By Christina Perkins, NaviNet vice president of product management and strategy, NantHealth.
Efficient and effective ways of exchanging information between patients, providers and payers have become even more important during times of crisis, like the COVID-19 pandemic, with a greater demand for urgent, high-quality care. Physicians need more time to devote to saving lives as the healthcare system is overwhelmed with patients and still bogged down by administrative tasks.
According to Sage Journals, the average doctor spends about 8.7 hours per week on administrative tasks, which amounts to nearly a full work day. With the current pace of the pandemic paired with the need for maintaining preventative healthcare through regular appointments, such as physicals or cancer screenings, physicians need as much time as possible to pay attention to the task at hand: patient care.
Technology is the powerful tool necessary to streamline physician workflows by increasing efficient, effective communication between payers and providers in order to determine the most appropriate treatment plan for an individual patient based on their condition and health plan. One such workflow that can oftentimes be quite time-consuming for payers, providers and patients due to disputes or other disagreements around a therapeutic path is prior authorizations.
Streamlining the prior authorization process can alleviate the burden for all stakeholders, reduce delays, and offer providers and their patients confidence they are getting the most appropriate care with the highest chance for success. With the right technology in place, prior authorizations can be streamlined greatly.
Leveraging electronic tools to enhance administrative workflows can make it clear to providers when and why a prior authorization is required, what information is needed for each kind of service, and which services are within the guidelines for treatment.
By implementing digital technologies to streamline processes like these, there is a greater reduction of time and money spent to arrive at the best possible treatment plan – bringing about a new era of value-based care. Giving doctors tools they need to efficiently get tedious administrative tasks done will greatly improve the treatment process for all stakeholders. This is the gateway into enabling true value-based care.
Interoperability also plays a critical role in uplifting value-based care by boiling down the superfluous tasks, reducing heavy administrative lifts for providers. Allowing a range of healthcare information technologies to exchange, interpret and use data cohesively consistently leads to higher quality care by relying on a value-based and evidence-based care system. There are three foundational ways in which efficient and effective exchange of information through the use of technology can be extremely valuable to the healthcare system, including: