The discussion with Palmetto indicated that only fully processed claims data were populating the PHR. Given that claims had to be submitted by providers and then complete claims processing, there was a certain level of unpredictability regarding when information would be available in MyPHRSC. Patients may have encountered a lag between a healthcare encounter and when the information became available in the PHR.
While HealthTrio had prior experience with importing claims data into PHRs, discussions with Palmetto and HealthTrio revealed that they met several times to identify and coordinate the claims fields that would be used to populate the PHR with the appropriate data. Based on these discussions, Palmetto developed and implemented a specific extract program to create the necessary format required to populate data into HealthTrio’s existing PHR product.
Once a beneficiary signed up for MyPHRSC, HealthTrio notified Palmetto. Within 48 hours of a beneficiary signing up, Palmetto made available 24 months of Medicare claims data for each beneficiary and populated each MyPHRSC account.
Palmetto and HealthTrio reported that no claims data was altered. Therefore, any inconsistency or inaccuracy of the information displayed in the PHR was a function of incorrect/inaccurate information being submitted on the original claim. Additionally, HealthTrio indicated that, in order to make medical terms more understandable to users, they convert International Classification of Diseases, 9th Revision (ICD-9) codes and Current Procedural Terminology (CPT) codes to Systematized Nomenclature of Medicine (SNOMED) terms.