Unify clinical and claims data with FHIR®-powered EHR connectivity.
Benefits
Health plans need clinical data to run their most critical programs, but reliably pulling it from providers’ EHRs is harder than it should be. Manual chart chasing, infrequent data pulls, and fragmented sources leave plans working with an incomplete picture.
1up Clinical Connect automates clinical data acquisition directly from providers’ EHRs, unifying USCDI-standard clinical data with claims into a single longitudinal member record. Unlike chart-chase vendors working retrospectively, one member at a time, 1up Clinical Connect runs continuously in the background, surfacing insights your teams would otherwise never see.
Surface completed care from EHR data that claims miss, improving numerator capture.
Support more accurate HCC coding and stronger RADV defensibility with provider-documented diagnoses.
Help care teams catch utilization issues earlier with a complete clinical picture.
Act on clinical signals, like lab trends and care gaps, to prioritize outreach before issues escalate.
Eliminate manual chart requests with FHIR-based data retrieval integrated into providers' existing EHR workflows.
As CMS and NCQA move toward full-population, FHIR-based digital measurement, health plans must rethink how clinical data is acquired, validated, and activated across the enterprise. Watch the recording to see what this shift means for quality, risk, and care management.
FEATURES
Automate clinical data acquisition from provider EHRs and turn it into insights your teams can act on.
LOWER DATA ACQUISITION COSTS
EHR Connectivity
EHR Connectivity
Connect to provider EHRs using FHIR APIs to securely retrieve USCDI-standard clinical data at scale.
SIMPLE POPULATION SETUP
Roster Management
Roster Management
Define patient populations using uploaded rosters or claims-based generation.
DEEPER MEMBER INSIGHTS
Longitudinal Member Record
Longitudinal Member Record
Combine clinical and claims data into a complete view of each member.
COMPLETE MEMBER VISIBILITY
Member Directory
Member Directory
View and manage members with easy access to data and roster updates.
FASTER DATA ACTIVATION
Flexible Data Export
Flexible Data Export
Deliver normalized, FHIR or non-FHIR data to existing systems, analytics tools, and data warehouses.
FULL DATA VISIBILITY
Ingestion Reporting
Ingestion Reporting
Track incoming data in real time, including source, status, and newly retrieved records.
STRONG DATA GOVERNANCE
Role-Based Access Control
Role-Based Access Control
Manage access to data and functionality based on user roles.
An automated, always-on pipeline that turns EHR data into a unified member record.
Upload a roster or generate one from claims data to identify which members' clinical data to retrieve.
1up connects to provider EHR systems, including Epic and athenahealth, via secure FHIR API connections to retrieve clinical data.
Members are matched to their provider patient records to ensure accurate, reliable data retrieval.
USCDI-standard clinical data, including observations, encounters, conditions, clinical notes, and procedures, is retrieved from the EHR.
Retrieved clinical data is validated, tagged with its source, and combined with existing claims data into a longitudinal member record.
Unified data is delivered in normalized, FHIR or non-FHIR formats to your existing systems, activating richer member insights across the organization.
The benefit of combining claims with clinical data adds up fast, and as HEDIS goes fully digital by 2030, that depth of data becomes a requirement, not just an edge.
1up Clinical Connect currently connects to Epic and athenahealth via secure FHIR APIs, with additional EHR integrations on the way. Reach out to the 1up team to discuss your specific EHR needs.
1up Clinical Connect retrieves structured USCDI-standard data elements, including labs, conditions, clinical notes, procedures, and medications, directly through certified EHR APIs. This gives health plans a broader, more consistent view across a full population rather than the narrower, manually pulled records typical of traditional chart retrieval.
It’s passive by design. Once a connection is configured, 1up Clinical Connect automatically pulls clinical data on a recurring schedule (for example, daily or weekly) without requiring any ongoing action from the provider. Providers can see what data was shared and when, but they don’t have to manage or initiate the process themselves.
There’s no limit on 1up’s side to how far back a data request can go. In practice, the lookback window depends on what each provider’s EHR supports and how long the member has been enrolled with the health plan.
Members are matched to their corresponding provider patient records before any clinical data is retrieved, ensuring that the data entered into the longitudinal member record is tied to the correct individual and reliably linked to existing claims data.
No. 1up manages the EHR connections, data retrieval, validation, and source tagging automatically, with full visibility into ingestion status through the 1up Console.
Stop chasing charts. Start acting on a complete member picture. Automate clinical data acquisition from provider EHRs with 1up Clinical Connect.
