This business process is similar to sharing a discharge summary for consumption by downstream systems. The "old" payer (possibly informed by the wishes of the patient) determines what data will be shared. This accomodates both the fact that not all data is relevant/appropriate to be shared (the old payer gets to decide) as well as that the "new" payer might not know what to query/look for to find the relevant data. Finally, additional context/narrative can be helpful in understanding the discrete data or summarizing the information in a way that greatly reduces the effort of consuming the data. As an example, consider having the ability to query all of the patient's vitals vs. receiving a narrative statement that said "the patient's blood pressure dropped precipitously on day 3 but was stabilized after the administration of X". The latter draws attention to the relevant bits that would require considerable time to extract from the raw data. (And in this payer situation, the raw data - in the form of actual claims/prior authorizations won't necessarily even be shareable.) In short, the document function with organized narrative is likely to always be needed in at least some cases, even if payers eventually develop the intelligence to generate it automatically based on their own data structures.