Term: CORE


CORE is an acronym for the Committee on Operating Rules for Information Exchange.
It is a subgroup of the Council for Affordable Quality Healthcare (CAQH).


The CAQH is an association of healthcare industry entities and policy makers with the common intent of promoting initiatives that will simplify and streamline healthcare administration. Their goal is to create systems that allow for higher quality interactions between health plans, care providers, and other concerned parties by encouraging information exchange and data integration.

It has been recognized by the industry that an interoperable healthcare system can benefit all and the creation of CORE represents a response to this challenge.
Benefits from CORE recommendations include but are not limited to:
1. Reduced medical errors by having access to information instantly at the point of care
2. Allowing physicians and patients to make better-informed decisions about treatment options.
3. Reduced costs and frustrations incurred by current administrative practices and procedures.

There are obstacles facing CORE that prevent them from completely solving this problem. First, there is the resistance to using new technologies. Data security and inconsistencies are also problematic. Finally, data transactions and interactions between entities need to be seamless and are not currently so.

To solve this CORE has set standards for connectivity and data exchange and created operating rules modeled after the banking industry’s ATM system. These rules and standards make it possible for providers to immediately determine whether or not a patient has health coverage and at what level including copay and deductible amounts.
As of March 2007 the CORE guidelines have been adopted by dozens of health plans, clearinghouses and vendors affecting nearly 70 million Americans.

NoMoreClipboard.com (NMC) is an online Personal Health Record (PHR) management system created in 2005 to consolidate medical information in one secure location for easy retrieval. It is the first PHR to be certified by CORE an as of June 2007 is the only PHR that can interoperate and render patient information correctly with each and every participating healthplan’s and provider’s specific forms.

Organizations that are adopting CORE guidelines are said to be helping to define the future of electronic communication between health plans and providers. And the guidelines are hailed as central to realizing our national goals for better healthcare quality and efficiency.

Web Resources:

To read a complete list of organizations that have committed to CORE standards go to www.caqh.org and click on the CORE link. From the expanded menu select "Participating Organizations."

Visit http://www.caqh.org/CORE_operat_rules.php for more information about CORE.


Related Terminology:



PDF File: http://www.himss.org/content/files/CORE_Presentation20060418.pdf

Health organizations commit to CORE rules. (Committee on Operating Rules for Information Exchange)
Health Management Technology. Nov 2006 v27 i11 p8(1).
Retrieved from database using WebFeat – Health & Wellness Resource Center - Thompson-Gale Database

NoMoreClipboard.com is First PHR to Receive CAQH CORE Certification.
Business Wire. June 7, 2007 pNA.
Retrieved from database using WebFeat – Health & Wellness Resource Center - Thompson-Gale Database