The healthcare industry is well on its way through a digital revolution, with a focus on patient engagement and seamless data sharing. A critical piece of this puzzle is ensuring accurate and consistent patient identification across various healthcare systems. This blog post explores how payer and provider organizations are leveraging healthcare master data management (hMDM) to overcome identity challenges and unlocking the potential of digital health initiatives to improve the patient, member, and provider journey as shared in a recent Reuters webinar.
The power of master data management in healthcare
For both payer and provider organizations, fragmented data siloed across different systems is an ongoing challenge. Even with a solid data governance structure in place, the very nature of healthcare leads to constant work in addressing siloed data.
Going beyond de-duplication: Innovative data use cases in action
During a recent Reuters Events webinar, “Drive Digital Engagement and Improved Data Sharing with an Intelligent End-to-End Data Management Process,” industry leaders from both payer and provider organizations came together to share their experiences with data and member/patient experience. On the panel were Ray Halper, Staff VP of Analytics, Engineering, and Data Governance at Centene Corporation; Doug Nowak, VP of Enterprise Data Analytics at Sanford Health; and Rob Cimino, VP for Digital Health Strategy and Implementation at Maimonides Health.
Below are some of the powerful use cases that are actively leveraging healthcare master data management and identity solutions. Use these learnings to drive how your organization thinks about this critical piece of infrastructure beyond de-duplicating records.
Maimonides Health: A patient-centric approach driven by identity
Maimonides Health, one of New York’s largest healthcare systems and one of the largest teaching hospitals in the state, utilizes Verato’s patient identity management to unlock new business value. By leveraging their data, they enable a frictionless digital front door experience and more automated interoperability. Two specific examples include:
- Engaging patients at the digital front door: “By having a complete view of each patient, we can offer personalized care and efficient service,” Rob Cimino, VP of Digital Health Strategy and Implementation at Maimonides explained. Maimonides’ digital front door, hosted through their mobile app, enables users to enroll anonymously without an invitation. On the backend, Maimonides can accurately identify existing patients and link them to their correct records, which is essential for several reasons. This capability increases app usage by providing a seamless user experience, enhances patient retention by ensuring continuity and accuracy in their care, and builds trust between the health system and its users by demonstrating reliability and precision in managing patient data.
- Streamlining emergency care: Maimonides’ identity management solution with Verato streamlines the pre-registration process for patients arriving at emergency facilities. By ensuring accurate identity matching, staff can avoid the time-consuming task of patient lookup during critical moments, allowing them to focus on providing informed and immediate care. This enhances operational efficiency, reduces wait times, and improves patient outcomes by ensuring that healthcare providers have the necessary information right at check-in.
Centene: A payer’s perspective on quality improvement
Centene, a leading health insurance company, leverages the Verato hMDM platform in several ways, but two of the most valuable for the health plan today include:
- Boosting quality measures and creating a holistic member view: Accurate member identification enables Centene to integrate member data from various sources, significantly enhancing the precision of quality measure calculations.
Ray Halper, Staff VP of Analytics Engineering and Data Governance at Centene explained, “Quality calculations are not just simple, straightforward ‘one system, one algorithm’ scenarios. They require claims information, potentially from different claims systems and different types of claims (medical, dental, etc.), admit and discharge information, lab results from many different systems, supplemental files provided directly from the providers, and even continuity of care documents provided electronically.”
These systems often lack a common identifier for patients or members, creating data silos that pose risks to the organization when calculating quality. Halper went on to explain the negative impact of siloed data: “If individuals are calculated in silos, it makes the membership look artificially inflated because the same person is counted multiple times. You end up with gaps in care associated with two separate records even though when they are put together you could have a holistic or longitudinal view.” - Presenting a unified front door from multiple backend systems: Halper highlighted how that unified view of a member is not just critical to the plan, it’s an expected part of the member experience: “We have multiple lines we support (Medicare, marketplace, commercial, Medicaid); from the moment an individual enrolls with Centene, their experience within our ecosystem matters to us and it matters to the member. The member expects us to be able to leverage and access their data regardless of where it came from because to them, we are Centene.” This unified view enhances the member experience by ensuring continuity and consistency in their interactions with the health plan. It allows Centene to provide more personalized and efficient service, leading to increased member satisfaction, loyalty, and better overall health outcomes.
Sanford Health: A rural healthcare leader embraces virtual care
“With 250,000 square miles to cover, data and analytics play a crucial role in managing patient care and long-term care units efficiently,” Doug Nowak, VP of Enterprise Data Analytics at Sanford Health, explained. Sanford focuses on patient identity management to:
- Standardize data for interoperability and innovation: Standardized data is the backbone of interoperability—and not just interoperability between providers and payers, but within a provider’s systems themselves. Sanford Health is building a modern data infrastructure to consolidate information, allowing their teams to focus on innovation. Nowak explained, “We’ve got a large health plan membership, we’ve got large long-term care, and then we’ve got our health services division. And so we talk interoperability amongst systems. We need to talk interoperability within our system. And so that’s what we’re working at right now, so we can spend more time doing the innovation work we should be doing instead of trying to just make the technology work for us.”
- Virtual care for rural populations: “Patients are expecting healthcare to be dropped off at their doorstep” according to Nowak, and Sanford is particularly focused on providing a robust virtual care program given its massive geographic coverage and things like the tough Dakota winters, when care becomes even more difficult to reach. For Nowak, “it is very exciting to be able to focus on leveraging the digital initiatives so that we can actually start to focus on many of those gaps in the patient care continuum.” With a unified view of patient data, Sanford Health can improve care coordination between different facilities within their network. This approach not only creates smoother transitions of care but also improves access to quality care for rural populations.
The road ahead
Investing in data accuracy and strong data governance is no longer optional for health plans or provider organizations. As healthcare organizations continue to invest in digital health initiatives, robust identity management will play a critical role in ensuring accurate data, improved patient experiences, and better health outcomes. Not only is it central to operations today, it’s also critical as organizations prepare for the future. As health plans and health systems gear up for advancements in AI and machine learning, as well as for deeper personalization based on patient and member preferences, the importance of data fidelity and governance is escalating, mirroring trends in other industries.
Watch the webinar: Drive Digital Engagement and Improved Data Sharing with an Intelligent End-to-End Data Management Process
