Payer-Provider Data Integration Not Without Pitfalls

Christopher Cheney, July 2, 2014

Combining payers' claims data with providers' clinical data is an essential element of revolutionizing the delivery of healthcare. But there will be unintended and unfavorable consequences, says one data expert.

I gaze quickly at the watchcorder on my wrist. It's 4:05, my pulse rate is 74 beats per min and the blood sugar monitor is flashing at 81… I missed lunch, again.

I have a long drive home and it's always good to get ahead of the traffic coming out of Boston. It's Jan. 20, 2020, and tomorrow will be my sixth work anniversary at HealthLeaders. On the spur of the moment, I decide to pop into a nearby smoky bar to celebrate.

My belly has barely touched the lacquered mahogany expanse separating me and the bartenders at Phil's when the watchcorder lights up like a Christmas tree. The no smoking light. The no drinking light. The provider, payer, and employer wireless notification lights.

I'm in my 50s and my doctors have advised me to put my bad health habits behind me, especially smoky bars. My watchcorder's GPS, and its array of sensors embedded within the device and inside my collar have betrayed me.

I can count on a finger-wagging at my next primary care doctor appointment, an email from my insurance carrier announcing a $10 surcharge on my healthcare policy, and a letter from HealthLeaders' EAP urging me to seek smoking cessation and alcohol abuse counseling.

Christopher Cheney

Christopher Cheney is the senior finance editor at HealthLeaders Media.


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