RHIOs--build in healthcare fraud management from the beginning.
This article presents the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology's field-based research on the use of Health Information Technology to Advance and Expand Healthcare Anti-Fraud Activities.' The authors of this article directed and performed this research under contract to the Foundation of Research and Education of AHIMA. There is a tremendous potential to reduce healthcare fraud and achieve substantial financial benefits using a nationwide health information network with interoperable electronic health records. To achieve these benefits, there must be interoperability among providers and between providers and payers. The article will provide recommendations for regional health information organizations to incorporate healthcare fraud management in their early designs.
Hanson
Susan P
SP
TerraStar Consulting, Nashua, NH, USA.
Cassidy
Bonnie S
BS
D003195:Computer Communication Networks / Q000592:standards*; D005607:Fraud / Q000517:prevention & control*; D017408:Guidelines as Topic; D006302:Health Services Research; D006801:Humans; D008498:Medical Record Linkage / Q000592:standards*; D016347:Medical Records Systems, Computerized / Q000592:standards*; D012040:Regional Health Planning / Q000458:organization & administration*; D012308:Risk Management; D018511:Systems Integration; D014481:United States