master data management

Data governance and integration for the next generation of healthcare.
Gaine helps healthcare providers and payers navigate the journey to value-based healthcare.

  

 

Healthcare Data Management

Overview

At the heart of healthcare reform is the shift from a fee-for-service (FFS) reimbursement system to one based on value. Most value-based payment contracts are based on a shared savings model which aligns healthcare providers (HCPs) and insurers (Payers) to deliver high quality care at the lowest cost.

HCPs and payers start from widely divergent places as they move to value-based contracts, but neither of these groups has the data and systems required to navigate this journey.

Gaine works with both HCPs and payers to integrate and govern the data necessary for the new paradigm of value-based healthcare.

 

For Healthcare Providers

Improve interoperability of all applications by linking silos of disparate patient, provider, and facility data through a central Master Data hub. The MDX Master Data Management platform creates a virtual integration of data between systems and reduces integration time, costs, and risks.

Patient Registry

  • MDX generates a unique key for each patient irrespective of the Electronic Health Record (EHR) software or Health Exchange (HIX) platform.
  • MDX provides the most advanced matching technology, which eliminates duplicate patient records.
  • Personally Identifiable Information (PII) is separated from clinical data improving security and HIPPA compliance.
  • The patient registry can be accessed via secure web services connection in real time from any application.

Manage Provider Networks

  • MDX captures and builds relationships between clinical and non-clinical practitioners, healthcare facilities, and provider organizations for a complete picture of the care delivery network.
  • Standardize specialties, credentials, and services between systems for improved visibility into the capabilities of the care network.
  • Link providers to external data sources, web portals, and online ratings to ensure that your network is accurately represented online.

Manage Population Data

  • MDX creates a rich model for each individual within the population, which extends beyond typical patient records or health insurance membership information.
  • The MDX population model improves risk assessment and enhances service delivery design.
  • Support any population health management (PHM) analytic platform with enhanced population intelligence.

Care Coordination

  • MDX supports care coordination with geocoding of the provider network, all practice locations, and member home and work addresses.
  • Eliminate fragmentation and duplication of care to optimize the types of care delivered in each location by standardizing specialties, credentials, and services between providers and facilities.
  • MDX captures all contact details for all individuals including social, messaging, email, and phone.
  • Manage population demographics over time with the inclusion of the National Change of Address and Death Registry.

Medical Device GUDID Support

  • Support for FDA Global Unique Device Identification Database (GUDID).
  • MDX matches any device to the FDA UDI database, GS1, or Health Industry Business Communication Council (HIBCC) databases using fuzzy logic matching techniques.
  • MDX enables providers to obtain GUDID codes for all existing devices quickly and reliably.

Data Governance

  • Manage HIPPA and data security in a single location.
  • Apply data quality standards and manage data policies in a central location.
  • Engage with business users through easy to use workflows when data quality problems are identified.

 

For Healthcare Payers

Member Enrollment Support

  • Centrally manage member data to resolve data inconsistencies and harmonize these changes to all connected systems.
  • Identify duplicate members within and across enrollment periods.
  • Validate member details with online sources (including social sites).
  • Link members across plans and enrollment periods for improved longitudinal analysis.
  • Secure Personally Identifiable Information (PII) and reduce the risk of data security breach by adopting the MDX identifier token when transmitting member data.

Provider Master

  • Centrally manage provider data to resolve any inconsistencies and harmonize these changes to all connected systems.
  • Create relationships and affiliations between providers and facilities from claims data.
  • Eliminate 1099 tax reporting issues by tracking inconsistencies in billing practices for each supplier throughout the year.
  • MDX obtains and manages all identifiers for a provider including DEA, NPI, State license, TIN, and Medicare and Medicaid IDs.
  • Validate provider data against state registries, CMS, and third party data providers such as SK&A, AMA, HMS, and others.

Member Demographics

  • Support a more in-depth analysis of individual member risk through a richer profile of each member.
  • Extend the member profile to include web data sources, social sites, consumer data, and other socio-economic indicators arising from personal and professional data.
  • MDX builds relationships and affiliations between individual members for household analysis.
  • Geographically link members to provider locations to support care coordination efforts.

Data Migration from Legacy Systems

  • Transform data from legacy systems into modern core administration applications.
  • Improve data quality by eliminating duplicates and standardizing values.
  • Preserve historic data without the need to convert multiple years of history from legacy systems. 
  • Synchronize changes to master data between systems during periods of coexistence.
  • Maintain core master data such as providers and members in a central location and synchronize changes to all operational and analytic systems.
  • Create data quality rules and metrics that can be applied post migration to maintain high levels of data quality.

 

 

information agility healthcare

 

Resources

Data plays a key role in the Harvard Business Review roadmap to value based care.

Read more >

 
How U.S. providers and payers are working together to reduce the cost of care.
 
Actuarial risk models will require more extensive member data.
 
Universal Device Identifier overview.