Analyst Report

How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability


This Gartner research defines CDI processes and provides strategy and sourcing guidance to payer executives to achieve effective CDI at scale. Gartner®, who delivers actionable and objective insights to executives and their teams, recently published – How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability – Health Chain highlights our key takeaways and recommendations:

Effectively incorporating usable clinical data across Payer enterprise functions accelerates CDI
Payers being able to quickly demonstrate the value providers can recognize as a result of sharing more clinical data with the health plan is a must. In order to quickly and effectively demonstrate value to their providers, Payers must have the right infrastructure in place to support a robust data processing ecosystem that ensures data is high quality, reliable and consumable across enterprise functions. Without effective data cleansing, normalization and standardization supporting agility across the Payer enterprise, the time to value for providers is not fast enough to warrant more robust access to clinical data for the health plan.

The CDI value chain is complicated but optimizable.
Payers often face challenges in the clinical data integration process due to legacy systems and processes creating data siloes, requiring custom ETL and data curation processes, and ultimately inhibiting the health plan’s ability to unlock the value this clinical data holds. With the right technology in place, Payers can standardize their approach to clinical data integration, curation and normalization – accelerating any efforts aimed at integrating this clinical data with other types of member data to enable various health plan functions to play a more proactive role with providers and drive better member outcomes.

Download the Report to unlock the full potential of Clinical Data Integration (CDI). We feel Gartner® helps outline a comprehensive approach that guides organizations through the entire CDI process, from data acquisition to application for impactful use cases including risk adjustment, utilization management, care coordination, quality improvement and other advanced analytics.

View the Report

    By submitting this form, I agree that Health Chain may process my data as described in the Health Chain Privacy Policy.

    The Clinical Data Integration Value Chain

    Gartners clinical data integration

    Disclaimers and attributions:
    GARTNER® is a registered trademark and service mark of Gartner®, Inc. and/or its affiliates in the U.S. and internationally and is used herein with permission. All rights reserved.

    Gartner®, How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability, Healthcare and Life Sciences Research Team, Published 30th April 2024