Providence and Humana have teamed as much as launch a new data exchange program to enhance value-based care. Their mission, introduced on Monday, seeks to allow safe and standardized medical information sharing, streamline member attribution, lower administrative burdens and shut care gaps.
Healthcare’s poor information infrastructure is a well-documented issue. The trade’s present information administration methods are fragmented and tough to entry, which makes it difficult for suppliers and payers to coordinate care and observe sufferers’ outcomes. By leveraging nationwide requirements like FHIR, the brand new program rolled out by Windfall and Humana goals to create a extra interoperable ecosystem that ensures extra well timed and correct information.
The mission additionally seeks to create a scalable framework that may be replicated throughout different payers and suppliers, mentioned Michael Westover, Windfall’s vp of inhabitants well being informatics.
Humana is an appropriate companion for this mission as a result of it’s a giant nationwide payer, he mentioned.
“If Windfall and a small Northwest payer did one thing, folks would say, ‘That’s nice, however how’s that going to affect the world?’ However once we begin transferring over to Humana, which has numerous attain and will affect distributors and suppliers throughout the nation, I believe we’re actually speaking about altering the best way we do information trade as a nation,” Westover said.
He famous that value-based care solely works if information flows freely and bidirectionally between payers and suppliers. But, Windfall at the moment receives data in a whole bunch of inconsistent codecs, which he mentioned creates huge inefficiencies.
To assist repair this, Westover famous that the brand new program will use standardized APIs to permit for the real-time trade of rosters, claims, gaps in care and monetary information — lowering clinicians’ guide work and sufferers’ delays.
He identified that this effort is a part of Windfall’s broader technique to scale value-based care throughout its roughly 150 danger preparations.
In Westover’s eyes, Windfall is enhancing its efficiency and high quality metrics with out requiring habits adjustments from clinicians. He mentioned standardized information trade may lower implementation timelines from 18 months to days — in addition to make this technique replicable with different payers.
On the affected person aspect, Westover famous that information standardization can enhance affected person matching and care coordination, guaranteeing the appropriate particular person receives the appropriate care on the proper time.
He linked the trouble to CMS and ONC’s push for interoperability, saying Windfall is fulfilling commitments below TEFCA and different federal initiatives selling open information trade.
In the end, Westover mentioned this work is about releasing healthcare from “walled gardens.”
The aim, he added, is to interchange at this time’s costly, guide data-cleaning processes with a extra standards-based trade. This manner, supplier organizations can dedicate extra of their deal with affected person care and innovation.
Photograph: da-kuk, Getty Photos
