Data Management for Health Equity

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Data Management for Health Equity

The State of Colorado continuously seeks innovative approaches to accurately identify members between our programs and to better understand and support interventions to address health disparities. In support of the 2021 Colorado Health IT Roadmap, led by OeHI and steered by the eHealth Commission, the state established a statewide initiative to improve this process and enhance technology where appropriate. These improvements will result in better access to care, lower cost of care, and improved quality of care for all Coloradoans.

Identity Cross Reference Service (IDXR)

As health and human service providers have become more interconnected, so too have the IT systems that support those providers. Many of these systems were initially designed to address specific problems and were not intended to interoperate with one another. This resulted in patients/clients having individual profiles in each system without a means to connect those profiles between the systems. Identity resolution is the process of using information provided by an individual to identify them uniquely and accurately across multiple systems.

IDXR supports the:

  • Interoperability and scalability between systems
  • Identification of data quality issues
  • Creation of a Master Data Management (MDM) solution

Data Management for Health Equity Projects at OeHI

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Cross Reference Lookup

The process of cross-reference look up establishes a unique digital identity of individual members across State healthcare systems and Colorado’s health information exchanges(HIE), Colorado’s HIEs supply new patient demographic data as part of the identity resolution process offering the ability for care coordinators and primary care medical providers to develop personalized care plans. 

Standardized data collection with safeguards for privacy and confidentiality is critically important in the effort to understand and eliminate racial and ethnic disparities in health care.


Diagram of how the cross reference look up can inspect multiple names and identify a unique digital identifier for one individual

 

 

Demographic Enrichment

Enhancing a patient’s base identity with demographic data enhances the capacity of the Colorado health programs to bring together multiple data sources at the point of care to illuminate health disparities.  

Having data on member race and ethnicity will allow health professionals to better disentangle factors that are associated with  health care disparities. Further, collecting and analyzing patterns of health care by member race, ethnicity, and other demographic data can help the Department to monitor the quality of care provided by its provider networks. Such monitoring  can help to ensure accountability to enrolled members, improve member choice, and allow for evaluation of intervention programs, all with the ultimate goal of improving health equity.

Vaccinations and COVID 

The Colorado Department of Health Care Policy and Financing(HCPF) regularly requests Immunization records from the Colorado Department of Public Health and Environment(CDPHE). CDPHE stores immunization data that has been reported in the Colorado Immunization Information System(CIIS) production system. The Colorado Electronic Disease Reporting System(CEDRS) contains data pertaining to diseases reported, diagnosis made and course of action for treating the disease. Enrichment of data elements in CDPHE CIIS patient records improve the accuracy of Health Equity for Vaccine status reporting and enabling coordinated outreach to their unvaccinated population to encourage them to become vaccinated.

 

Importance of Data Management 

The healthcare industry is making significant progress towards technical interoperability but continues to struggle with accomplishing ubiquitous interoperable health data sharing. The inability to consistently and accurately match patient data across the numerous systems involved in the healthcare process creates a number of problems for providers, payers, and additional third party care partners. A mismatched record occurs when a patient’s record is linked with a record belonging to a different patient, or an additional record is created for an already established patient, resulting in two separate medical records for the same patient. As a result, providers may have an incomplete view of a patient’s medical history, care may not be well coordinated with other providers treating the patient, patient records may be overlaid, unnecessary testing or improper treatment may be ordered, and patient confidence may be eroded. In addition, patient privacy preferences may not be honored across organizations without accurate matching.

With insufficient matching practices, providers may experience a number of clinical workflow inefficiencies that are costly. Those include prolonged troubleshooting to find the correct patient record, a reversion to manual telephone and fax information exchange workflows, ordering duplicate tests, and failure to detect and honor patient privacy preferences.

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Relevant Materials

(1) A Patient Identity Management Case Study by The Sequoia Project and Blue Cross Blue Shield, demonstrating the benefits and difficulties of addressing uniquely identifying patients from the healthcare payer perspective: https://drive.google.com/file/d/1DiSbXg3s_RY6sGw8qehWHizc7SCN4wui/view


(2) The Sequoia Project Framework for Cross-Organizational Patient Identity Management, which is the foundational model we are leveraging in the Identity Resolution work for the State Master Patient Index: https://drive.google.com/file/d/1gyQ9GLo4gpc9l1_bPTWhvlS326op5gta/view

Get Engaged

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If you're interested in getting engaged, please reach out to our Ask OeHI email address at gov_ask_oehi@state.co.us.