Notable ambulatory EHR vendor Greenway and health insurance plan Florida Blue have started bi-directional exchange of patient information including health plan summaries that can help providers detect and address gaps in care, an important component of the patient-centered medicine becoming popular as providers switch to accountable care payment models.
The exchange is made possible by Availity, an HIE project started in 2001 by Florida Blue and Humana. Through the system, Greenway customers will be able to see up to two years of patient care history as a continuity of care document (CCD) readable within their EHR. In exchange, Florida Blue will be able to access a CCD of provider services, enabling them to collect information on care quality in order to make more informed decisions about pay-for-performance measures.
“As payment reform models evolve, whether they’re accountable care organizations or other risk-based models, there’s a demand for new information types,” said Availity CEO Russ Thomas in an interview with InformationWeek. “This is increasingly important to plans as they work to more effectively manage the cost of care.” Care summaries have been available on Availity’s web portal for several years, but few providers were accessing the documents, either because they didn’t know about it, didn’t want to bother with an external system, or had no real incentive to examine the data. With the increase in accountable care models and a focus on holistic patient care and preventative medicine, providers acting as a patient’s medical home may gain financial benefits from having a more complete view of the many facets of a patient’s healthcare activities.
Other major vendors, including athenahealth, Allscripts, GE Centricity, and eClinicalWorks are also integrated with Availity’s exchange capabilities, raising the possibility that more vendors and more health plans will begin working together to make it easier for providers to access a full spectrum of patient information. The CCD can automatically populate into the EHR’s patient history section, letting providers review the data with no extra work on their part. Eventually, providers will also be able to attach documents to insurance claims, further streamlining the payment process.