and timely measures of patient quality, risk score accuracy, and other clinical dimensions to improve value across the healthcare ecosystem – delivered to clinicians in their workflow.

The interoperability platform supports a seamless, controlled and automated approach to the following:

  • Clinical data review: For clinicians and medical groups that have connected to the interoperability platform, Inovalon’s systems automatically retrieve targeted patient clinical data to support clinical review used in support of quality and risk score accuracy solutions supporting value-based care.

    Additionally, the structured and unstructured clinical data extracted from CCD’s – using Natural Language Processing (NLP)/Machine Learning and Data Parsing  can be used to further fuel Inovalon’s predictive analytics engines in support of quality improvement or other initiatives to advance value-based care.

    Clinical Data Review
     
  • Analytically-Driven Encounters: Inovalon’s predictive analytic systems leverage both claims and clinical data to identify gaps in clinical care, quality, and risk score accuracy in real-time. These insights are able to be transmitted directly into a clinician’s workflow as care alerts informing the encounter for many of Inovalon’s EHR partners.

The Interoperability Platform facilitates maximum speed, cost, accuracy, and accessibility while minimizing medical practice disruption and friction with the clinician’s care team.

Direct EHR Interoperability facilitates maximum speed, cost, accuracy, and accessibility while minimizing provider disruption and provider network friction.

Integration with Health Information Exchanges (HIEs)

Taking EHR interoperability a step further, Inovalon integrates with state and regional Health Information Exchanges (HIEs) to facilitate the data exchange for clinical data reviews. Recognizing that not all EHR systems adhere to interoperability standards or, due to size and/or accessibility realities, lend themselves to realistic interconnection within fiscal constraints, Inovalon has undertaken an industry-leading HIE interoperability initiative to garner the “pushing” and “pulling” of clinical data of analytically identified gaps in quality, risk score accuracy, and utilization inefficiency.

Taking EHR interoperability a step further, Inovalon integrates with State and regional Health Information Exchanges (HIEs) to facilitate the data exchange for medical record reviews.

EHR Interoperability Video