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Access To CMS Medicare Beneficiary Data Enables DocGraph and CareSet Systems to Bring Insight to Healthcare Delivery Approaches

The outline of a person's head is filled with gears and ones and zeros are in the background.

It might not be obvious at first, but if you look at yourself closely, you’ll find that you are more than skin, and bones, and blood. If you look closely, you’ll find that in fact you are made up of an infinite number of ones and zeros, that you are a moving, breathing, living being composed of millions of bits of data.

Your life—in many ways—can be reduced, in simple terms, to data. Not convinced? When you fill out a form in the waiting room of the doctor’s office—that’s data. When you stand on a scale, get your blood pressure taken, have blood drawn—that’s data. When you sport wearable devices that track your steps, the hours you sleep, and the calories you eat (or hope not to eat)—that’s data. When doctors talk to one another, refer patients to each other’s offices, or collaborate on a patient case—guess what, that’s all data too.

Your life—in many ways—can be reduced, in simple terms, to data.

Now entrepreneurs and new companies are starting to see a pathway for taking this abundance of data and creating a valuable knowledge base through careful analyses, ultimately providing insight into better healthcare delivery approaches.

DocGraph and CareSet Systems, two such entrepreneurial efforts that work in tandem to create, maintain, and improve open healthcare datasets, are announcing on Monday, May 9 the release and analysis of a new dataset. According to DocGraph, the Medicare Referring Provider Utilization for Procedures (MrPUP) dataset details the healthcare procedures that Medicare providers referred in the outpatient setting in 2014, and is particularly useful in understanding how specific doctors use blood tests, CT scans, and MRIs to diagnose patients. The company developed MrPuP by using the Virtual Research Data Center (VRDC), an initiative that provides its members access to Medicare and Medicaid data that’s collected by the Centers for Medicare and Medicaid (CMS).

What MrPuP provides and addresses is an enhanced patient understanding of whether the tests, procedures, and referrals they are receiving are necessary and appropriate for their health conditions. This is a key example of how government data—dissected, analyzed, and interpreted in the right way by a non-government entity—can be useful in helping patients understand if the norms of their health care provider practices are comparable to the best levels of care. Or, if maybe, they fall short.

This is key example of how government data—dissected, analyzed, and interpreted in the right way by a non-government entity—can be useful in helping patients understand if the norms of their health care provider practices are comparable to the best levels of care.

This CMS data-access program allows DocGraph and CareSet Systems to specialize in this data subset and to provide the necessary tools to bring additional transparency to the healthcare market. The companies are working to enhance the value of medicare beneficiary data through their innovations in:

  • Identifying how datasets are linked together;
  • Determining how to work with data inside a data center like VRDC; and
  • Applying new technologies and methods for data analytics.

Out of the innovations and collaborations that have shaped the ways in which government and entrepreneurs can now work with the big data of health care—your doctor’s office form, your vital signs, your doctor’s referrals—have grown the insights to help us better shape and better design the new technologies and the new approaches to health care delivery programs that are based on improvements in quality and efficiency, obtained through the ones and zeros of our data.

Want to learn more about how data can contribute to improvements in health and advancements in our healthcare delivery systems? Visit healthdatapalooza.org, and join us May 8 - 11 for the health data event of the year.