Does our decision support system enable us to easily access and evaluate existing CAHPS data? For some plans, data is siloed and difficult to access. There is no real benefit in waiting for the latest release of the annual Consumer Assessment of Healthcare Providers & Systems survey results if your informatics team isn’t making good use of existing data. A best practice used by one of our highly CMS Star-rated clients is to enhance internal business user access to clinical quality data lakes by using advanced, real-time clinical data exchange tools.

Are we using quality reporting dashboards effectively? Insights resulting from analysis of critical quality measures can have a big impact on quality. Some leading health plans are providing earlier visibility to key provider and hospital quality metrics and trends by publishing easily deployable FHIR data-driven dashboards and analytics, enabling real-time intervention to proactively target quality metrics with their provider networks.

Do we have the right resources in-house? In almost every situation, health plans come to a “make vs. buy” crossroads point when evaluating the staffing resources required to implement a quality-focused clinical data integration strategy. According to Gartner^®, Inc., “payer IT, analytics and informatics organizations typically do not have the combination of science skills and clinical knowledge needed to normalize and derive meaning for blended clinical data sources. Solution partners offer this capability ”unicorn” as a service.”