UCHealth Adds Claims Data To Population Health Dataset

Posted on April 24, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A Colorado-based health system is implementing a new big data strategy which incorporates not only data from clinics, hospitals and pharmacies, but also a broad base of payer claim data.

UCHealth, which is based in Aurora, includes a network of seven hospitals and more than 100 clinics, caring collectively for more than 1.2 million unique patients in 2016. Its facilities include the University of Colorado Hospital, the principal teaching hospital for the University of Colorado School of Medicine.

Leaders at UCHealth are working to improve their population health efforts by integrating data from seven state insurers, including Anthem Blue Cross and Blue Shield, Cigna, Colorado Access, Colorado Choice Health Plans, Colorado Medicaid, Rocky Mountain Health Plans and United Healthcare.

The health system already has an Epic EMR in place across the system which, as readers might expect, offers a comprehensive view of all patient treatment taking place at the system’s clinics and hospitals.

That being said, the Epic database suffers from the same limitations as any other locally-based EMR. As UCHealth notes, its existing EMR data doesn’t track whether a patient changes insurers, ages into Medicare, changes doctors or moves out of the region.

To close the gaps in its EMR data, UCHealth is using technology from software vendor Stratus, which offers a healthcare data intelligence application. According to the vendor, UCHealth will use Stratus technology to support its accountable care organizations as well as its provider clinical integration strategy.

While health system execs expect to benefit from integrating payer claims data, the effort doesn’t satisfy every item on their wish list. One major challenge they’re facing is that while Epic data is available to all the instant it’s added, the payer data is not. In fact, it can take as much as 90 days before the payer data is available to UCHealth.

That being said, UCHealth’s leaders expect to be able to do a great deal with the new dataset. For example, by using Stratus, physicians may be able to figure out why a patient is visiting emergency departments more than might be expected.

Rather than guessing, the physicians will be able to request the diagnoses associated with those visits. If the doctor concludes that their conditions can be treated in one of the system’s primary care clinics, he or she can reach out to these patients and explain how clinic-based care can keep them in better health.

And of course, the health system will conduct other increasingly standard population health efforts, including spotting health trends across their community and better understanding each patient’s medical needs.

Over the next several months, 36 of UCHealth’s primary care clinics will begin using the Stratus tool. While the system hasn’t announced a formal pilot test of how Stratus works out in a production setting, rolling this technology out to just 36 doctors is clearly a modest start. But if it works, look for other health systems to scoop up claims data too!