Faisal as SVP & General Manager - Clinical Networks, leads business lines focused on enabling clinical connectivity for CHANGE Healthcare clients across various care settings. Most recently, Faisal was the President/CEO of Truveris Inc, a venture funded SaaS Healthcare IT company focused on managing pharmacy spend for Fortune 1000 and government entities. He successfully led significant up round of growth equity led by McKesson Ventures.
Executive Director of Consumer Payment Solutions, Change Healthcare
Consumer demand, the shift to value-based care, and the regulatory push for transparency are fueling the need for seamless integration and data sharing only achieved with cloud-based interoperability.
There are several factors driving collaboration across the healthcare ecosystem. Consumer demand, the shift to value-based care, and the regulatory push for transparency are fueling the need for seamless integration and data sharing only achieved with cloud-based interoperability. COVID-19 further underscores the importance of a centralized approach, which can more quickly arm the medical community with real-time information to help them fight the pandemic in addition to driving efficiencies and reducing costs in accessing, providing, and paying for healthcare.
The healthcare system has traditionally relied on manual, point-to-point systems to access and share clinical and financial data. Modern healthcare can now automate access to this data through a centralized, secure, and cloud-based infrastructure that adheres to industry standards for exchanging health information. Physicians are increasingly adopting cloud-based interoperability, creating a more connected system that can streamline the healthcare process, which delivers better clinical and financial outcomes and ultimately improves the healthcare experience for all.
Cloud-based interoperability enables physicians and their staff to focus on patient care rather than managing overly burdensome administrative work resulting from a fragmented IT infrastructure. In addition to caring for their patients, many physicians are often tasked with managing multiple point-to-point connections to share clinical data with other parties such as labs, referring physicians, and payers. It’s a cumbersome, time-intensive, costly, and often manual process. For example, sharing clinical care data with a payer requires manually retrieving, reviewing, and photocopying millions of patient charts. Physicians must dedicate scarce time and resources to providing a great deal of information and answering questions about patient care. Given that practices typically have more than a dozen payer relationships and a 5-to-1 ratio of support staff to physicians, this antiquated process significantly impacts provider operations and hijacks resources that could otherwise be applied to patient care.
On the clinical side, cloud-based interoperability creates efficiencies for all parties while supporting both patient access and treatment. Individuals have greater access to their own records and those records can be more easily and securely shared among providers or with other parties. This leads to better care coordination, health outcomes, and experiences for patients and business operations for practices.
Public health also benefits from cloud-based interoperability. COVID-19 testing issues brought the need for interoperability into the focus of mainstream media outlets. One of the underlying barriers was the absence of digital processes and continued reliance upon outdated communication technology like fax machines. These issues were also hampering physicians’ ability to find a lab and order a test in a timely manner. Given the wide range of provider organizations ordering tests and the fragmented approach to processing, knowing when results would come back was a guessing game. Cloud-based interoperability allows for a nationwide lab network that helps to coordinate testing and provides physicians with better and more options to identify a lab, order a test, get the results, and initiate care for positive tests, while alleviating worries for patients who test negative.
Interoperability is becoming essential to the modern Electronic Health Record (EHR) as vendors increasingly adopt interoperability standards of the not-for-profit trade association, CommonWell® Health Alliance. As more providers join alliances like CommonWell, there will be a network effect. The more systems that are connected, the more patients, providers, and payers will want to be connected, leading to better clinical and financial outcomes.
Physicians can make it easier and more convenient for their patients to pay by adopting cloud-based interoperability solutions. Providers are able to offer a wide range of payment options and methods, which speeds-up collections while also improving patient satisfaction. Cloud-based interoperability optimizes the collections workflow by integrating with major EHR and Health Information Systems (HIS), reducing third-party collections by increasing payments and streamlining vendor management.
Integrating payers into this process through interoperability further enhances utility and efficacy. As mentioned above, physicians typically maintain more than a dozen payer relationships. Each payer has a different process and requires different information when fulfilling claims. As more physicians adopt interoperability and accompanying standards, the payment process will become increasingly consistent and streamlined. Standardization will improve claims payments and strengthen a physicians’ revenue cycle.
Adopting cloud-based interoperability makes business and strategic sense for physicians. The resulting transparency strengthens physicians’ relationships with payers and patients. While it requires a great deal of trust among all parties, interoperability is needed to support other trends including the move to value-based care, the building of systems with much greater transparency, and the rise of virtual care due in part to the COVID-19 healthcare crisis. By adopting cloud-based interoperability, physicians and providers can come to together to realize these clinical and financial benefits sooner. They can create a more patient-centered healthcare system and an experience that is better for everyone.