Google Cloud CEO Thomas Kurian speaks at the Google Cloud Next event in San Francisco on April 9, 2019.
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Highmark Health announced Monday that it is integrating technology from Google cloud and healthcare software company Epic Systems to try to improve data collection for providers and payers.
Consumer healthcare data is stored in different systems and formats across the U.S., and fragmentation can make it difficult for payers and providers to access the accurate information they need. It's a growing opportunity for cloud providers like Google, microsoft and Amazon Web services.
Pittsburgh-based Highmark is the parent company of a health plan with 7 million members, a provider network of 14 hospitals and several other entities.
Combining Epic's Payer platform, which sends patient data between payers and providers, with Google's analytics and artificial intelligence capabilities will allow faster access to useful data about a patient, such as their upcoming visits, medical history, claims insurance and health plan benefits, Highmark said. .
This type of information is often stored in multiple databases and formats, meaning it can be difficult and tedious for doctors and insurance workers to locate it, experts said.
A 2022 report from the American Medical Association said fragmentation is a “perpetual failure of our current health care system” and the organization called for the creation of new technologies and policies to help reduce it. The “substantial cognitive load” of organizing large volumes of data in complex software is causing physician burnout, according to an April 2023 study published in the Journal of Primary Care & Community Health.
Highmark said its new integration will automate administrative processes such as prior authorization, an insurance cost control process that the AMA says is “manual and time-consuming.”
Dr. Tony Farah, director of medical and clinical transformation at Highmark Health, said the integration will also help physicians make more informed decisions about appropriate next steps and ultimately reduce the cost of care for patients.
“Doctors don't need help once they have information; the problem is they don't have it,” Farah told CNBC in an interview. “The idea is to provide this type of actionable information well in advance, at any time of the day.”
Richard Clarke, chief analytics officer at Highmark Health, told CNBC that easier access to data about a patient will help doctors ensure that patients receive the best care for them and avoid unnecessary steps, such as additional visits or readmissions.
Highmark said its new integration will also help it aggregate clinical data from its hospitals that its health plan representatives need to access. The technology can automatically notify the health plan about upcoming patient visits, for example.
“It really eliminates the need to do it manually, where the health plan may have formally sent some requests to the provider or called them and created a series of manual steps,” Clarke said. “This can be done without problems now.”
Highmark said its provider system estimates that shared claims data from the Google Cloud integration will help it save about $2.7 million each year.
Amy Waldron, global head of healthcare strategy and solutions at Google Cloud, told CNBC that with the Highmark integration “the consumer will finally get value from their healthcare data.”
It's too early to know whether Highmark's integration will make a significant difference for your providers, your health plan, or the overall quality of patient care.
Highmark said it plans to roll out the technology to its provider network by the end of the second quarter and to at least two additional Epic-based providers within its insurance network by the end of 2024.
