APCD Questions on Merging Claims and Clinical Data? FHC Answers.


This week FHC President and CEO John Freedman, MD, MBA gives his answers for how APCDs will merge claims with clinical data:

How will APCDs merge claims with clinical data?

FHC President and CEO John Freedman, MD, MBA, answers: “Many see the merger of clinical and claims data as the ultimate goal in health informatics. A combined database can assess both functional outcomes and costs of knee replacement surgery, or medication adherence by comparing clinical prescribing data with prescription claims data. We expect successful initiatives will feature:

  • Repository-type health information exchange (as opposed to a federated or distributed model)
  • Common master patient and master provider indexes across both clinical and claims data
  • Community commitment from stakeholders’ senior leadership
  • Experience from an initial data interchange pilot with robust local EHRs
  • Recognition of different timeframes for generating claims and summary clinical information
  • Project management and technical teams familiar with both claims and clinical data

“Challenging? Yes – but with enormous potential for driving towards the Triple Aim of improved experience of care, improved health, and lower cost of care.”

For more information, contact Dr. Freedman at john@freedmanhealthcare.com or 617.243.9509 x200.


Subscribe to our newsletter!
Boston Web Designer