A study led by Brigham and Women's Hospital found that a sensor-embedded pill can accurately track vital signs in patients being treated for sleep apnea and can be used to monitor fentanyl overdoses.

Researchers at Brigham and Women’s Hospital are reporting good results from a study that used a sensor-embedded ‘pill’ to monitor a patient’s vital signs.

The study, published in Device, gives new value to a digital health form factor that has seen its share of ups and downs, but could prove valuable in remote patient monitoring programs for a wide variety of health conditions.  

“We have developed an ingestible electronic capsule that detects different movements associated with specific vital signs,” Giovanni Traverso, MB, BChir, PhD, a gastroenterologist in the hospital’s Division of Gastroenterology, Hepatology, and Endoscopy and co-corresponding author of the study, said in a press release. “We anticipate that there will be broad applications for this device, with the potential to improve monitoring for sleep apnea and other breathing conditions.”

In their research, Traverso and his colleagues tested the Vitals Monitoring Pill (VM Pill) on 10 patients living with sleep apnea. They found that the device, developed by Massachusetts-based Celero Systems, which was launched through the Mass General Brigham innovation network, captured respiratory and heart rate data that was comparable to other monitoring devices. It also captured moments when the patient stopped breathing, either intentionally (when a patient holds his or her breath) or during a sleep apnea event.

The device was also tested in a preclinical model for fentanyl overdose, and was able to detect respiratory depression caused within a minute of overdose in real-time. That capability is timely, given the nation’s opioid abuse epidemic and efforts to find new ways to monitor patients and reduce deadly overdoses.

The study was done by researchers at Brigham and Women’s, a member of the Mass General Brigham health system, the Massachusetts Institute of Technology, and West Virginia University, as well as members of Celero’s team. Some 57 hours of data was gathered from the patients at WVU Medicine’s Sleep Evaluation Center.

Healthcare organizations and pharmaceutical companies have been experimenting with ingestibles for years, but have struggled to find the right technology and use case. One of the first companies to develop “smart pills’ was Proteus Digital Health, which at one point was valued at $1.5 billion and had a partnership with Otsuka under its belt before filing for bankruptcy in 2020. Smaller, more recent studies have centered on monitoring GI issues and delivering and tracking the effectiveness of timed doses of medications.

Traverso, who launched Celero in 2017 and sits on its board of directors, says sensor-enhanced pills have great potential in RPM programs where providers need accurate data without worrying that the patient will affect the data-gathering. Data is transmitted from the pill to a receiver attached via USB interface to a laptop until the pill is discharged.

“Our study provides a tangible product with real commercial value,” he said. “Ingestible vital monitors can really transform our capacity to rapidly respond to life-threatening events.”

A new program at Bassett Healthcare monitors email inboxes and helps the health system react quickly to important patient emails.

With more and more healthcare being conducted online these days, health systems are struggling to get a handle on messaging between care teams and their patients.

Enter the Inbox Ninjas.

Launched in late 2022 by the Bassett Healthcare Network, the Ninjas are full-time advanced practice clinicians (APCs)–or staff with similar qualifications–hired by the health system to review email messages sent by patients to their care providers. The Ninjas separate the messages into different categories, giving high priority to messages that require action, such as answering an urgent medical question, scheduling an appointment, or filling a prescription.

The program addresses a vexing pain point for healthcare organizations, putting pressure on already stressed doctors to keep their inboxes up to date, even when they’re away. Missing those messages often leads to interrupted or delayed care, which affects care plans and clinical outcomes and boosts expenses.

Some health systems, including the Mayo Clinic, Cleveland Clinic, Vanderbilt Health, UCSF Health, Northwestern Medicine, BJC Healthcare, and even the Department of Veterans Affairs, are charging fees to answer emails, under the idea that a fee will cull out unnecessary messages and compensate care teams for their time.

Paul Uhrig, chief legal and digital health officer at New York-based Bassett and executive director of the Bassett Innovation Center, says leadership didn’t want to add that burden to their patients, many of whom live in rural areas and are concerned about the cost of healthcare.

“There’s a lot of messages coming into our providers now through the portal that need to be answered, and [those providers] were answering them during their pajama time,” he says, referencing the time spent by providers at home. “We wanted [a program] that takes the burden off them while not shifting that to their patients. We’re very conscious about not shifting cost to patients.”

Meeting a distinct need

Bassett launched the program to meet a very distinct problem. According to Halley Chiodo,  the health system’s telemedicine specialist, a large primary care provider in Cooperstown, New York, had closed down, leaving thousands of patients without a PCP. Bassett stepped into the void to help but needed a means of sifting through the inboxes of the departed PCPs, tagging urgent messages to prevent lapses in any care plans, and shifting those patients to new providers.

They had little to work with at first.

“We built this program from the ground up,” she said during a presentation at the Northeast Telehealth Resource Center’s (NETRC) annual meeting this fall in Nashua, New Hampshire. “We had no model to work with.”

Chiodo said management didn’t want to pull in current staff and add to their workflows, so they created a new position, one that is all-virtual and requires APC-level qualifications so that they can answer questions and fill prescriptions on their own (the health system currently requires a New York license and three years of clinical experience). The role seems especially suited to clinicians at the late stages of their career or in retirement, who might enjoy a job that they can do from home.

With approval from leadership to hire five FTEs, the program launched in late 2022. Uhrig said that while the initial intent was to focus on the inboxes of doctors who were no longer with the health system or those on vacation or out of office for a period of time, leadership realized the program could benefit any and all care providers.

It also became apparent very quickly that addressing every single email message would be too much, even for the Inbox Ninjas. Chiodo said the health system adjusted the protocols to enable the Ninjas to sort through all emails but answer only the priority messages.

“Nobody needs a clean inbox,” she said.

With that model, Chiodo said, the health system found that the Ninjas could also be put to use supporting Bassett’s telehealth programs, providing an extra layer of clinical backup.

Calculating the ROI

Both Chiodo and Uhrig say the Inbox Ninjas have been successful in cleaning up inboxes and addressing care gaps for patients, but whether that makes the program sustainable is uncertain. Chiodo—who noted Bassett is hiring more Ninjas soon—said the program is all-virtual, so the workforce is unique and requires a different management style. She also noted that other departments have asked about having their own Ninjas.

As for cost, the program can be adjusted to fit the needs of the health system. The higher level of clinical proficiency, the more that a Ninja can do with regard to fielding and addressing requests for medical services, which also means the money spent on staffing will increase.

Chiodo said the health system is working on a formula that would establish the number of billable clinical encounters needed to support one Ninja—while adding that ROI shouldn’t be linked solely to billable encounters. Uhrig, who noted the program did receive some outside funding to get off the ground, also noted the challenge of determining value.

“How do we turn some of these activities into billable activities?” he asked. At the same time, he added, there are benefits that aren’t billable, including improved patient satisfaction and engagement and a less-stressed corps of doctors who aren’t worrying about their inboxes so much. Eventually, he added, the health system might be able to link those timely responses to e-mails to specific improvements in clinical outcomes and reduced healthcare expenses, along with less staff stress, a better workplace, and improved staff retention.

Chiodo says there’s no shortage of qualified people who are interested in the job.

“After all,” she said. “Who wouldn’t want to be called a Ninja?”

Research finds that patients are less likely to get follow-up diagnostic tests after a telehealth appointment than after an in-person visit. To address this, health systems need to provide better follow-up services.

Telehealth programs may be great for connecting patients to their doctors, but new research suggests it isn’t closing the gap on diagnostic tests and referrals.

A new study posted in the Journal of the American Medical Association (JAMA) by researchers from several notable health systems finds that diagnostic loop closures for colonoscopies, cardiac stress tests, and dermatology referrals were worse for patients after virtual visits than for those patients seeing their doctor in-person.

The research, conducted by affiliates of Harvard Medical School, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Northeastern University, and Stanford, suggests that health systems aren’t providing the appropriate support after a telehealth visit to ensure follow-up tests are done. That would include sending messages to the patient after an initial visit to schedule and follow through on diagnostic tests.

Without that follow-up to close the loop, diagnostic tests aren’t taken and the care plan is interrupted. This could mean patients aren’t alerted to a serious health concern such as cancer or advanced cardiac disease and don’t take the necessary steps to seek treatment.

“When investigating notable differences in loop closure for orders placed during telehealth visits, our findings suggest that differences in loop closure may be inherent to telehealth as a modality,” the study team concluded. “One potential mechanism to explain this may be the lack of systems in place to help patients complete test and referral orders. During in-person visits, members of the support staff team sometimes help patients schedule their tests at checkout; however, this support is absent during telehealth visits. After the visit, patients do not receive any communication reminding them to schedule the test or referral, which may further limit loop closure.”

“Other potential explanations include the possibility that it may be more difficult to remember information provided during telehealth visits, that telehealth may present unique communication barriers, or that it may be more difficult to engage patients in shared decision-making during virtual visits, thus decreasing patient engagement with test and referral orders,” the team added.

In the study of more than 4,100 patient visits at a Boston-based primary care practice and affiliated health center between March of 2020 and January of 2021, researchers actually found low follow-up for each of the three tests, but lower after a telehealth visit. Overall, 58% of tests ordered during in-person visits were completed, while 43% of tests ordered after a virtual visit were completed.

Broken down further, colonoscopy referrals made up 78.7% of all orders. Of those, almost 57% were completed within a year by patients who’d seen a doctor in person, while about 39$ were completed by patients who’d used telehealth. For dermatology referrals, comprising 11% of all visits, 61.5% of those ordered after an in-person visit were completed within 90 days, and 63% were completed by those using virtual visits. For cardiac stress tests, comprising 10.3% of all orders, the numbers were 63% completed within 45 days of an in-person visit and 59% completed after a telehealth visit.

While identifying the challenges associated with virtual care, the researchers also emphasized that neither in-person nor virtual visits are performing well in closing the diagnostic testing loop.

“While the differences in loop closure between telehealth and in-person visits may be concerning, system-level changes are needed to improve test completion rates across all modalities,” they wrote. “These might include automated tracking for outstanding tests within electronic medical records and interventions such as telephone outreach to patients, automated text and email reminders, and the use of referral managers. These considerations may be particularly important for patients who rely heavily on telehealth, such as those in remote rural areas and disadvantaged patients with limited health access and literacy.”

The partnership with Talkspace addresses a surge in teenagers—both in the city and nationally--reporting severe behavioral health concerns and not receiving care.

New York City officials have launched a telehealth platform specifically designed to give teens access to behavioral health services.

The ‘TeenSpace’ platform, developed in a partnership with digital health company Talkspace, enables those between the ages of 13 and 17 to meet with a licensed therapist by phone, video, or text at no cost.

The program comes at a time when healthcare organizations across the country are struggling to find the resources to help a teenage population facing a surge of behavioral health issues. The National Institutes of Health (NIH) says depression in that age group has increased to the point that it’s a “major public health concern,” with some studies estimating one in every five is in need of care and more than half of those aren’t getting the care they need.

NYC officials say that percentage is even higher in the Big Apple. According to the city’s Department of Health and Mental Hygiene (DOHMH), some 38% of NYC high school students in 2021 reported feeling so sad or hopeless almost every day for at least two weeks during the past 12 months that they stopped doing their usual activities.

These concerns also show up in hospitals, with emergency departments facing a high number of teens seeking mental health services and having few resources to handle them.  Many health systems are integrating behavioral health services into their primary care platform, as well as partnering with specialists to handle the influx of ED patients needing urgent care.

"Coming out of a once-in-a-century pandemic, we know that levels of anxiety and depression have increased particularly among our young people," Deputy Mayor for Health and Human Services Anne Williams-Isom said in a press release put out by the mayor’s office. The new telehealth portal "puts access to mental health support right in the hands of our young people. They can use their smart phone or other devices to connect with a practitioner in a time and space that works for them.”

Talkspace will manage the platform, which was designed by the company and city officials with input from teens. The service also enables a mental health professional treating a teen to refer that teen to additional resources, including in-person care.

The CFO of the Hospital for Special Surgery details its three financial priorities for 2024 and why other finance leaders should do the same.

2023 was a tumultuous year for hospital and health system CFOs. Even though CFOs saw some financial relief as revenue increases offset rising expenses and operating margins began to stabilize, 2023 was far from easy.

Unfortunately, 2024 is likely to be just as bumpy.

CFOs will need to continue to be strategic in 2024 as they aim to maintain healthy operating margins and a strong balance sheet. In this article, Stacey Malakoff, the CFO of New York-based Hospital for Special Surgery (HSS), details the three financial initiatives she will be focusing on to ensure financial success in 2024 and why other CFOs should prioritize the same.

When planning financial goals for the new year, CFOs need to think about 2024 in the context of long-range strategic plans and financial projections, Malakoff says. 

“It is imperative for CFOs to continue to maintain healthy operating margins, strong philanthropy, and a strong balance sheet—all while still making the critical strategic investments that will ensure future success,” according to Malakoff.

Here are three of HSS’ 2024 financial priorities that other CFOs should consider as well:

Its people and culture 

More so than ever, it is imperative that HSS invests the appropriate resources to ensure that it can recruit and empower the most talented clinical and ancillary staff to ensure the highest quality patient experience and support planned expansion and growth, Malakoff says.

“Empowerment includes investments in professional development, employee engagement, safe work environment, and wellness and resiliency,” Malakoff says.

For example, HSS is approaching its fourth year with a best-in-class, internal wellness program led by a U.S. Special Forces veteran who is also a nurse.

Patient access

“We have lots of opportunity to expand access as demand for HSS expertise is high and growing throughout the NYC tri-state area, nationally, and internationally as consumers and employers increasingly understand the importance and variability of quality in musculoskeletal health,” Malakoff says. 

That’s why HSS is investing in the transformation of its NYC main campus to a more ambulatory setting and complex joint/spine center. HSS is also opening new regional locations, increasing capacity and service offerings at several current regional locations, and expanding its physical footprint in Florida. 

“Additionally, we invest in improving access to knowledge in many ways, such as the HSS eAcademy which provides continuing medical education to specialists in 145 countries,” Malakoff says.

All of these major investments need to be made in a carefully planned manner to ensure the highest standards of care and prudent financial management, she says.

Operational efficiency

A continued focus on efficiency is imperative given expense inflation and other economic pressures affecting healthcare providers, Malakoff says.

“Investing in our priorities requires that we find efficiency and economies throughout the organization,” she says. That’s why, Malakoff says, HSS’ financial and operations leadership teams are collaborating to capitalize on synergies and address needs that have been reshaped significantly by the rapidly changing environment. 

“One example of this is our focus on optimizing space and capacity utilization across all facilities and service lines,” she says.

A new partnership in Atlanta is helping church-goers monitor blood pressure and live healthier lives.

A new partnership in Atlanta is launching a remote patient monitoring program through area churches to address chronic care management in underserved communities.

Digital health company Rimidi is partnering with the Brighter Day Health Foundation to launch wellness clinics at Atlanta-area churches, beginning with Impact Church and World of Faith Family Worship. Brighter Day will locate weekend clinics within those churches and use RPM technology from Rimidi to help church-goers monitor their blood pressure and manage their health.

With underserved populations at a higher risk of developing chronic conditions and often facing barriers to accessing healthcare, healthcare organizations are looking for new ways to reach them and improve access to resources and care management. Some programs have located care teams and clinics in barber shops, beauty salons, community centers, fitness centers, libraries, and retail sites like malls and pharmacies.

[See also: Memphis Project Brings Primary Care to Urban YMCAs.]

Community health outreach is vital to health systems, both in improving clinical outcomes and reducing adverse health concerns that result in expensive trips to the doctor’s office, emergency care clinic, or hospital ER. Hospitals and health networks that collaborate with or support these programs can reduce acute care costs and ED traffic, while promoting healthier communities.

Some 350 church-goers are currently engaged in the Rimidi-Brighter Day program, in neighborhoods that are 80% African-American and the average age is 55. The participants have access to a nurse practitioner and dietitian at the weekend clinics and are given connected devices to track their blood pressure at home and send that date to their care teams. Staff at the clinics work with these patients to develop care management and healthy living plans at home.

[See also: Grant Program Targets Telehealth Access in Underserved Neighborhoods.]

“Chronic diseases are some of the most prevalent, yet challenging conditions to manage, especially when social determinants of health can create barriers to care,” Lucie Ide, MD, PhD, founder and CEO of Atlanta-based Rimidi, said in a news release. “It’s our responsibility as a clinical management platform to reduce those barriers through innovative technology, such as RPM. Our partnership with Brighter Day Health Foundation is aiming to meet patients where they are–literally–in their communities. Together, we will seek to provide individuals who currently may have limited access to healthcare within the Atlanta community with new tools and services to better manage their chronic conditions and improve their health overall.”

“Our goal at Brighter Day Health Foundation is not to take the place of the primary care provider, but to provide timely secondary interventions that help preclude ‘rising risk patients from becoming high risk patients,’” Eric Nixon, MPH, Brighter Day’s president and CEO, said in the press release. “Our faith-based model brings people into the healthcare system by creating new care access points and removing the non-clinical barriers to care that have historically plagued minority and underserved communities.”

The executive identifies pivotal strategies and trends for 2024 and beyond.

In her two-plus years at Oscar Health, Executive Vice President & Chief Insurance Officer (CIO) Alessa Quane is helping the insurance company target profitability and grow responsibly.

In this exclusive with HealthLeaders, Quane identifies three growth strategies, how key marketplace trends highlight both competition and collaboration, and how Oscar’s "Never Build Alone" and "Make It Right" approaches create a member-centric culture and plan designs.

HealthLeaders: If you could sum up Oscar Health’s market strategy in a single statement, what would it be and how does that differentiate you from your competitors?

Alessa Quane: For 2024, Oscar is really gearing up for growth. We've been very focused over the last few years on getting the fundamentals of our business right and moving the company to profitability. We feel really good about our progress on that path, so we’ve spent our time making sure we could use that as a springboard to get back to a larger growth narrative. From 2020 to 2022, we doubled in size. And while we’re not looking to do that again, we definitely want to grow profitably and serve as many people as possible in the growing ACA market.

HealthLeaders: Can you provide details on what it means for Oscar to gear up for growth?

Quane: Oscar has implemented a significant amount of expansion. First — while we're not entering any new states in 2024 — we are expanding to 165 new counties. This includes approximately 100 that meet the definition of a rural county. Often, there is less competition and less accessibility for people in those counties, so we’re hoping to offer more affordability and more options.

[Note: Oscar Health operates Marketplace plans in 11 states. Across all lines of business, as of March 2023, the company operates in 20 states.]

Second, we are enhancing our existing diabetes care plan and are introducing a chronic care plan for individuals with asthma and COPD called Breathe Easy. This plan offers a much lower cost share for benefits directly related to these illnesses to help members manage their chronic illnesses themselves.

The last thing we're doing, for our Spanish-speaking members, is offering an experience called Hola Oscar. A large part of the growing ACA population are Spanish speakers, so this program really allows us to deliver socially and linguistically authentic experiences when they call our concierge service — like matching members to providers who speak and can provide documentation in their language.

HealthLeaders: How are traditional benefits affected in specialty health plans — what is the impact, if any?   

Quane: The other benefits pretty much stay the same. What these plans try to do is provide financial incentives for members to manage their disease in a way that is more specific and more affordable overall. For example, these plans put a member’s specialist copay [e.g., a frequently seen pulmonologist] on par with their PCP copay. For patients with asthma or COPD, a specialty plan lowers the cost of oxygen services and covers nicotine replacement [to discourage smoking].  

Oscar Health's EVP and CIO, Alessa Quane. Photo courtesy of Oscar Health.

HealthLeaders: What is most important about the Marketplace, in 2024 and in coming years?

Quane: The continued growth in the market is a big topic: where that growth is coming from, including Medicaid Redeterminations and beyond that for populations that were previously uninsured. We've seen smaller employer groups — not in a material way at this point ACA — turning to the individual market. I think that's a real potential tailwind over the longer term.

I also think there's more stability in the market this year. We don’t have big insurer exits like the year before. We also have new entrants that are continuing to expand their footprint in new markets or engage in strategic retrenching in other markets. What I’m really looking for in our markets is: Are they doing what they need to do? Do our products meet members’ needs? And you know, from a business perspective, is this doing what we need it to do?

And so, the rationality of the players is good. I think that bodes well for the future of the market and to reduce overall volatility.

HealthLeaders: What are your thoughts on whether expanded subsidies will continue beyond 2025?

Quane: Quane: The last thing you want to see is a mass exodus from the market from an affordability perspective. That's an important topic for the industry to be thinking about, but beyond that Congress will have to take action. The expanded subsidies will expire if no action is taken. I think the Presidential election is key. There’s really no way to know what will happen until then.

HealthLeaders: An interesting component of Oscar’s values is “Never build alone.” How does that apply to your Marketplace strategy, as well as your own leadership style?

Quane:  Never build alone is a subset of one of our values, Make It Right. Do your best work. When you make a mistake, admit it, and share what you're learning — whether it's through mistakes, innovation, or just your day-to-day.

No one is super successful on their own. When I think about how to go to market, Make It Right and Never Build Alone touches on every single part of the organization. Collaboration is super important. When we bring +Oscar and our technology to others in the market, it's to make the healthcare ecosystem more efficient, more affordable, and more accessible. That’s our mission.

HealthLeaders: What else is top of mind as we close, Alessa?

Quane:  The one thing that I would want to say about Oscar generally is that we're not trying to get more members by just having a lower price. We strive to offer innovative plans and go after different markets — which is really for our members and to be a very member-centric company. The member is really the North Star. We have a Net Promoter Score, or NPS, that is substantially higher in the market, and we want to continue that. [NPS measures the loyalty of a customer to a company.]

Whatever we're building, wherever we're going, however we're innovating, the way in which we partner with or use our technology to support others is really all in service of the member. That’s an important point and differentiator about Oscar. It’s what drives me as a leader and what drives the teams we have at the company.

The health system has created its own data exchange technology and tested it with a regional payer to ensure it meets HEDIS standards.

Providence has unveiled an HL7 FHIR (Fast Healthcare Interoperability Resources) tool that enables seamless data exchange with payers.

The Washington-based health system, which spans more than 50 hospitals in seven states, tested the technology earlier this year with Premera Blue Cross, one of the largest health plans in the Pacific Northwest. Officials say it was vetted by internal teams as well as HEDIS (Healthcare Effectiveness Data and Information Set) auditors.

With the tool, Providence pushes to the head of the pack in the nationwide quest for interoperability through national FHIR standards, alongside federal efforts to develop TEFCA (Trusted Exchange Framework and Common Agreement). The goal is to create a national framework for the exchange of all data between healthcare organizations, health information exchanges, payers, consumers, and other stakeholders, eliminating silos, improving clinical and business operations, and moving the industry toward value-based care.

[See also: ONC Commits to Support FHIR in Updated TEFCA Standards.]

“Interoperability is critical within value-based care, and FHIR integration allows healthcare organizations to exchange comprehensive clinical data that enables more accurate risk assessments, enhances care coordination and captures outcomes more effectively,” Michael Westover, the health system’s vice president of population health informatics, said in a press release. “By using a national standard for contract gap closure and capturing the much-needed clinical data, we empower all stakeholders in their ecosystem to make more informed decisions, improve patient outcomes and enhance the overall quality of care to our patients – who are always at the center of all our efforts.”

The nation, as a whole, has been struggling to reach interoperability because of the lack of standards for data sets, particularly at a time when the industry is seeing a wealth of unstructured data from sources outside the health system. As a result, few organizations use the same rules to organize and share data, using everything from spreadsheets, fax machines, emails, and secure file transfer protocols (SFTP) to share information.

In an email to HealthLeaders, Westover said Providence is a “trailblazer” in developing data exchange standards that meet HEDIS quality measures.

“We had to wrestle with a new data standard, new technology, and a new data security model,” he said. “We tested for months with our health plan partners and frankly learned some hard lessons as we used a generic clinical exchange standard for a targeted business case. We are now using what we’ve learned to scale the platform with other health plans.”

At Providence, the health system’s data-as-a-service (DaaS) tool leverages the Member Attribution (ATR), Clinical Data exchange (CDex) and Bulk Implementation Guides as national data exchange standards developed through the HL7 Da Vinci Project, which is billed as an industry-led project to enhance data sharing between payers and providers to enable the industry’s transition to value-based care.

A key aspect of the project was securing participation from a payer.

“We initially targeted the clinical data elements for 15 or so clinical measures that have a big impact on patient care and payer finances,” Westover explained. “We were surprised at how excited our health plan partners were and how they immediately asked us to expand the number of included measures and the qualifying patient population in the dataset. Our partners quickly saw the impact this type of DaaS could make on their business during difficult financial times.”

“Payers currently get much of their clinical data from patient charts and from data manually keyed into clunky websites or spreadsheets,” he added. “This solution allows health plans to exchange curated patient data rapidly using a nationwide standard format. If health plans can get higher quality data faster and easier than they could before, they will outperform their competition on important HEDIS, 5-Star, value-based care metrics, and other government programs.”

According to Westover, more efficient data exchange with payers means that providers and payers will have a shared understanding of their patient populations, which in turn will help improve care management and coordination.

Providence executives plan on using the tool to partner with other payers and vendors on data exchange..

“The technological and regulatory environments are evolving so quickly that we expect to see a few different approaches to these types of healthcare interoperability challenges,” Westover said. “Some groups will ask their EMR vendors to take care of it for them. The most successful health organizations will be those that can exchange vital data more efficiently than the rest.”