Google and Microsoft are both rolling out new cloud-based care management platforms designed for payers that will support unlocking unstructured data and better member outreach.
Google Cloud said April 13 it has launched an AI-enabled platform for prior authorization and claims processing powered by a new data and analytics tool, Claims Data Activator.
The new offering will convert unstructured data into structured data and can help payers meet current and proposed CMS rules around interoperability and prior authorization, including using HL7 FHIR.
Blue Shield of California is already using Google Cloud technologies to streamline its prior authorization process and help deliver timely clinical care for 4.8 million members.
"Streamlining the prior authorization process is one important part of Blue Shield of California's journey to enable a more real-time exchange of data and provide more retail-like experiences. We want to help ease the administrative burden on our healthcare providers so they have more time to deliver the best care possible," Lisa Davis, senior vice president and CIO at Blue Shield, said.
The new platform is available to Google Cloud customers now, with some features to launch later in the year.
Microsoft Cloud is expanding member and care management services to payers, the company's corporate vice president for worldwide health, Tom McGuinness, wrote in an April 12 blog post
The latest payer features for the Microsoft Cloud for Healthcare program were first previewed in October and will offer a comprehensive view of member data and insights in one location, including information about claims, coverage, risk profiles, and care plans.
Other new features for payers:
- Care journey templates for member care management. Providers and payers can communicate through Microsoft Teams about the patient's interaction timeline and message through Microsoft's patient access portal.
- Device data support for remote care management, which will enable better hybrid care. Clinicians will be able to remotely monitor patients' vital health data, identify trends, and manage inventories of assigned medical devices.
- Enhanced operations support for virtual health data tables, including support for creating, updating, and deleting FHIR data. Users will be able to trigger real-time updates of clinical data from FHIR without the need for duplication first.
- The features will live within existing Microsoft Dynamics 365 Customer Insights and the Microsoft Power Platform for new member profile templates.