Highmark, headquartered in Pittsburgh, is the parent company of health plans with 7 million members, a provider network of 14 hospitals and several other entities.
Highmark said Epic’s payer platform, which transmits patient data between payers and providers, combined with Google’s analytics and artificial intelligence capabilities, will help track future visits, medical history, claims, Users will be able to quickly access useful data about their patients, such as their health plan benefits. .
Experts say this type of information is often stored across multiple databases and formats, which can be difficult and cumbersome for doctors and insurance officials to track.
The American Medical Association’s 2022 report said fragmentation is a “permanent flaw in our current health care system,” and the organization called for the creation of new technologies and policies to reduce fragmentation. An April 2023 study published in the Journal of Primary Care & Community Health found that the “considerable cognitive load” of organizing large amounts of data across complex software is contributing to physician burnout.
Highmark said the new integration will automate administrative processes such as pre-authorization, an insurance cost management process that the AMA describes as “manual and time-consuming.”
Dr. Tony Farrar, Chief Medical and Clinical Transformation Officer at Highmark Health, said this integration will ultimately help physicians make more informed choices about the appropriate next steps. said that the cost of treatment for patients would be reduced.
“Doctors don’t need help when they have the information. The problem is they don’t have the information,” Farah said in an interview with CNBC. “The idea is to provide this kind of actionable information well in advance, at any time of the day.”
Richard Clark, chief analytics officer at Highmark Health, told CNBC that data is now more accessible. Information about patients helps clinicians ensure patients are receiving the best care for them and avoids unnecessary steps such as additional visits or readmissions.
Highmark said the new integration will also help aggregate clinical data from hospitals that health plan representatives need to access. This technology can, for example, automatically notify health plans about upcoming patient visits.
“Where a health plan may have formally sent out some requests to providers, or made phone calls to providers, and created a number of manual steps, now you have to do it manually.” It really is gone,” Clark said. “Now we can do it seamlessly.”
Highmark said its provider system estimates it will save approximately $2.7 million annually through shared billing data through integration with Google Cloud.
Amy Waldron, Google Cloud’s global director of healthcare strategy and solutions, told CNBC that the Highmark integration “will finally allow consumers to get value from their healthcare data.”
It is too early to know whether Highmark’s integration will result in significant changes for providers, health plans and the overall quality of patient care.
Highmark said it plans to roll out the technology to its provider network by the end of the second quarter and to at least two additional Epic-based providers in its insurance network by the end of 2024.
