Highmark Health disclosed Monday its initiative to integrate technology from Google Cloud and health-care software company Epic Systems in a bid to enhance data gathering for providers and payers. Consumer health-care data in the U.S. is dispersed across various systems and formats, posing challenges for payers and providers to access precise information.
This scenario presents a burgeoning opportunity for cloud providers like Google, Microsoft, and Amazon Web Services. Headquartered in Pittsburgh, Highmark serves as the parent company of a health plan encompassing 7 million members, a provider network comprising 14 hospitals, and several other entities.
By merging Epic’s Payer Platform, facilitating patient data exchange between payers and providers, with Google’s analytics and artificial intelligence capabilities, Highmark anticipates expedited access to pertinent patient data, including upcoming visits, medical history, insurance claims, and health plan benefits.
This critical information is often dispersed across multiple databases and formats, complicating retrieval for medical practitioners and insurance personnel, as noted by experts. A 2022 report by the American Medical Association underscored fragmentation as a chronic issue within the healthcare system, advocating for innovative technologies and policies to mitigate it.
Moreover, an April 2023 study published in the Journal of Primary Care & Community Health highlighted the significant cognitive strain associated with organizing extensive data volumes across intricate software, contributing to physician burnout. Highmark asserts that its new integration will automate administrative processes like prior authorization, a manual and time-consuming insurance cost-control procedure per the AMA.
Dr. Tony Farah, Chief Medical and Clinical Transformation Officer at Highmark Health emphasized that the integration would empower physicians to make informed decisions regarding patient care, ultimately aiming to reduce care costs. Farah stated to CNBC, “Doctors don’t need help once they have information; the problem is they don’t have it.
The idea is to provide this type of actionable information well ahead of time, any time of the day.” Richard Clarke, Chief Analytics Officer at Highmark Health, highlighted that enhanced access to patient data will enable clinicians to ensure optimal care delivery, minimizing unnecessary procedures like additional visits or readmissions.
Moreover, Highmark anticipates that the integration will streamline the aggregation of clinical data from its hospitals, facilitating access for its health plan representatives. For instance, the technology can automatically alert the health plan about forthcoming patient visits.
Clarke elaborated, “It really eliminates the need to do that manually, where the health plan may have formally sent some requests to the provider or called them and created a bunch of manual steps. This can be done seamlessly now.” Highmark estimates that the shared claims data resulting from the integration with Google Cloud will yield approximately $2.7 million in annual savings within its provider system.
Amy Waldron, Global Director of Healthcare Strategy and Solutions at Google Cloud, expressed optimism about the integration’s potential to deliver value to consumers through their healthcare data. However, it remains too early to gauge the tangible impact of Highmark’s integration on its providers, health plan, or overall patient care quality.
Highmark plans to deploy the technology to its provider network by the second quarter’s end and extend it to at least two additional Epic-based providers within its insurance network by 2024’s close.
