Policy Ingredients for Real-Time Improvements in Health Care, Prior Auth, and Claims

Many of us look forward to digital interactions in health care that work as simply as a retail sale or airline reservation. Don Rucker, MD, chief strategy officer at 1upHealth, shows us in this video how current regulations and FHIR standards will actually make that happen. In a fast-paced exchanged with John Lynn of Healthcare IT Today, Rucker covers regulations and evolving data exchange standards that foster interoperability and data analytics. “The real point of interoperability is continuous, real-time computing,” according to Rucker. He points out that not just payers, but some employers, are demanding access to claims information in order to run analytics. In addition to broad, high-level critiques of the current health care industries, they delve into details such as the three stages of API in prior authorization. Rucker points out that the current data exchange standard in health care, the Trusted Exchange Framework and Common Agreement (TEFCA), is “anchored on 1990s document exchange” and is useful for slow-moving bureaucratic decisions, not providing continuous access to data for improved health care. Watch the video for more details about pressures on Medicare Advantage plans, rules about prior authorization, FHIR APIs, and more. Learn more about 1upHealth: https://1up.health/ Listen and subscribe to the Healthcare IT Today Interviews Podcast to hear all the latest insights from experts in healthcare IT. And for an exclusive look at our ...
Source: EMR and HIPAA - Category: Information Technology Authors: Tags: Ambulatory C-Suite Leadership EMR-EHR Health IT Company Healthcare IT Hospital - Health System Interoperability Regulations 1upHealth Don Rucker FHIR FHIR APIs Health Data Exchange Healthcare APIs Healthcare Interoperability Source Type: blogs