NC HIE Improving Transparency and Medical Decisions, Restraining Costs

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Data Use Agreement First Step Toward Medicaid Reform, Greater Healthcare Transparency

L. Allen Dobson, Jr. MD, President and CEO of CCNC

“We’ve taken the critical first step in Medicaid reform and started down the road from paying for volume to rewarding favorable patient outcomes.

The North Carolina Department of Health and Human Services has executed a data use agreement with the North Carolina Health Information Exchange (NC HIE) that implements legislation introduced in the North Carolina Senate to improve health care transparency and give doctors more complete patient information.

The agreement paves the way for marrying Medicaid clinical and claims data for the first time and making that data available to physicians at the point of care. Current gaps in data make it hard to root out fraud and abuse and can lead to duplicate testing, unnecessary treatments and medical errors that drive up costs and reduce patient safety. Poor communication of records is also responsible for as many as 50 percent of all medication errors and up to 20 percent of adverse drug events.1

First step toward Medicaid Reform
The NC HIE is a statewide data exchange is changing that picture by giving healthcare providers access to comprehensive medical data on all their patients.

Said L. Allen Dobson, Jr., MD, President and CEO of Community Care of North Carolina (CCNC): “We’ve taken the critical first step in Medicaid reform: getting data that tells us what we’re spending money on so we can allocate resources as efficiently as possible. It moves us further down the road we know we have to travel – from paying for volume of medical services to a value-based system that rewards providers for favorable patient outcomes.

“CCNC applauds the Department of Health and Human Services for moving the state forward on data transparency and the NC General Assembly for enacting legislation that makes healthcare in North Carolina more transparent. I’m proud that North Carolina continues to show leadership in improving healthcare delivery.”

NC HIE has already signed participation agreements with 27 North Carolina hospitals and more than 600 medical practices across the state. There is a growing realization that even among the largest and most sophisticated health systems, much of the care patients receive isn’t captured in their electronic medical records. Providers are increasingly turning to NC HIE can help them close those gaps in an affordable manner, while building on state and federal investments in the health exchange technology.

While Electronic Medical Record (EMR) systems are an important step in modernizing the current healthcare delivery system, Health Information Exchanges enable EMRs to be more effective by offering a broader view of a patient’s medical history so physicians can spend less time asking questions about medical histories and more time making treatment decisions.”

This is a key consideration for busy primary care doctors with limited time to spend with patients. It’s also critical for family physicians managing “medical homes” to be aware of treatment their patients have received elsewhere. Arming clinicians with this information promises to make care more cost-effective while reducing duplication and the potential for medical errors. Good data is also a prerequisite for the operation of Accountable Care Organizations and achieving shared savings in the Medicaid program.

In addition to linking to hospital systems and medical practices, NC HIE is also working with the NC Office of Rural Health and Patagonia Health to establish HIE connectivity for a growing list of local health departments across the state. This is helpful in broadening access to key public health data such as immunization records.

For more information about the data use agreement, please see the NC HIE news release.

1. Institute for Healthcare Improvement website, Reconcile Medications at All Transition Points, 2014

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Paul Mahoney
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Community Care of North Carolina
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