When they are released “into the wild,” however, they don’t actually solve user problems and they end up as shelfware. Fortunately, it doesn’t have to be this way.
During a Vim featured session at Becker’s Hospital Review’s Payer Virtual Forum, Jonas Goldstein, Vice President of Strategy and Commercial at Vim, discussed the current provider enablement technology landscape, as well as challenges and opportunities associated with scaling these solutions.
Four key learnings were:
- A convergence of market trends is driving adoption of point-of-care solutions. On the provider side, operating pressures and labor costs are up. Teams are stretched, yet are being asked to take on additional work to support value-based care and to improve the patient experience. At the same time, health plans are deepening their reach into the provider space through vertical integration. That can mean outright ownership, joint venture partnerships, or advanced contracting.
Increasingly, enlightened health plans are extending enablement technology into the point of care for provider networks. “This is leading to a wave of investment in point-of-care solutions sponsored by health plans, risk-bearing providers, managed service organizations, and even providers themselves,” Goldstein said. “The goal is to reduce the administrative burden for providers and accelerate the pathway to performance in value-based care.”
- Provider feedback and modern web-based technologies are the key to creating agile workflows and driving user engagement. In recent years, a lot of standards-based interoperability work has occurred. Although standards like HL7 and FHIR are necessary, they aren’t sufficient for enhancing the patient experience and reducing provider burden. “The interoperability work done to date is fantastic foundationally, but we think there’s a next level that the industry is waiting for and that’s what we’re working on,” Goldstein said. “You must work backwards from provider engagement and create the technology needed to support that, rather than playing within the guardrails of a restrictive ecosystem. We’re focused on next-level solutions that move past standards-based integration and toward performance-based integration.”
- Vim’s point-of-care solutions address health plan and provider needs. Vim works at the intersection of health plans and other content sponsors. Health plans, ACO enablers, and risk-bearing entities that contract on behalf of small providers have content and data that providers need to do their work more effectively. That information must be deployed into workflows for tasks like quality gaps and prior authorization. “If you don’t build with the user in mind, however, you create connectivity ‘bridges to nowhere.’ We focus on a two-sided value proposition that meets health plan and provider needs,” Goldstein said.
With quality and diagnosis gaps, for example, payer information comes from portals, spreadsheets, snail mail, and faxes. Taking this information and matching it to upcoming patient visits creates a huge amount of manual work for providers. Vim’s applications for quality and diagnosis gaps work alongside the EHR and are context aware, meaning when a patient is in view, the workflow can be digitized. Prior authorization is another workflow with high administrative costs. Vim’s Prior Authorization solution recognizes orders, pings back to payer rule sets and alerts providers in real time about likely prior authorization requirements. “This eliminates portal visits and calls to health plan service lines. That is good on both sides — providers have more time to focus on care and payers can reduce call center staffing as inbound call volumes decrease,” Goldstein said.
- To scale provider enablement technologies, companies must address both the technical and business challenges. Vim just signed its 700th provider organization. One reason for the company’s tremendous market success is its novel and powerful technology platform that connects seamlessly to EHR workflows. Vim is also focused on the business challenges facing providers and health plans. “Our go-to-market strategy is backed by some of the largest and most innovative health plans in the country like UnitedHealthcare, Anthem, and Florida Blue,” Goldstein explained. “They arm us with data to connect with provider EHRs and workflows. Our multi-payer application is easy to connect to applications. It’s a compelling value proposition and there’s no cost to the providers because the health plans are sponsoring this.”
Until recently, there haven’t been many bright spots in point-of-care engagement. Vim, however, is changing that. “Through automation and matching data to workflows, we are reducing the time to complete tasks,” Goldstein said. “The more minutes we can add to a provider’s day and the more they can focus on patients, the better. When we bring that back to health plan partners, that’s engaging and powerful.”
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