Case Study: Large Academic Healthcare Organization


A large Academic Healthcare Organization consisted of a semi autonomous Faculty Plan and a network of owned and affiliated hospitals liked to a large prestigious Medical School in a densely populated urban area.  Providers in the Faculty Plan saw patients independently but also made referrals to the hospitals in the network


The Faculty Plan physicians dealt with a number of patients and referring providers over a large geographical area and had opted in the past for a dedicated clinical system that provided a database for capturing referring providers for communications and billing.  The hospitals in the system elected to centralize their disparate systems with a different clinical and administrative vendor based on technical performance and perceived economics.  As a result there were a large number of referring providers in the Faculty Plan that did not exist in the hospital based systems. Conversely because of the existence of large turnovers in the resident programs and incomplete admitting information in stressful urban settings, hospital provider files were inaccurate.

FolioMed Problem Solving

FolioMed initially licensed its reference databases for a tri state region that was made available to both the Faculty Plan and the Hospital based system.  Later both the Faculty Plan and Hospital provider databases were uploaded to FolioMed and FolioMed constructed Master Index Files that incorporated both sets of identifiers in the separate files and matched to FolioMed’s own national and proprietary identifiers. Because of the size of the files (over 1 million records) it was determined that the hospital system would submit weekly change files to FolioMed.  FolioMed would then process these theses against its reference databases to identify variances, new records and records with incomplete information.  At the same time FolioMed captures its own independent change records for the period. A combined change file is then uploaded to the Faculty Plan and Hospital system in their own file structures.  Records received will then be appended to the separate systems and new distinct Provider identifiers added. .


The FolioMed solution resolved the disparities between the two systems and allowed an ongoing maintenance of both Provider databases.  As a result the disputes between the Faculty Plan and Hospital about correct and consistent information were dramatically reduced, accurate clinical communications increased and administrative and other costs reduced.