AHIP, the American Medical Association (AMA), and the National Association of ACOs (NAACOS) have combined forces to develop data-sharing best practices that organizations may voluntarily adopt to support the growth of value-based care.
Over the past several months, the partners convened an advisory workgroup of members from each association, established a managing committee of association leaders, directed a literature review and environmental scan, and conducted interviews with subject matter experts.
During a July 25 webinar, Danielle Lloyd, senior vice president of AHIP, highlighted several issues and themes that can influence the willingness of participants to share data and that can influence their readiness to ingest and act on the data.
One issue involves data privacy. “As we share more data across more types of organizations, we have to be really vigilant around the potential impacts on security as well as patient privacy,” Lloyd said. Second, she said, a lack of mature data standards can be a barrier across various use cases of the data. Also, variability in the data infrastructure can be a challenge This means that the capabilities to share can vary by region. (Some regions have access to robust health information exchanges and some don't.) Another issue is around participant readiness. Bothplans and providers have different levels of experience and capabilities.
While recognizing different entities have inherently varying needs and uses for data, the workgroup identified five key areas of opportunity:
- Create an Interoperable Data Ecosystem: Adopt consistent content and exchange standards to simplify and expand data sharing.
- Share More Complete, Comprehensive Data: Empower value-based care participants with complete, accurate, and consistent data that paints a more comprehensive picture of a patient or population.
- Improve Data Collection and Use to Advance Health Equity: Collect and share data to identify and address health disparities as well as barriers to care beyond the clinical setting, while ensuring transparency, appropriate use, and confidentiality.
- Share Timely, Relevant, and Actionable Data: Prioritize sharing focused insights and data early, often, and in accessible ways to improve care.
- Make Data Methodologies, Calculations, and Context Readily and Easily Available: Share detailed information on how and what data were derived from to foster trust among value-based care participants in the data they receive, use, and by which performance is measured.
“To be successful in these models, you have to be speaking the same language, and the systems have to be able to interface, whether it's physicians or hospitals or health insurance providers,” Lloyd said. “We have to be able to ingest and understand that information. How do we make sure that we're using standardized data elements and standardized data sets? There's also a need for use of exchange standards. How do you get the information from one place to another? To give an example of some issues, aggregating data across different electronic health records and electronic medical records within an ACO can be difficult. In the report, we include references and resources to various standards and operating rules that we think are helpful for different organizations.”
In terms of sharing timely, relevant and actionable data, Aisha Pittman, senior vice president of NAACOS, said we have to present information in a way that can be leveraged to help make decisions. Data that is going to support clinical decision-making needs to be available at the point of care, she said. “Some of the things to consider within having timely, relevant and actionable data is the formats in which the data are shared,” she said. “One of the best practices is to be nimble and meet the varying needs of participants and accept varying formats and use varying formats. We know some value-based care entities would like to receive raw data because they have the in-house capabilities to process and analyze that data, while others want to have more of a focus on having dashboards available to them and not wanting to have to process that data.”
The playbook marks the beginning of an ongoing partnership among the three organizations to explore how to sustain momentum for and grow broad-based participation in value-based care arrangements. The first phase of this effort focused on data sharing as a fundamental building block of value-based care operations.
“It is our hope that this unprecedented cross-industry effort can translate into tangible industry-leading practices informed by real-world experiences that our nation's healthcare leaders can directly apply to build our own success with VBC and payment arrangements,” said Carol Vargo, vice president of practice sustainability at the AMA. “Importantly, these best practices are applicable to a broad audience with a wide range of experience with VBC, including those already offering or active in arrangements and those who are seeking to participate in the future.”