Reduce career gaps via payers information

The health care industry does not resemble any other sector, in particular with regard to the organization, aggregation and data sharing. Most hospitals and health systems are between a world of faxes and inherited systems and digital innovation. The history of Megan Zakrewsky are imbued with health care innovation, in particular the passage of paper to digital medical records, with almost 20 years of his career focused on interoperability. The challenges of adoption and implementation of health technology are not new to it. His role of auxiliary professor at Thomas Jefferson University in Philadelphia while being vice-president of the product at Veradigm allowed him to balance the service of a provider of health technology while engaging with various stakeholders in the ecosystem of health care.

In an interview, Zakrewsky spoke of the role of Veradigm in reducing the administrative burden of suppliers by rationalizing fragmented approaches and eliminating the experience of the “crowded office” in electronic health files (DSE). Veradigm works with payers and suppliers to strengthen and rationalize workflows to reduce multiple care gaps.

Zakrewsky said she joined Veradigm for the opportunity to fill the links between providers and payers. At that time, the payers were far behind suppliers from an adoption point of view, which presented him with an exciting challenge.

“It seemed like we already had a work plan that we were doing by throwing these foundations and paths so that we can really fill connectivity, because payers began to constitute their ability to consume large amounts of clinical data and do something.

The veradigm payer insistence solution is designed to rationalize clinical work flows by reducing the time necessary to open third -party applications outside the DSE, improve care gap closures, improve the quality of care and improve patient results.

When asked if there was an 80:20 rule that could be applied to the administrative burden of health technology, Zakrewsky admitted that 80% of the burden comes from the management of a small fraction of gaps in terms of care.

“Many gaps are created because the data is difficult to reach. Interoperability is always difficult, especially for communities suppliers who do not necessarily have technology and resources to connect with all the different places they need to find data,” said Zakrewsky. “If we can focus on the vast majority of shortcomings that move in the ecosystem using solutions like what Veradigm tries to do inside our own DSE and other DSE suppliers, we can have a real impact to reduce this administrative burden.”

Thanks to intuitive workflows for clinicians at the care point, health technology companies can help payers and providers to reduce the fight to sail in different systems.

However, some factors are completely out of the hands of payers and suppliers. When patients are missing annual screening, vaccinations and other regular medical meetings, the risk is that small changes in their health are not captured early and will aggravate instead and increase the risk of higher hospitalization and medical costs, in charge of the health system.

“Payers have a more complete vision of patients because they receive information from the various clinicians whose patients can request care. In some respects, payers can connect points much faster than clinicians, “said Zakrewsky. “We are also able to alert health care providers on data on chronic conditions which must be recovered from year to year and documented from the point of view of the CMS.”

Zakrewsky has recognized that there is an administrative burden and significant pressure at the point of care, but its insistence on the payer can give clinicians a more complete image of their patients. Payers can sometimes extrapolate data from the members of the health regime that other conditions may be present that primary care providers are not aware. With the help of Veradigme, payers can identify “suspected conditions” according to clinical data and other information in the patient’s medical history – whether drugs that the patient takes or the procedures they could have. Payers can display data from a financial and clinical context and can display the source of complaint data. They can use these opportunities to stimulate communication with suppliers and determine whether follow-up care beyond preventive care is justified.

“We really want to make sure that when the patient is face to face with the supplier, because many open conditions can be dealt with as possible, because you do not know when this patient can come back. We want to make sure that the three stakeholders – the payer, the supplier and the patient – are also at the table and can defend the best results for patients, “said Zakrewsky. “What I think is so exciting at the moment is to link data to reduce disconnection between these different parties.”

Just as not having enough data can create caregivers, having too much data can also cause problems. Several payers trying to generate information at the care point, only Down suppliers with more and more applications and workflows so as not to remember to spend their day. A survey of 250 American clinicians in the report: “How DSE’s workflows have an impact on clinicians’ experience, patient care and profitability,” said 91% of respondents said they had six external tools or more decision -making aid on their computer. About 80% of clinicians in the report said they had avoided tools providing paid information that exists outside the DSE.

These statistics say a lot about the interest of implementing tools that provide useful information to clinicians, but also on the need for this information to be easily accessible in clinical workflows. There must be ways for payers to easily transmit information and information to suppliers who share the assertions and clinical data with them, noted Zakrewsky. Because Veradigm is between payers and suppliers, it is only placed to create solutions that simplify collaboration between these groups.

These bidirectional capacities support reflux and data flow between payers and providers. Although providers have been able to transmit data to payers for a while, it is not as common as payers communicate information to suppliers outside of prior authorization.

“It is this duality that is really essential for real collaboration, right? Because we cannot have suppliers who simply send their clinical data to payers when we see the full view of a patient,” said Zakrewsky. “There must be ways for payers to recover information and information from suppliers who provide them with complaints and clinical data.”

DSE suppliers cannot be everything for everyone in the health care ecosystem. There is always a new emerging technology that can increase the user experience of a supplier. For example, AI has an important role to play in reducing the administrative charge to which clinicians of clinicians helping to automate tasks through automatic learning and predictive text.

“If we can automate the tasks that help clinicians accurately capture patient data, this could have a positive impact on patient care,” said Zakrewsky.

Confidence and transparency are essential for solid collaboration. The adoption of health technology by suppliers is based on some constants: utility, ease of use, easily adapt to workflows and ability to transmit data solidly and effectively. But for the relations between providers, payers and providers of health technology to prosper, confidence is essential. Zakrewsky has referred to a “trust factor” which is essential for health technology providers in order to comply with the highest quality and safety standards.

Shared incentives are also an important characteristic of successful collaborations. Zakrewsky noted that the transition from the compensation industry to risk -based care based on value where payers and providers are also encouraged to improve patient care and patient results. Impact aligned incentives for better results for patients are also important.

“With all this Great Technology COMES GREAT Responsibility. We WANT TO MAKE SURE WE’RE DOING IT RIGHT AND THAT The Information That’s Being Surfaced to Providers and Facilitating Pay-Provider Collaboration is accurate because, Honestly, Once We Start Surfacing Things to Clinicians, If that’s not 100% Them Up for Risk, then it Will Immoredelly Get Shut Down.

Photo:: The good brigade, Getty Images