Baylor Health Care System implemented IBM Initiate Provider software to create a centralized provider master file and address issues with inconsistent provider data across its facilities. The new system matches and links provider records from multiple sources to create a single, accurate view of each provider. This allows Baylor to uniquely identify providers enterprise-wide, streamline processes like credentialing, and ensure compliance. It has also improved data quality, increased efficiencies, and enhanced patient and provider experiences.

1. Case Study
IBM Software Group, Information Management Healthcare
Baylor Health Care System creates a composite view of provider data
with IBM®
Initiate®
Provider to streamline processes, ensure
compliance and reduce costs.
The demand for provider registries is increasing as health systems
strive to improve the accuracy of provider identification and linking of
provider records to offer better patient care, increase provider
satisfaction and reduce costs. Provider registries enable comprehensive
provider data to be made available to all clinical and administrative
systems within an organization. This sharing of data allows healthcare
organizations to streamline administrative processes, reduce manual
entry, automate provider communications and collaboration, and ensure
regulatory compliance.
Baylor Health Care System is at the forefront of delivering complete
provider data enterprise wide to its 12 hospital facilities. Recognized as
one of the nation’s Top 20 integrated health care networks1
, in 2010
Baylor recorded more than 2.6 million patient encounters, $3.8 billion
in operating revenue and $513.5 million in community benefit. Now,
with the help of IBM Initiate Provider software, Baylor has created a
single source of truth for its provider information. By centralizing
provider information from multiple data sources, each with tens of
thousands of member records, Baylor has been able to streamline and
automate provider data management, increase quality of care, improve
data accuracy and reduce costs.
“We were centralizing our IT operations and implementing enterprise-
wide systems, and needed to be able to consistently identify providers
across the organization,” said Diane Ries, Manager of Interface Services
at Baylor. “By creating a centralized database of provider information
we can accurately match up provider information from different data
sources and reduce duplicate identities.”
To improve the accuracy and completeness of its provider data, Baylor
implemented IBM Initiate Provider, which integrates with existing
systems and data sources to match and link different representations of
provider data and create a master view. The master provider index
enables Baylor to assign a single identifier for each provider for use
throughout its network.
Mastering Provider Data for
Enterprise-wide Advantage
Business Benefits
The Need
Baylor Health Care System determined
that it needed a better way to accurately
define providers and manage provider
data and privileges across facilities.
The Solution
Baylor created a provider master file
using IBM Initiate Provider to match and
link provider data from multiple locations
within and outside of the organization
to ensure accuracy and automate
processes.
What Makes it Smarter
A single identifier can be used across the
organization. Providers log in using the
same ID at all facilities, and provider data
can be managed and governed
consistently from a single location.
The Result
“The single source of provider truth that
we have created with IBM has enabled
us to increase provider and patient
satisfaction while improving care and
reducing costs.”
—Dave Kozusko, Project Leader for EMPI
and Provider Master File, Baylor Health
Care System
1 According to SDI, a leading health care market insight and analytics firm and the nation’s
premier rating system.

2. 2
Case Study
IBM Software Group, Information Management Healthcare
Consolidating Provider Identification to Reduce Costs,
Improve Accuracy
Some facilities within Baylor Health Care System were acquired and
others were built from the ground up. At one point each facility had its
own health information system, which stored provider data in its own
unique way. Identifying a provider across multiple systems within the
enterprise was difficult, as providers who practiced in all facilities could
have 12 different identifiers. In addition, provider credential numbers
were different at all facilities, which made it difficult to ensure that the
enterprise-wide credentialing system was up to date in each
downstream application.
“We wanted to transition to an enterprise-wide system that
consolidated all identifiers and provider information into one system to
create a composite view, and standardize practices for how providers are
managed across the entire Baylor network,” Ries said. “With IBM
Initiate Provider, we can more accurately define providers, centralize
demographic and credentialing information, and distribute that
information out to other systems from one location.”
Enabling providers to log in at every facility using a single identifier not
only increases efficiencies by simplifying and streamlining processes,
but also helps to protect patient privacy and improve evaluation and
treatment processes. A single provider identifier reduces duplication of
provider identities, which ensures that only authorized providers can
access patient data. In addition, quality of care is enhanced as patient
test results are automatically faxed to physicians, and will be emailed in
the future.
Ensuring Compliance with Regulatory Requirements
Baylor is required to comply with audits that ensure its provider
credentialing is up to date. “Ensuring we are in compliance and can
easily meet regulatory and audit requirements was one factor in our
decision to centralize provider information,” said Ries. “IBM Initiate
Provider helps Baylor comply with these complex requirements.”
Individual facilities are responsible for credentialing providers for their
location and uploading the information to Baylor’s enterprise-wide
credentialing system, which made it difficult to ensure that data was
always up to date across the organization.
“IBM Initiate Provider enables us to tie the credentialing system, our
in-house identity system and information from the Texas Medical
Board together, which results in more accurate provider records,” said
Dave Kozusko, Project Leader for EMPI and Provider Master File at
Baylor. “This helps us ensure that compliance and renewals are current
for each facility and for the entire organization.”
“With IBM Initiate
Provider,we can more
accurately define
providers,centralize
demographic and
credentialing information,
and distribute that
information out to other
systems from one location.”
— Diane Ries, Manager of Interface Services,
Baylor Health Care System

3. 3
Case Study
IBM Software Group, Information Management Healthcare
Legislation requires all referring physicians to be licensed in Texas
resulting in significant procedural changes for Baylor. A team is now
responsible for ensuring that each referring physician is licensed in
Texas, confirming that the data is included within the provider master
file, or manually entering licensing information if required. Once
licensing information is added, downstream systems are automatically
updated.
In some ways, the legislation makes processes less complex since Baylor
only needs to verify that a physician is certified with one licensing
organization, instead of the global requirements that it had when IBM
Initiate Provider was originally selected. Previously, Baylor was
attempting to verify physician licensing in other states and countries,
which is something it still may need to do in the future to manage
providers outside of Texas for special cases, such as transplants.
Streamlining Processes to Increase Efficiencies and
Patient Satisfaction
The data within provider records in Baylor’s provider master file is
more accurate than before, which streamlines processes, reduces
manual entry and costs, and results in better data quality overall.
The IBM Initiate Provider solution provides Baylor with the following
benefits:
• Automatic updates of downstream systems with the latest provider
information helps ensure that data in clinical and billing systems is
reliable.
• Validation of provider data is easier for staff members as it is now
contained within a single source system.
• Provider records are more accurate and data management is more
efficient as a result of data being managed in one location.
• Time and costs of billing insurance companies and patients are reduced
because missing information required for billing purposes is
automatically populated.
In addition, the amount of time required to register patients for
treatment is reduced. “When a patient presents an order from a
referring physician, there is a greater likelihood that the provider is
already in our system, which eliminates the need for the administrative
staff to make phone calls to physician offices and other departments to
set up the provider,” Kozusko said. “This results in faster registration
processes and more satisfied patients.”
Future Plans for Better Referral Tracking to
Business Benefits
• Establish a centralized repository of
provider data to help meet
organizational goals to create
enterprise-wide IT systems.
• Enable providers to reduce their login
information, from up to 12 separate
logins to a single identifier for
increased satisfaction.
• Deliver test results to physicians
automatically to improve care.
• Ensure that credentialing information is
available to all facilities from a central
location to ensure compliance and
prompt renewals.
• Automate downstream system
updates of provider information to
increase data accuracy and improve
care.
• Provide a centralized framework to
track referring physicians to improve
future marketing efforts.

4. 4
Case Study
IBM Software Group, Information Management Healthcare
Improve Marketing
The first step in Baylor’s deployment of IBM Initiate Provider was to
populate the centralized database with correct and comprehensive
provider data. “The challenge in this phase was getting everybody to
trust that the provider master file we created had the best data, so that
they would use it and integrate their systems with it,” Ries continued. “I
think we have achieved that now and people trust that the IBM Initiate
Provider system is delivering the best provider data enterprise wide.”
In the second phase the implementation team has been focused on
distributing provider data to as many downstream systems as possible,
which takes some time with a healthcare system of Baylor’s size. Within
the next couple of years, the team hopes to have all of its major systems
communicating with the provider master file.
Baylor has also begun to link patient and provider data together based
on patient encounters. A future goal is to utilize the relationship
manager capabilities of IBM Initiate to understand the links between
patient and providers. Once these capabilities are implemented, Baylor
will be able to visualize the relationships from more than 2.6 million
annual patient encounters to create a complete picture of each patient’s
care teams.
“IBM Initiate Provider will enable us to deliver complete, accurate
information and statistics about who is referring patients into Baylor
facilities,” Kozusko continued.
In addition, other areas of the organization will most likely benefit from
more comprehensive provider reports and statistical information to
improve operational, financial and clinical processes.
Why Baylor Chose IBM Initiate Provider
After completing a competitive evaluation and assessment, Baylor
determined that IBM Initiate Provider was the best technology to meet
its requirements. The decision was based on the software’s ability to
accurately link complex records together from multiple internal and
external data sources, and create a composite view.
Ries also noted that the ease of migrating was one of the reasons Baylor
chose IBM Initiate Provider. “We had already deployed IBM Initiate
Patient as our enterprise master patient index,” said Ries. “The team
was familiar with how the system worked and liked the fact that much
of the administration and maintenance can be done in-house without
incurring the expense of external services.” Baylor also saw a significant
advantage in the fact that IBM Initiate Provider would work well with
its existing enterprise master patient index (EMPI) technology, that it
could be deployed using the same database, and that it would be easy to
eventually tie patient and provider records together to identify
relationships.
“IBM Initiate Provider
will enable us to deliver
complete,accurate
information and statistics
about who is referring
patients into Baylor
facilities.”
— Dave Kozusko, Project Leader for EMPI and
Provider Master File, Baylor Health Care System

5. © Copyright IBM Corporation 2011
IBM Global Services
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Produced in the United States of America
September 2011
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About IBM Initiate Provider
IBM Initiate Provider enables healthcare organizations to create a
single trusted view of care providers and provider organizations to
improve data quality and access for targeted and consistent
information delivery. The solution establishes a master provider
index by linking provider records across disparate systems and
incorporating third party data from marketing, insurance and
licensing sources. In tandem with IBM Initiate Patient, IBM Initiate
Provider offers the ability to visualize and leverage data relationships
between patients and providers.
About IBM Information Management solutions
for healthcare
The journey to sustainable healthcare systems starts with a smarter
approach to information sharing. IBM Information Management
solutions for healthcare deliver master data management (MDM)
capabilities that help stakeholders to connect and share clinical
information accurately, securely and cost-effectively. IBM Initiate
Patient and IBM Initiate Provider are a trusted foundation for
information sharing around the globe; they help healthcare
organizations improve collaboration to increase quality of care,
streamline compliance and increase patient and provider satisfaction.
For more information
Contact your IBM sales representative or IBM Business Partner, or
visit us at: www-01.ibm.com/software/data/infosphere/provider/