10:45 a.m. -11:45 a.m.

Aligning Clinical and Claims Data to Improve Outcomes and Quality

Electronic Health Records have made a significant impact on how clinicians take care of their patients. Being able to see a patients' health history allows the clinicians to have a more holistic view of care. However, EHR data is not necessarily combined with a patients' claim data, making the water murky as clinicians have no idea what claims their patient has already made as they come in to receive care. While EHR data primarily focuses on recording patient care, and claims data focuses on the billing of health services, combining these two records has shown to improve overall quality measurement.

Key topics:

  • The different layers of EHR and claims data

  • How complicated is combining these two forms of data? Is it worth it?

  • What are the benefits of combining EHR and claims data? Are there drawbacks?

  • Could the combination of data help address social determinants of health or prevent the onset of chronic conditions?

Tony Farah, MD

Executive Vice President, Chief Medical and Clinical Transformation Officer

Highmark Health

Neil Gomes

Executive Vice President for Technology Innovation and Consumer Experience

Thomas Jefferson University

Justin Hammerling

Associate Vice President

ProMedica Innovations