Cindy LeRouge is from Washington Univ in St Louis, and has been working with Wellpoint on a study of integrating claims and chart data….there is some chart-type data (i.e. lab tests) around so some chart elements (electronic) can be put together.
Insurers are not yet seeing costs savings or consumer push for this, but there might be a competitive first mover advantage (if you can delay first mover as much). Insurers would like to see some chart data (e.g. getting lab data or blood pressure for DM). So there are reasons at the margin for plans to do this (although I might have to pick a fight with her later about this!). So out of claims they can start to generate reports that patients can view, and emergency rooms.
Running a test in Missouri, which will integrate data from certain hospitals in Missouri, and will eventually allow Wellpoint claim data to post back into some hospital forms and reports.
Oh, but of course the internal data at Wellpoint is a mess, so that data scrubbing issue remains a problem…and legal is getting in the way.
And then what about moving records between plans (UPIN and all that)? Do we go to a credit bureau-type reporting structure?
And why would providers want to share their chart data? (Good question!). Why are they going to the brain damage of working with providers to get that part of the chart in? Apparently there’s something in the chart that they need for UM that they can’t get out of the claims (but it’s not in the attachment either). And it’s all been driven by the marketing department. Strikes me that the Blues yet again need more consulting help!