Anthem Integrates Epic Payer Platform For Care Coordination, Interoperability

Anthem Inc. announced the integration of Epic’s EHR Payer Platform to improve patient health data interoperability and boost care coordination.

Integrating the payer platform into its operating system will allow Anthem to leverage data to improve quality of care and patient outcomes.

“As an organization committed to a digital-first approach, we know that enhancing the interoperability of health data is critical in redefining the future of healthcare,” Ashok Chennuru, chief data and insights officer at Anthem, said in a press release.

“This effort helps bring the industry into the next step of its evolution where the right information gets to the right people at the right time – resulting in a more seamless healthcare experience and consumers receiving the care they need – where and when they need it,” Chennuru continued. “Our work with Epic stands to benefit more than 14.7 million consumers served by Anthem’s affiliated health plans who see clinicians using Epic’s software.”

The health IT platform allows for clinical data exchange, as well as admission, discharge, and transfer data from hospital stays.

“By better bridging communications between providers and health plans, this connection is making it possible for patients to receive timely access to appropriate care,” said Alan Hutchison, vice president of population health at Epic. “This effort will also give clinicians more time to focus on delivering care and improve quality for consumers.”

The technology analyzes consumer health information provided by clinicians, then develops data-driven insights that can be sent back to the care team almost instantly. Bolstering payer-provider data exchange will allow for data-driven insights to flag potential care gaps, resulting in better care coordination.

Anthem will integrate the near real-time data with claims data and health information it receives from sources such as health information exchanges (HIEs), allowing them to advance digital health even further.

Increased interoperability will also help streamline administrative processes. For example, Anthem-affiliated providers will now be able to send prior authorizations through Epic instead of via phone or fax. This will lower administrative burden and allow providers to deliver care in a timely fashion.

In addition, the health IT technology will allow for the timely exchange of data regarding significant health events. Providers will be notified when their patients are discharged from the hospital, which may prompt them to conduct timelier follow-up care.

The Cleveland-based MetroHealth System will utilize the Payer Platform to improve care management and follow-up care.

“Being able to better communicate and reduce the amount of time we need to spend on administrative processes will allow our clinicians to spend more time delivering care,” said David Kaelber, MD, PhD, MPH, chief medical informatics officer at MetroHealth. “Improving exchange and interoperability of data will help us give consumers the healthcare experience they have come to expect.”