Streamlining the EHR Provider Directory: A Data Analyst's Journey

Maintaining a comprehensive and accurate provider directory is a critical task for any healthcare organization. However, as many data analysts and software engineers know, this process can feel like a boss battle with an ever-changing spreadsheet. Provider data changes constantly, with about a quarter of providers changing organizations or locations annually and many others updating their contact information. For a hospital with a 50,000-entry directory, that’s roughly 12,500 updates a year, or 34 every day. Keeping up with this volume of change can be a significant challenge. It's like trying to debug a live production system—you fix one thing, and three more issues pop up.

Without automated solutions, managing a provider directory can become a demanding, manual process that requires dedicated staff. Some healthcare systems may have multiple full-time analysts dedicated solely to this task. Let’s take a closer look at the typical stages involved in this process.

The Typical Provider Directory Workflow

Stage 1: Data Ingestion and Formatting

The initial step involves bringing data in from various sources—sometimes 30 to 40 files a month—and formatting it to be compatible with a system's importer, such as Epic's. External data sources often don't match the required format, so analysts must manually adjust each file to fit a specific CSV template. This can also involve translating external specialty codes into the system's unique code system. It's like mapping chess pieces to a deck of playing cards, and the chess pieces keep changing.

Once the files are ready, the system runs a "Compare Process," which starts with an error check. The system is designed to be very precise, and a single formatting error, like a missing digit in a zip code, can cause an entire file to be rejected. This requires analysts to manually correct each error before the file can be successfully imported. At this point, you'll probably find yourself questioning if you're a data analyst or a digital detective.

Stage 2: Managing Provider Records

After the error check, the Compare Process identifies potential matches for new data with existing provider records in the database. The system then outputs a CSV file of these matches for manual review. Analysts must carefully review each entry and decide whether to merge, replace, add, or reject the new data. This step is crucial for preventing duplicate entries and ensuring data integrity. It's similar to a code review, but instead of fixing logic, you're trying to avoid duplicate entries and insufficient data from corrupting the system.

Any new provider without an existing record is placed in a secondary database for unvalidated data. While this data can be searched, it cannot be used for communication until it has been verified and validated. This leads to the next step in the process.

Stage 3: The Verification Process

When a user attempts to use an unverified provider, the system may suspend the communication and, in Epic’s case, create an Unverified Provider Maintenance (UPM) record, alerting the IT team. For an average hospital, this can happen 20–40 times a day. An analyst must then download these UPM records, manually add any missing information, such as qualifications and license numbers, and upload the file back into the system. This process can feel like you're playing a real-life version of "Whack-a-Mole," but the moles are insufficient data, and the hammer is your sanity.

A similar manual process occurs when a provider isn't in the directory at all. With the Epic Provider on the Fly process, a user can research a provider’s information, fill out a form, and submit it to IT, which can take several minutes of a clinician’s time. These requests are then downloaded as another UPM file, and the entire manual verification process is repeated.

The result of this manual workflow can be a team stretched thin, delayed communications, and a directory that is not as accurate as it could be.

A More Efficient Path Forward

Fortunately, there are ways to streamline this process. Solutions like careMESH's "Fully Managed Directory Service" can help by providing a single, comprehensive data source for providers nationwide that is already formatted and error-checked. This can eliminate the need for analysts to juggle dozens of files and manually fix errors. These services can also manage the Compare and UPM processes, saving valuable time.

Automating these routine tasks can allow system analysts to focus on more strategic and innovative projects. It can also lead to a more accurate and complete directory, which benefits both clinicians and the entire health system. A more precise directory enables smoother care coordination with outside providers, improving efficiency and communication. As our friends at Tampa General Hospital note, “happy providers vote’ with more referrals.” 

Ultimately, this leads to a better experience for everyone - providers, analysts, and most importantly, patients.