Using master data management for provider data

The third largest health system in the United States, Providence St. Joseph Health System struggled with an issue common among health systems: how to bring together disparate data and develop one source of truth for provider data.

“The two big issues relevant to providers were how do we manage data for current providers and how do we manage data across the organization for all of the different providers that span the many medical staff offices, payer enrollment, payer credentialing, etc.,” explains Brigitte R. Workman, BA, senior consultant, master data management for Providence St. Joseph. 

One common solution is for health systems to encourage all medical staff services and credentialing teams to switch to the same credentialing software. However, leaders from Providence St. Joseph realized that doing so would cost time and money, and it might not produce the breadth of results they wanted. According to Workman, having a source of truth that is based off of credentialing applications is short-sighted.

“It is short sighted in the sense that you are not able to capture all of the other data you might need to develop a true source of truth. You want to also include employment information, EHR data, and common reference values for providers. You also want to provide your organization with clear data about providers who participate in other types of programs such as additional networks, health plans, or providers who have certain roles that they participate in,” says Workman. “Those are things that are not commonly held in credentialing applications. They are things that if you ask a credentialing team to manage they will decline because it is more work on their plate.”

Instead, the health system used master data management (MDM) to provide its source of truth. Implementing MDM throughout the 7-state health system has connected the system’s 50-plus acute care hospitals 1,000-plus clinics, and 25,000-plus practitioners while eliminating the need for them to use the same credentialing software/applications, while providing clear data for other services like web directories, identity and access management services, and CRMs.

“It's alleviated the demands for reporting from the medical staff offices, payer enrollment teams, and more. Because the data is widely available to the organization via self-service platforms, systemwide projects can readily obtain values needed in a matter of seconds. Using Provider Master Data Artificial Intelligence can rapidly identify and serve up analytics previously inaccessible,” says Workman.

There are more than 200 data fields available to provide information about a practitioner. Some of the data fields include:

• Practice affiliations
• Languages spoken
• Ages seen
• Employment relationships
• Primary locations
• Participation in charity care
• For hospitalists: employed or contracted?
• For primary care physicians: employed or independent?

Source: News and Analysis