Regions
MAIN/REGIONS
regions/
Regions
  1. Americas
  2. Asia & Oceania
  3. Europe
  4. Middle East & Africa
  1. Solutions
  2. Insights
  3. Events
  4. Contact Us
MAIN/search
MAIN/Solutions
Solutions/
SOLUTIONS
  • Life Sciences Solutions
  • Healthcare Solutions
  • Medical Device and Diagnostic
  • U.S. Government
Life Sciences Solutions

Bringing together unparalleled healthcare data, advanced analytics, innovative technologies, and healthcare expertise to create intelligent connections that speed the development and commercialization of innovative medicines to improve patient lives.

Learn More
Life Sciences Solutions
Healthcare Solutions

Accelerate digital innovation to enable smarter decisions that reduce cost, modernize patient and consumer engagement, and improve health outcomes.

Learn More
Healthcare Solutions
Medical Device and Diagnostic Solutions

Your world is unique – and quite different from pharma. In the U.S., decision-making has shifted from individual physicians to integrated networks--GPOs, IDNs and payers. These groups have heightened the focus on proving your solution’s value, demanding outcomes analyses and putting pressure on pricing.

Learn More
Medical Device and Diagnostic Solutions
U.S. Government Solutions

For government agencies and organizations at every level—from federal or national to regional and local—Big Data can have a huge impact on public health.

Learn More
U.S. Government Solutions
MAIN/Insights
Insights/
U.S. PROGRESS POINT

A curation of IQVIA's best thinking on topics and trends driving change, disruption, and progress in the United States healthcare market.

LEARN MORE
U.S. BLOGS

Get the latest insights on our life sciences, healthcare, and medical technology solutions in the United States. Follow our blog today!

LEARN MORE

U.S. INSIGHTS LIBRARY

"Browse our library of insights and thought leadership.

LEARN MORE
MAIN/Events
Events/
ON-DEMAND WEBINARS

Visit our library of on-demand webinars.

LEARN MORE
UPCOMING EVENTS & WEBINARS

View our upcoming events and webinars.

LEARN MORE

FEATURED WEBINAR

"Top Issues for Pharma to Watch in 2022 and 2023

WATCH NOW
MAIN/Contact Us
Contact Us/
Blog
Payers: It's time to get ready for Interoperability with TEFCA
Steven Schneiderman, Practice Leader, IQVIA Healthcare Solutions
May 20, 2020

As we begin the journey to recovery from the pandemic, we understand that the after-effects of COVID-19 will be with us for a long time.  Not only do we want to address the needs of the recovering COVID-19 patients, but also the effects of resource restrictions on urgent non-COVID-19 conditions, the impact of interrupted care on chronic conditions, and the long-term mental health impacts of the pandemic.

While there is a need to reassess the priorities set at the beginning of the year, the pandemic and its after-effects underscore the need to accelerate the exchange of Electronic Health Information (EHI) and move toward interoperability with the new Trusted Exchange Framework and Common Agreement (TEFCA). 

Payers are large, complex organizations that process thousands of transactions daily across multiple systems. These systems often have their own data schema and unique record keys. Simply look at the practitioner records maintained in a single payer system and it’s easy to understand the challenges involved in keeping this data clean and accurate. Integrating this same set of data to other systems within the walls of the payer organization adds another layer of complexity.

Is it any wonder why the Centers for Medicare & Medicaid Services (CMS) routinely identify high rates of inaccuracy when conducting audits on provider directories at payer organizations? It’s time to assess and address data quality, not just for provider data, but across the payer enterprise. 

The Office of the Coordinator for Health Information Technology’s (ONC) 21st Century Cures Act, finalized in March 2020 and published in May, requires payers to make their provider directory available through the mandated standards-based Patient Access Open application programming interface (API), as defined in Health Level Seven International’s (HL7) Fast Healthcare Interoperability Resources (FHIR) API standards by January 1, 2021. Shortly thereafter, payers need to exchange Electronic Health Information (EHI), as well as accept incoming EHI, as directed by the members. Preparing for this exchange is no small task and requires an evaluation of all stored EHI data, how it is maintained and accessed today to determine what needs to evolve to handle these transactions tomorrow.

The good news is there is still time to develop a plan to address these upcoming regulatory changes. The first step is understanding your data; how it is formatted, where it is stored, and the quality of the data. 

IQVIA has helped payers with data quality and integration for years. Our expert team can assess your readiness for the upcoming changes. If you are not familiar with the Cures Act and Interoperability, I suggest you take a look at this white paper Cures Act: Getting Ready for the Implementation of TEFCA and Healthcare Interoperability Standards.

Ready to speak with a solutions expert to help your organization prepare for the Cures Act? Let’s talk! 

Contact Us