Inside the Primary Care Information Blueprint: How Elation Helped Shape a New Data-Sharing Playbook

In value-based primary care, data can be either a catalyst or a constraint. Too often, it’s the latter: fragmented portals, missing attribution lists, delayed performance files, and no single source of truth for population health.

To change that, the American Academy of Family Physicians (AAFP) led the development of the Primary Care Information Blueprint, a practical guide to transforming raw data into the actionable information primary care teams need to succeed in value-based payment (VBP).

Elation Health was proud to sponsor this project alongside Centene and to contribute clinical and product expertise through Dr. Sara Pastoor, our Head of Primary Care Advancement and an advisory group member.

A Vision Grounded in the Realities of Primary Care

The Blueprint starts from a simple but powerful premise: primary care cannot deliver on value-based care if physicians are left to chase data across systems.

AAFP and its advisory group asked four grounding questions:

• What do successful value-based primary care teams do differently from fee-for-service-oriented practices?

• What information do those teams truly need?

• How do they use it?

• How hard is it to get, today?

From that work, AAFP identified essential data elements practices must have at their fingertips to manage populations, optimize visits, and manage performance under VBP contracts, including:

• Accurate, comprehensive patient lists and demographics

• Medical history and risk level

• Transitions of care alerts (admissions, discharges, transfers)

• Medication adherence data

• Cost and quality information to guide high-value referrals

• Contract-specific performance metrics

From Data to “Information in Action”

The Blueprint is not a technical spec or API standard. Instead, it’s a conversation starter and contract guide — a way for payers, practices, health IT vendors, and data intermediaries to agree on:

• What information will be shared

• How often

• In what form

• And who is responsible for what

Central to this vision is the role of health information exchanges (HIEs) and health data utilities (HDUs) as payer- and physician-agnostic data intermediaries. These entities aggregate clinical and non-clinical data, enforce governance, and deliver a comprehensive, person-centered record back into the primary care team’s system of record — often the EHR.

The goal is “information in action,” not just delivery of data. When done well, this enables:

• Proactive outreach to high-risk patients

• Real-time response to ED or hospital utilization

• Smarter referrals based on cost and quality

• More transparent, timely contract performance tracking

If you’re ready to put those Blueprint principles into practice — bidirectional data flows, person-centered records, and actionable information at the point of care — talk with the Elation team about how to activate the right connections, reporting, and workflows for your practice.