Registry adds value to regional data exchange

By Patty Enrado
07:58 AM

CareSpark, a nonprofit regional health information organization (RHIO) serving Northeast Tennessee and Southwest Virginia, is proving the value of health information exchanges through several projects that rely on its provider registry.

As a participant in the Social Security Administration (SSA) pilot project, CareSpark receives patient authorization requests from SSA and forwards the necessary provider records to SSA through secure messaging. This electronic process reduces the turnaround time for disability determination from weeks to hours, according to Pat Pope, provider relations coordinator for CareSpark. As a result, both patients and healthcare providers get paid more quickly. "We're taking the doctor's office out of the process," Pope said.

SSA does not require a provider registry to complete the transaction, but CareSpark created one, with the help of Initiate Systems, to further automate the process. The RHIO is leveraging its provider registry for other purposes as well.

This year, CareSpark began work on a three-phase immunization project for the Commonwealth of Virginia and the state of Tennessee. The project's goal is to reduce duplication of immunizations. One in five children has had duplicative immunizations by the age of six, Pope said. The first phase involves loading available records so physicians retrieve basic immunization data on their patients. Thus far, 500,000 records from Virginia have been loaded.

In Phase 2, data within CareSpark and Virginia's registry are checked and any updates are made to Tennessee's immunization registry. In Phase 3, when physicians immunize their young patients the data is automatically updated in the Tennessee registry, Pope said.

At the request of the Centers for Medicare & Medicaid Services, CareSpark is participating in CMS' Physician Quality Reporting Initiative (PQRI) using its provider registry for two-way communication. The RHIO can submit quality reporting directly to CMS and provide statistical reports, as well as updates, targets and goals, back to the physicians throughout the year. Pope pointed out that CMS could work with all HIEs to give and get provider data for its PQRI. "These projects have potential for growth in the community," she said. "We are the bus to get them (CMS) there."