CAQH lays out gradual changes to efficiency, flexibility and standardization of provider data

Electronic Data Capture
CAQH says once industry leaders endorse its roadmap for improving provider data, "the process will proceed under its own momentum."

The Council for Affordable Quality Healthcare (CAQH) wants to redesign the way data flows through the healthcare ecosystem to lessen the burden on providers and improve the accuracy of medical data.

To do that, the organization’s Provider Data Action Alliance laid out a roadmap that begins with an endorsement from industry leaders and advocates for a gradual overhaul of data systems and standards.

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The draft (PDF), "An Industry Roadmap for Provider Data," was released by CAQH last week and boils existing challenges associated with provider data down to four basic concerns:

  • A lack of authoritative data sources and reliable aggregators
  • Varying data requirements and standards make it difficult to align data across various platforms
  • A complex ecosystem of downstream consumers that makes updating or correcting data demanding
  • Insufficient engagement from the provider community to “holistically” address data concerns

To address those shortcomings, CAQH proposed establishing a nonprofit coalition of stakeholders to develop “fundamental” data elements and transactions and a standardized format. CAQH also advocated for a centralized database that can effectively disseminate provider data.

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The staged approach would include the formation of a governing body to oversee ongoing efforts and serve as a middleman between regulators, providers and consumers during the development of standards. But, CAQH said a critical first step will be getting buy-in from industry stakeholders to endorse the roadmap.

“Once several leading organizations across the industry have made a public commitment to the process of creating industry alignment on provider data issues, a tipping point will be reached and the process will proceed under its own momentum,” the Alliance wrote.

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