Electronic Prior Authorizations in 2021, Are Fax Machines Finally in Danger?
Episode 10125th May 2021 • This Week Health: News • This Week Health
00:00:00 00:06:48

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  Today in health it, this story is prior authorizations electronically. Wow. Slow down. I'm getting whiplash. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current and engaged. I wanna thank our sponsor for today's Serious Healthcare.

They reached out about this time last year and said we'd love what you're doing and really appreciate your mission to develop the next generation of health leaders. The rest is history as they say. If you believe in our mission and wanna support the show, please shoot me a note at Partner at this week in health it.com.

a phone or fax. This just in:

We can actually do this digitally in healthcare. Let me give you some excerpts. I. Anthem has announced a collaboration with Epic to facilitate secure bi-directional exchange of health information between providers and Anthem's affiliated health plans. The initiative leverages Epic's payer platform for data-driven insights in care decisions, clinical data, as well as admissions, discharge, and transfer data from the hospital stays.

We'll be integrated with Anthem's operating system for an interoperable exchange of information between health plans and providers As an organization committed to a digital first approach, we know that enhancing the interoperability of health data is critical in redefining the future of healthcare.

Said. Ashok ura, chief Data and Insights Officer at Anthem Anthem's work with Epic stands to benefit more than 14.7 million customers in Anthem's affiliated health plans who see clinicians using Epic software. RA said. By better bridging communications between providers and health plans, this connection is making possible for patients to receive timely access to appropriate care.

Said Alan Hutchinson, vice President of Population Health at Epic. There you go. There's your press release. Alright, so the reason I like these stories is because they actually break it down. They do a, so what they do, a why this matters, and here are some of the things they gave us why this matters. The interoperability capability is intended to help close.

Clinical and medication gaps. It will also help to streamline administrative processes such as prior authorizations, which has been an issue for hospitals and physicians. Providers will be able to send prior authorizations through Epic instead of using phone or fax. Health plans can then quickly make decisions and electronically communicate back.

To the provider, Anthem will be able to capture consumer health information provided by clinicians, analyze that data and develop data-driven insights. These insights can then be delivered back to the care team in near real time to flag potential care needs and address care gaps such as medication adherence.

Providers will be notified when their patients are discharged from the hospital and encouraged to conduct more timely follow-Up Care. And let's see. Finally, to advance Digital Health as part of its broader Health OSS strategy anthem, we'll also integrate this near real-time data with claims data and health information that Anthem receives from sources such as health information exchanges, lab companies, and other partners.

This approach enables providers to have a longitudinal view of a consumer's health, helping clinicians make more informed decisions. Anthem said, all right. So here's my take on this. My So what, if you will, there's a couple really good insights right here. So let's just go through those real quick. We get closer to near real-time, prior authorizations that can close clinical and medication gaps.

Awesome. It will also help streamline administrative processes such as prior authorizations, which has been an issue for hospitals and physicians. Again. Awesome. We get closer to axing. The fax. Fax machines are an indication. That something is broken in your digital process somewhere. I talked to a CIO once and he said he just walks around and wherever he sees a fax machine, he knows that there's a digital process broken in their health system.

He tries to root those out and get rid of the facts. That is just an easy way to spot. The areas where your digital process is not working. And finally, providers will be notified when their patients are discharged from the hospital. This is also fantastic. We can get more timely follow-up care. So those are the things that the article identified.

I'm gonna put on my cynical hat for just a second. Why now? Why not five years ago? Perhaps this is the interoperability and the information blocking rules starting to loosen things up. I don't know. It's not like this couldn't have been done five years ago. It's not like this is rocket science. There was just no institutional will to make this happen on all sides, payer and provider, it's a shame really, when these breakthroughs, such as the digitized medical record and interoperability become a capability.

is couldn't have been done in:

You know, someone might ask Why take the cynical approach on this? So I'm not really trying to shame Epic and Anthem as much as I'm trying to say what opportunities the entire industry, what opportunities have been enabled as a result of the digitized medical record and the interoperability that's now available that we can improve health outcomes in our communities and make the experience better for the patient.

That's really what I'm after. That's all for today. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com or wherever you listen to podcasts. Apple, Google Overcast, Spotify, Stitcher. I. You get the picture. We are everywhere.

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