Payer Benefits

• Benefits:Identify successful practices for applying CDS to address specific improvement imperatives of particular interest that are being used by payer network providers
• Support widespread and effective implementation of these practices across provider network.
• Leverage CDS 5 Rights framework and CDS/QI Resources to identify ways to disseminate payer-supplied patient data and clinical knowledge to providers and patients in a more efficient and effective manner to improve outcomes
• Collaborate more effectively with provider network to coordinate payer-based and provider-based CDS activities
• Leverage multi-stakeholder nature of Collaborative to achieve broad consensus on CDS standards and related infrastructure needed across the industry, and help drive these changes where appropriate

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Collaborative-enabled Activities to Realize Benefits:

• Create a payer-focused sub-community that uses tools such as the CDS/QI Worksheets and discussion forum to enable provider network sites to share target-focused CDS configurations and implementation strategies of particular relevance to the payer's interests and activities
  • Infrastructure for this sub-community could leverage the broader Collaborative’s website and discussion group (e.g., creating ‘closed’ versions of each exclusively for the payer and its network) and/or use the payer’s own collaboration and sharing infrastructure
• Encourage network providers to join the Collaborative and complete the CDS/QI Worksheets for clinical targets of shared interest
• Widely disseminate successful CDS/PI strategies across the network, e.g., via Collaborative or other channels such as online forums, teleconference and face-to-face meetings
• Work with Collaborative provider, HIT vendor, federal agency and other participants to identify shared impediments to accelerating CDS/PI activities (e.g., lack of needed CDS-related interoperability standards) and develop strategies (e.g., speaking with a common voice to standard development organizations) about approaches to addressing them.