Session ID: 
52

How an HIE and a Health Plan Innovated to Improve Medical Reconciliation

3:00pm - 4:00pm Tuesday, March 6
Las Vegas - Venetian Convention Center
Murano 3301

Description

Newly evolving HIE services are creating opportunities for health plans and providers to improve transitions in care, particularly for underserved populations. A next-generation HIE offering CCDs post-discharge from hospitals in a large metropolitan area collaborated with the leading Medicaid managed care plan to improve timely medication reconciliation. Patients facing the challenges of low health literacy and social determinants are more likely to fall through the cracks for transitions in care. Using risk stratification to target the most-needy members, high-quality data delivered by the HIE, and automated matching of the CCD data with other medication sources, the plan was able to identify patients needing immediate follow-up. Insights around HIE and health plan collaboration, data consistency and quality in a multi-hospital environment, medication matching, HIE design, and plan-provider communication offer lessons learned for this and similar use cases.

Learning Objectives: 

  • Recognize the new and evolving patterns in HIE development and opportunities for health plans and providers to use them to improve access to quality care
  • Evaluate the limitations of traditional medication reconciliation processes
  • Identify innovative data-driven opportunities for medication reconciliation monitoring and improvement
  • Assess challenges in using HIE data for critical healthcare processes, including medication reconciliation
  • Analyze collaborative opportunities for health plans, HIEs and providers for improving transitions in care

Speaker(s): 

Senior Vice President and Corporate Chief Medical Officer,
AmeriHealth Caritas Family of Companies
Executive Director,
HealthShare Exchange of Southeastern Pennsylvania
Continuing Education Credits: 
ABPM
1.00
ACHE
1.00
ACPE
1.00
CAHIMS
1.00
CME
1.00
CNE
1.00
CPHIMS
1.00

Audience: 

CIO, CTO
Nurse, CNO, CNIO
Physician, CMO, CMIO

Level: 

Intermediate

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