Open Revenue Cycle Reveals Opportunities for Patients, Providers

At this point, it’s likely not a surprising statement to say that implementing innovative technology is a key element of growth. But the impact that innovative technology can have should not be underestimated.

When is the last time that you sent money via Venmo or PayPal? What about the last time that you used an app to manage your bank account? Those are all examples of technologies built on an open architecture—a technology opportunity that can help take modernization and automation to the next level.

Open architectures use agents called application programming interfaces (APIs) to enable collaboration between applications. APIs give third parties the opportunity to employ their specialized features and workflows into a software. For example, if a revenue cycle has an open architecture, then a third party that specializes in scheduling can be involved in the development process for that specific function.

Additionally, APIs—and the interoperability associated with APIs—are not exclusive to one third party in an open architecture, thus, creating more flexibility for healthcare systems and developers to mix and match their third-party technologies.

Ideally, open architectures allow the parties involved to assess the strongest option for a workflow or function and plug that into the software architecture. Interoperability, automation, repeatability, and specialization are all key advantages of an open architecture. Not to mention, open architecture is more aligned with a model experience than a closed architecture.

“At a basic level, open architectures are beneficial anywhere that there’s a record of truth around a person and a necessity to transport that and share it with others,” says David Harse, Vice President and General Manager of Patient Engagement at Cerner.

Bill payment is an example of a revenue cycle “record of truth” that can be streamlined by an open architecture. Assume that you’re a patient and you call your provider to make a payment over the phone. Your provider accidentally posts an incorrect payment amount. If the health system’s software does not have an open architecture and uses a historical model that relies on data extract, then you won’t get notified of the payment amount until hours later. At this point, it might be after hours, in which case there would be no one available to immediately address the incorrect payment amount.

Now, let’s assess that situation from the lens of a healthcare system that has an open revenue cycle. In an open revenue cycle operating with APIs and a bill payment vendor that can also operate with APIs, the payment amount could be posted in near-real time on an app. In the scenario with the open revenue cycle, the patient benefits from the use of APIs and the open architecture.

“Any time you have a consumer interaction, using APIs has the opportunity to make the consumer experience better,” says Bob Hansen, Senior Director of Product Management at Cerner.

Similarly, Harse states, “Ultimately, patients are positively impacted by open architectures. The care teams working to care for that patient are also positively impacted because they’re able to access the correct information within the workflows and tools used to facilitate the care process—inclusive of the financial element of care delivery. So certainly, revenue cycle management is positively impacted by an open architecture.”

An open and extensible revenue cycle has numerous benefits to healthcare systems. One of the main benefits is that it is more cost-effective. Revenue cycles that do not utilize APIs tend to have one-off fees for service, in addition to a longer implementation process. And once again, an open revenue cycle that uses APIs is much closer aligned to a model experience than one that does not.

In summary, you have likely experienced the benefits of open architecture in other industries. The benefits of utilizing an open and extensible architecture in healthcare—and specifically in revenue cycle management—can be beneficial from both the patient perspective and the healthcare organization perspective. Taking this step toward a more streamlined, innovative revenue cycle management is validation that healthcare is too important to stay the same.

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About Cerner

Cerner’s health technologies connect people and information systems at thousands of contracted provider facilities worldwide dedicated to creating smarter and better care for individuals and communities. Recognized globally for innovation, Cerner assists clinicians in making care decisions and assists organizations in managing the health of their populations. The company also offers an integrated clinical and financial system to help manage day-to-day revenue functions, as well as a wide range of services to support clinical, financial and operational needs, focused on people. For more information, visit Cerner.com, The Cerner Blog or connect on Facebook, Instagram, LinkedIn, Twitter or The Cerner Podcast. Nasdaq: CERN. Healthcare is too important to stay the same.

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