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Health equity and languages spoken

The Need for Linguistically-Appropriate Services On April 20, 2022, CMS released an action plan that establishes health equity as a ‘first pillar’ of its strategic vision under the Biden-Harris Administration. Included in its priorities are two actions that consider languages spoken: Promote culturally and linguistically appropriate services to ensure understandable and respectful care and services …

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The Importance of Health Plan Information and Identity

Defacto Health has been reviewing health insurers’ Provider Directory APIs in terms of availability, issues, and use cases for almost a year now. This post is a continuation, and we are focusing on the importance of health plan information within the APIs. While many exchanges between patients and providers about insurance stop short at “Do …

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Using Provider Directory APIs to assess provider network size

When CMS issued its requirement for payers to publish Provider Directory APIs, it contemplated use cases such as in-network provider search and health plan shopping. Consumers shopping for health plans want to check whether their preferred providers are in-network, but they are also likely interested in the robustness of the network. Carriers may lever up …

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Analysis of top 50 payers’ Provider Directory APIs

In our previous post, we reviewed aggregate statistics on payers publishing provider directory APIs in the first six months of enforcement of the CMS Final Rule. In this post, we will look in more detail at the top 50 payers and understand and compare their processes around API access, registration (if required), issue reporting, and …

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Payer Compliance: Provider Directory APIs in the first six months since CMS Final Rule enforcement

The CMS Final Rule on Interoperability and Patient Access requires payers to publish provider directory APIs and has been enforceable since July 1, 2021. CMS issued the rule to increase provider network transparency and to encourage third-party developers to leverage machine-readable provider network data from payers to develop new experiences around in-network provider search, health …

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What indoor healthcare wayfinding taught me about the governance of practice location data

With the convergence of payer and provider interoperability, there is growing interest in how data sourced directly from EHRs could support provider search and patient access use cases. Providers have for some time been working towards using EHRs (and adjacent credentialing systems) to support their own provider search tools. Recent partnerships (Epic/Mapquest and AllScripts/ZocDoc) demonstrate …

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Epic partners with Mapquest: EHR and location awareness

Last week, Epic announced it is partnering with Mapquest to ‘enable location services within its EHR system’. Three questions come to mind immediately: First, what in the world is Mapquest doing these days? Second, how is Epic thinking about incorporating location into its EHR workflows? Finally, does it mean that we can begin expecting EHRs …

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Prevalence of centralized appointment phone numbers in health plan provider directories

This is the first of a series of posts analyzing payer-published provider directory data sets mandated by the CMS Final Rule. Defacto Health is accumulating data from payers’ provider directory APIs to assist in in-network provider search and related use cases. The first question we are posing is “how prevalent are centralized appointment phone numbers?” …

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monk transcribing book

Still generating user guides the old-fashioned way? Try this instead

As a product manager you need to provide product documentation to your users and customers. There are many ways to do this, and choosing one can be hard. But user documentation forms part of the product experience and should be given due consideration. I recently needed to publish some documentation for a very early-stage product. …

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Hire healthcare data to do a job

Applying Job-to-be-done Theory to Healthcare Data I believe that when a customer purchases a product, they are “hiring” that product to do a job. I am influenced by Clayton Christensen’s job-to-be-done theory described in his classic book The Innovator’s Dilemma. In the book, he recounts a time when he worked with fast food chain McDonald’s …

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