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GRIPA: Next-Generation EMPI for Healthier, Happier Community

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Challenge

GRIPA provides member physicians with care management services and with information on their practices’ performance against the Healthcare Effectiveness Data and Information Set (HEDIS) quality care measures. The organization is pursuing four key goals with data and analytics:

  • Identify and close gaps in care
  • Reduce avoidable admissions
  • Lower medication costs
  • Help high-risk patients

“We needed to take a cloud-first approach to our data management architecture, so we could lower our total cost of ownership and rapidly onboard many more data sources,” Vice President of Information Technology explained.


The organization struggled with the heavy resourcing required for a legacy on-premise EMPI. This highly customized, legacy EMPI was expensive to update and maintain, requiring many a la carte customizations. One of GRIPA’s employees worked full-time to resolve patient data issues, tackling 4,000 tasks a month. GRIPA was ready for a cloud-native solution that would be easier to govern and scale, helping the organization to advance quality care and population health.

 

Solution


“I view vendor relationships as a partnership,
and we absolutely have that with Verato.”
Vice President of Information, GRIPA

GRIPA selected Verato as their next-generation, cloud-based EMPI to replace NextGate’s on-premise EMPI. “It took only 36 days to implement Verato. There was a high level of integrity and collaboration between our teams.” Working together, the GRIPA and Verato teams identified where and how existing data quality could be improved. “We found significant issues with the logic in our legacy Master Patient Index and with data quality. Verato completely corrected these issues and has empowered us to pursue new analytics initiatives,” Vice President of Information, GRIPA

Results

Speed to Value

The implementation was fast—and it also quickly delivered value. “Verato’s technology worked across a million records to find and fix identity issues— including duplicate records—for 30,000 people. This meant we immediately achieved a 6 percent improvement in patient matching.”

More Accurate Data

It’s no longer necessary for an employee to work full-time on patient identity resolution issues, and there are even more important, long-term benefits. Accurate, actionable data supports GRIPA’s commitment to high-quality care and better health outcomes. In just a few months, GRIPA has seen a decrease in laboratory and imaging costs due to more appropriate utilization, as well as improved patient compliance with preventive care guidelines.“ Just one duplicate record can negatively impact quality-based accreditation. For example, breast cancer screening is an important HEDIS measure. With accurate, consistent data, our members avoid including and contacting a double-mastectomy patient for a measure that’s no longer appropriate.”

“Verato is an important reason why we’ve been able to confidently refine our quality initiatives. We’re providing our members with clear, timely information that improves people’s lives.” Vice President of Information, GRIPA