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A Modern Approach to Provider Data Management

Accurate provider data is critical for operational performance by healthcare providers to realize consumer satisfaction. Health payers are now facing stiff penalties for erroneous or out-of-date provider information – particularly when such information is published to plan members. A plan may be exposed to additional liability if a member claims erroneous data leads to incorrect plan or provider selection, or otherwise contributes to poor service or care.

This paper co-authored by Wipro and Reltio health care industry experts provides an overview of the challenges healthcare organizations face while managing provider data and recommends an approach to achieving Provider Master Data Management (MDM) that should be considered when establishing a sustainable provider data management process and platform.

Modern data management platforms leverage graph technology to help with discovering and presenting the provider’s relationships with other data entities such as healthcare organizations, plans, specialties, and patients and provides the foundation with reliable data and relationships that can be used for analytics or visualized in the form of various data-driven applications.