User Guide — Risk Contract API

To display risk contract information in the patient chart, you must have permissions to view patient information in athenaClinicals and access to athenahealth APIs.

If your organization would like to use the risk contract API, please contact your Customer Success Manager by sending an email to athenaCare@athenahealth.com.

You can use the risk contract application program interface (API) to display risk contract information in athenaClinicals. The risk contract information is clearly visible during all stages of the clinical workflow — Scheduling, Intake, Exam, when working on documents, and in the patient chart. This information alerts clinicians that the patient is attributed to a payer risk contract and that additional care management resources may be available to the patient.

If your organization has software development resources, such as an IT staff member, you can use the risk contract API to enter a patient's risk contract information and display the following information in the patient chart:

• Name of the risk contract in the patient banner
• Description of the risk contract (optional) in patient demographics (that is, when you expand the patient banner)

Important: The optional risk contract API is recommended only for organizations that have software development resources.

Using the risk contract API, you can create a risk-related label that meets your organization's quality goals and initiatives (the label must be risk related). Examples of risk-related labels include: RISK CONTRACT, ATTRIBUTED, MEDICARE ACO, and NEXTGEN ACO.

For more information, see "API endpoints."

Although a graphical user interface is available for testing purposes, we strongly recommend that only individuals with software development knowledge (those who are familiar with working with code and API endpoints) use the risk contract API. Payers may send risk attribution files to your organization, and each payer may use a different file format and include or organize content in that file slightly differently.

IT expertise helps to ensure that your organization can:

• Convert risk attribution data to a format that the API accepts
• Associate risk contracts with specific patients
• Update information as risk contract status changes

1. Go to the athenahealth API Developer Portal.
2. Register for a Developer Portal Account.
3. Use the Global Sandbox Environment to test the risk contract.

Using the risk contract API, you can create and update risk contracts and associate risk contracts with specific patients. For a full list of the API endpoints available, please review the documentation on the API Developer Portal.

Following are some guidelines about two of these endpoints:

API to store risk contract information

 

Use the API to store risk contract information to set up and update the risk contract names and descriptions that appear in the clinical workflow. Guidelines for this API are as follows:

• Risk contract name is not required — If no risk contract name is entered, athenaOne does not display a risk contract name in the patient banner.
• Risk contract name must be unique — Two risk contracts cannot have the same name. If you attempt to create a risk contract with the same name as an existing risk contract, the new contract overwrites data in the original entry.
• Description is optional — If no description is entered for a risk contract, athenaOne does not display any risk contract-related information in patient demographics.
• Space limitations determine how much information appears — athenaOne displays 20 characters in the patient banner and 500 characters in patient demographics.

API to store patient-risk contract associations

 

Use the API to store patient-risk contract associations to:

• Establish and update which patients are associated with which risk contracts.
• Define patient populations for other risk-related initiatives.

When you associate a risk contract with a patient, you can specify whether athenaOne should display risk contract information for that patient in only one department and one chart sharing group, or for all departments and all chart sharing groups.