Improving provider-payer interoperability to drive meaningful collaboration

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The interoperability of healthcare data has been an issue ever since the first EHR was installed. The problems are particularly acute in the provider-payer exchange of patient records, which are still mired in excessive and unnecessary cost, complexity, deficient quality, delays and methods that can compromise privacy.

Improving this process and driving down costs requires combining technical interoperability with accuracy, precision, and control — enabling high-quality, actionable data to reach the right hands at the right time, while enabling the provider to manage and regulate what data is securely shared.

According to KLAS Research, “Health systems face a growing list of use cases that require clinical data (such as risk adjustment, quality improvement, care management, payment integrity and forecasting). Historically, health systems have delivered this data via heavily manual, time-consuming processes, including fax, paper, CDs, portals, on-site retrieval and phone calls. However, the increase in requests has made these processes difficult to sustain.”

Although progress is being made, clinical data exchange requires a complete reconfiguration where the needs of the patient come first, and providers and payers move beyond data exchange to data activation. This shift will reduce friction, lower administrative costs and improve outcomes.

Continue to Health Data Management to read the full article.

About Eric Kijak

As Vice President of Strategy, Eric leads Moxe's corporate development activities and engaging with partners, customers, and investors.