Expanding the value of MDM—The Clinical Perspective

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Health MDM programs can deliver high value to many areas in a provider, life science, or payer organization. Recently Thea Campbell from Cedars Sinai Medical Center in Los Angeles and I shared at a conference the financial, clinical, and operational values that can be achieved as a MDM program matures, or strategic direction of an organization evolves. Here are a few highlights:

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Patient data domain -Establishing the identity of a patient is foundational to creating the clinical record that documents and supports current as well as future care.  Additionally, the record may also serve as the foundation for billing and patient access. Governance and stewardship of the patient level data begins when mastering the patient data domain.

Provider data domain – While healthcare provider organizations usually begin MDM deployment with the patient domain, the provider domain is increasing in scope, complexity, priority, and importance. Delivering the right information to the right provider location or system requires that the MDM deployment masters provider data based upon individual, organization, and location. Providers may practice at different locations with different systems on varying days, thus accurate delivery of the information to the “right” provider and system is essential to care delivery and timely reimbursement. Data exchange within an organization or to non-affiliated providers needs robust, multi-faceted provider MDM that is not delivered by the EHR.

Multi-source record linkage – Creating a single view of a patient or provider across systems (EMR, clinical, patient accounting) is essential to care delivery, care coordination, and patient safety. Having the complete record available for care delivery is foundational to providers making informed clinical decisions, as opposed to partial information that may create redundant, expensive testing, incorrect decisions, or patient safety challenges.

Meaningful Use (MU) – If you are a provider in the United States and qualify for the Meaningful Use program, many of the measurements require that unique patients be counted in the numerator and the denominator. Over-counting patients due to duplicate medical record numbers could mean the MU participant is not eligible for the MU incentive compensation, thus losing tens of thousands of dollars per year.

Clinical research cohort selection – The latest value the IBM customers are realizing is the “tradition” MDM deployment’s single view of the patient is “thinned” to a limited data set, and associated with structured and unstructured data to define cohorts for research. Probability and similarity algorithms, as well as natural language processing, are integral to this new program, along with self-service queries. We’re excited about the value this new approach brings to defining cohorts for research and analytics, or for quality improvement studies.

The stakeholder roles have expanded significantly in the past few years as a result of broader use of MDM, including roles in marketing, compliance, and risk, and titles such as the Chief Technology Officer, Chief Information Security Officer, and Chief Medical Officer. The business collaboration as evidenced by the new roles and expanded value means patients, provider, and the industry as a whole benefit from more accurate, complete information to support high quality, cost effective care.

My thanks to Thea for speaking with me, and I hope you will contact me to gain more insight about the potential benefits your organization could gain from an IBM MDM program.

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