From Connectivity to Real Provider Usability: Enhanced Reconciliation for Healthcare Data

This research brief describes an approach to enhanced data curation (de-duplication and reconciliation) that will support the integration of any outside data sources and data classes into a patient’s chart. It meets the organization’s need for more satisfied, efficient clinical users by satisfying clinician’s need for complete information and simplified workflows.

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The Health Cloud: Key Infrastructure for Digital Transformation

This report is available to subscribers of the Chilmark Advisory Service via the client portal, or may be purchased separately by clicking below. To accompany the release of this report, author Alex Lennox-Miller hosted a live roundtable in June with Dr. Don Rucker, Julia Millard (Bright.MD) and Mike McSherry (Xealth), which can be viewed here.

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Virtual care plays an essential role in solving the problems of modern healthcare. The necessary remote appointments and home care of the COVID pandemic have driven use of virtual care to new heights, but its real promise goes far beyond these uses. When seen as part of a system of distributed healthcare, virtual care can play a vital role in the long-term care relationships that occupy most of the modern healthcare system.

This research report looks at the rapidly growing market opportunity, which at a CAGR of >20% is projected to reach in excess of $20 billion USD by 2027. The report segments growth in the four leading markets for VCM: commercial payers, self-insured employers, health systems, and independent ambulatory practices.

The work looks closely at a broad cross-section of vendors that are leading the VCM charge, ranging from incumbent EHR and population health vendors to best-of breed solution providers. The research also discusses the most significant trends in technology, reimbursement and regulation, and how those will impact adoption and implementation of these offerings over the coming years.

Each type of solution (EHR, PHM, Best of Breed) is evaluated based on how they address the needs of providers and patients. The report reviews the current state of the market, the maturity of solutions, and the strengths and weaknesses of each solution type. Each vendor profiled is evaluated on 17 metrics – twelve (12) for specific product functionality and five (5) for market execution.

This report also introduces the new Flagship Vendor category, which recognizes solutions that excel in each of the aggregated capability categories. For this report, those vendors are (Vendor – Category, presented alphabetically):

  • Amwell – Omnichannel Functionality
  • Innovaccer – Enrollment and Assignment
  • Epic – Reporting and Analytics
  • Neuroflow – Care Management
  • Teladoc – Patient Engagement

Vendors Profiled: Amwell, athenahealth, Bright.md, Caregility, Cerner, Doxy.me, Epic, Gyant, Health Catalyst, Innovaccer, NeuroFlow, NextGen, Persivia, Philips, Silvercloud, SymphonyRM, Teladoc/Livongo

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If this research interests you, consider joining our Chilmark Advisory Service. The CAS is our premium annual subscription that provides a steady feed of research on the most pertinent trends in the adoption and use of healthcare IT.

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This report is available to subscribers of the Chilmark Advisory Service or may be purchased separately by clicking below.

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Chilmark Research’s latest report, Integration Infrastructure: Building 21st Century Healthcare IT, captures a market transitioning to new approaches to development and integration, enabling greater usability of data across organizations and applications. Pressure has long been building towards streamlining the flow of data between provider, payer, and patient. Driven by both market and regulatory forces, the movement towards better data availability will increasingly rely on APIs and other services to provide this connectivity.

Data has long been a treasured commodity in the healthcare industry, and many enterprises are seeking faster, cheaper routes to utilization as the quantity and liquidity of data increases.

This research predicts the market for integration technology and services will amount to $2.09 billion by 2026, representing 14% CAGR across all healthcare sectors. However, non-traditional sectors, including Life Sciences, will grow far faster (3-4 times the rate in traditional buyers) and will amount to the largest single market for this technology by 2026. 

Data aggregation, until now mostly a precursor for analytics and reporting applications, is important for a more diverse set of applications and range of access requirements. Building the data stores behind APIs, creating cohort-level data on demand, and supporting analytics on-demand are examples of growing market needs that this report discusses.

The building of new price transparency tools for members and patients will be greatly aided by the products and services described in this report. Many providers and payers will use the data aggregation capabilities highlighted to harness new data, contributing to a better understanding of their pricing position compared to similar local organizations.

Quality of care, growth potential, and regulatory compliance all hang in the balance as the race to greater data liquidity continues. Purchase a license to this report today help you understand how each vendor differentiates and what to consider when planning your own development and integration strategy.

Vendors Profiled: Allscripts, Amazon Web Services (AWS), CareEvolution, Cerner, Epic, Google Cloud, Health Catalyst, InterSystems, Lyniate, Microsoft, NextGen, Orion Health, Philips, Redox

Cost of report: $6,000

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Check out some of our other research on data collection, management, and analytics:

Addressing Social Determinants of Health: IT Solutions to Engage Community Resources

This report is available to subscribers of the Chilmark Advisory Service or may be purchased separately by clicking below. To accompany the release of this report, co-author Jody Ranck hosted a webinar with end users on December 9 and will be hosting another webinar with leaders at some of these companies in February.

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Increasingly, providers and payers seek to address social determinants of health (SDoH) in their patient populations to lower utilization costs as value-based care becomes more prevalent. To do so, the providers and payers must engage with organizations capable of affecting changes in aspects of patients’ lives that traditionally existed outside of the scope of healthcare.

>80% adoption across providers by 2030

Predicted 10-Year SDoH Adoption Trajectory

This report evaluates these solutions, identifying the strengths and weaknesses of options in the market and predicting how the market will develop in the future. Research in this report is based on interviews with executive leadership teams of solutions vendors, executives from the major EHR companies, and extensive secondary research.

Key Takeaways

  • The steady march to value-based care (VBC) amplifies interest in solutions that contribute to utilization management strategies.
  • Providers that wish to address patients’ social needs can do so efficiently through referrals to community partners. This is made dramatically easier with community resource engagement solutions.
  • Integration with community partners remains the main barrier to implementation, given challenges with data governance. Legal and internal engagement issues also slow adoption.
  • The next two years will bring expansion of product capabilities with slow and steady growth in implementation as the market better defines standards for performance. Years three through 5 will see acclerated adoption and growth.
  • Within five years, a public option for insurance will dramatically increase the rate of solutions adoption, culminating in >80% adoption in provider locations by 2030.

Vendors discussed: aunt bertha, Cerner, Epic, HealthEC, Healthify, NowPow, Signify Health, Solera, Unite US, Xealth

Cost: $1750

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Revenue Integrity in Healthcare: Solutions Driving Payment Performance

This report is available to subscribers of the Chilmark Advisory Service or may be purchased separately by clicking below. To accompany the release of this report, lead author Alex Lennox-Miller hosted a webinar presenting and discussing the report’s key findings on September 3, 2020 watch now >

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Revenue cycle issues manifest in the claims process of submission, appeal, and remittance, but causes are found much earlier in clinical workflows. Rather than think of these as disparate issues, they should all be considered under a broader category of revenue integrity.

This latest report from Chilmark Research reveals a market in flux as new technologies are applied to old problems, increasingly complicated by contracts that include performance and reporting requirements.

These activities are essential for healthcare enterprises of all sizes, scopes, and specialties. They are needed whether the organization is primarily concerned with fee-for-service (FFS) reimbursement or value-based care (VBC).

The ongoing COVID-19 public health emergency has made the need for automation and reduced administrative costs even clearer. With appointment volumes dropping, provider organizations are faced with the need for reliable, accurate payments for their care activities more than ever. These solutions are equally valuable for traditional provider care and for modern virtual care solutions like telehealth.

The report reviews the current state of the market, the maturity of solutions, and the strengths and weaknesses of each solution type. While the current market is valued at more than $20 billion, projections within the report show growth should approach $35 billion in the next five years. The report shows which segments of this market can expect annual growth rates exceeding 10% and which will slow to under 2.5%.

Projected Market Growth for Revenue Integrity Solutions

Each type of solution (EHR, Platform, Best of Breed) is evaluated based on how they address the needs of provider enterprises. In addition to the categorical analyses, this report includes 13 profiles of major and promising vendors. Each profile includes an assessment of the vendors strengths and challenges, detailed descriptions and evaluations of the product capabilities and market execution, and rankings across 24 categories.

Vendors Profiled: 3M, Allscripts, athenahealth, Cerner, Change Healthcare, Epic, Hayes|MDAudit, Medicomp Systems, Optum, PatientMatters, RevSpring, Sift, and ZOLL.

Cost: $6,000

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Open APIs in Healthcare: The Future of Data Integration

This report is available to subscribers of the Chilmark Advisory Service or may be purchased separately by clicking below. To accompany the release of this report, lead author Brian Murphy hosted a webinar presenting and discussing the report’s key findings watch here.

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As healthcare enterprises look to bounce back from the impact of the current pandemic, the need for alternatives to prevailing industry practice becomes apparent. The necessity of newer functionality in development and integration is now more pressing than ever before.

The API Moment in Healthcare

Application programming interfaces (APIs) have become an essential part of technology and its evolution, and decades of implementation have improved data access and integration significantly. However, conventional approaches have proven cumbersome and slow in the response to the current health crisis.

Currently, there is a vast amount of data scattered across various healthcare communities. Post-COVID-19, synergizing value from these various data sources will be a critical element in clinical and financial renewal. The report describes a general model for understanding the different categories of information exchange products and services, identifies sources of health-related data are most likely to be API-accessible, how APIs are contributing to development and integration across healthcare, and estimates the much larger potential of widespread adoption.

Open API market won't be huge, but it will be significant and most of all highly relevant to the capabilities of other offerings

Forecast of IT Spend for Data-Oriented API Infrastructure

Additionally, the report includes detailed breakdowns of a key set of 20 influential vendors responsible for APIs that provide live healthcare data, usually for transactional purposes. Specifically, the focus is on the many uses of discrete data elements about single patients or members, as opposed to aggregated data about groups of patients or members. These breakdowns will be essential to building a greater understanding of the evolving, competitive market surrounding APIs and data integration.

Vendors Profiled: 1upHealth, 4Medica, Allscripts, Apple, athenahealth, Availity, Blue Button 2.0, Cerner, Change Healthcare, Datica, Epic, Human API, Meditech, NextGen, NCPDP, Particle Health, The Sequoia Project, Redox, Surescripts, and Validic

Cost: $6,000

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