Additionally, Clarify Health provides payers with AI-driven cost reduction solutions and quality improvement data, and athenahealth introduces athenaOne for Behavioral Health.
Over the past week, a number of healthcare IT suppliers have revealed new products that assist health systems in enhancing patient access, addressing provider constraints, and promoting cost optimization.
Luma Health unveiled machine learning and natural language processing advancements on Tuesday to alter workflows, while Oracle Health stated on Monday that it intends to help manage provider administrative problems by substituting human processes with cloud-based automated claims processing.
This past week, athenahealth also announced that it plans to enhance the delivery of holistic care by integrating additional mental health services into its cloud-based electronic health records. Additionally, Clarify Health aims to promote increased openness and trust by providing direct access to predictive analytics and performance metrics including cost, quality, and use.
Oracle makes use of FHIR
According to Oracle, the way authorizations are handled will alter if automated data sharing between payers and healthcare providers becomes widely available.
Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences, stated in a statement that “healthcare has long been plagued by costly, time-intensive, and antiquated claims processing that results in billions of unnecessary fees each year, and ultimately a strained relationship between providers and payers.”
According to Oracle, about 25% of the documentation pertaining to reimbursement are shared by payers and providers, while over 70% of authorizations are handled over the phone or by fax.
Through the secure, centralized network that the new clinical data exchange platform uses to transmit medical records, it may be possible to reduce the workload associated with administrative duties and wean payers and providers from these manual procedures. According to Kent Hoyos, vice president and chief information officer of Pomona Valley Hospital Medical Center, it also assists providers in streamlining payer data request answers and reducing staff workloads.
According to Oracle, providers can audit specific clinical data with selected payers to check exactly which data was received. They can also choose which data to make available to their payer partners in the platform. Payers do not need to make additional point-to-point connections in order to access clinical data via FHIR queries or bulk processing in an industry-standard format.
Additionally, quicker payer responses and claim reimbursements may accelerate the delivery of patient care.
“Automating the process will help speed approval of necessary patient clinical services as well as payment processing and shorten the wait time for our patients to receive the care they need,” Hoyos stated in a statement.
Luma uses genAI to automate
On Tuesday, San Francisco-based Luma Health revealed two new AI tools for its patient success platform. High phone volume and manual fax processing are two frequent operational difficulties for health systems that can be addressed by the multi-model generative AI called Spark.
Aditya Bansod, co-founder and chief technical officer of Luma, stated in a statement, “Our vision is to use this latest groundbreaking technology to solve persistent challenges on a massive scale, and now the technology is equipped to help us deliver a next-generation patient experience.”
“Health systems are doing more than ever to serve their patients with fewer staff and resources, and they don’t have time to waste on AI solutions that offer shallow EHR integration or create more overhead,” Adnan Iqbal, Luma’s co-founder and
“That’s why we focused Spark on the most common challenges we hear from health systems: high call volume, backlogged referrals, lost revenue and not enough staff to handle it all manually.”
According to Luma, Spark provides bi-directional connection with top EHRs like Oracle Health, Epic, eClinicalWorks, Meditech, athenahealth, NextGen, and Greenway Health, and is integrated into the company’s patient success platform.
The first two Spark-enabled tools, Luma’s Fax Transform and Luma’s Navigator, automate fax processing and offer a voice AI concierge for patients.
In order to automatically check information in referrals, prescription refills, and other structured data from faxes, provider staff can utilize Luma’s Fax Transform. Once the information is verified, the referral is automatically established in the electronic health record of the system.
With the new solution, DENT Neurologic Institute reports three times faster fax processing and 70% time savings on fax operations.
“The organization receives more than 500 faxes every day, and manually keeping up with them is just not feasible,” stated Emily Smythe, the manager of quality and analytics at the institute, in a statement.
One fax can take up to five minutes to process. Filing a fax just takes ten seconds or less thanks to Fax Transform’s total automation.”
According to the statement, the University of Arkansas for Medical Sciences used Luma’s AI concierge and within one month reduced the number of manual call center staff hours by 98, automated 95% of phone call responses, handled 1,200 cancellations without requiring any human interaction, and more.
As per Michelle Winfield-Hanrahan, RN, UAMS’s chief clinical access officer and associate vice chancellor for access, “the team was spending three hours daily just listening to patient voicemails and then going in and canceling appointments,” the statement read. “Our outcomes have been very positive, and really exceeded what I expected.”
Behavioral health is integrated by Athenahealth.
Athenahealth, an EHR provider, has introduced athenaOne for Behavioral Health to facilitate individualized care. Athena said this week that the package includes tools for patient interaction, customized session documentation, treatment plans, group therapy capabilities, and more.
Vice President of Product Management Chad Dodd of the organization said in a statement that “behavioral health providers strive to provide comprehensive, meaningful care but are often faced with a perfect storm of challenges that can get in the way of delivering care that achieves desired health outcomes.”
Along with features for managing revenue cycles and mental health practices, the new certified platform also has integrated services for coordinated care, workflows, and services.
Providers can access pertinent patient data from across the healthcare ecosystem in a single view by combining behavioral health and primary care into a single solution that supports multiple care models, such as intensive outpatient programs, partial hospitalization programs, and outpatient behavioral health practices.
On the new site, patients may also self-schedule appointments and contact with staff and clinicians.
Launches AI for performance control with Clarify
Clarify Health stated that it is utilizing its Clara IQ artificial intelligence to enable health plans to create value since traditional analytics are unable to give actionable intelligence that efficiently manages costs and optimizes provider networks.
According to a statement from Todd Gottula, the founder and president of the organization, “our industry continues to struggle with delivering more effective care for each dollar spent.” “We’ve made a considerable investment in creating standards and fully integrated metrics. Health plans can now gain a detailed understanding of clinical populations, referrals, use trends, and physician performance.”
With the help of the Clarify Atlas Platform, the new Performance IQ Suite gives providers insight into their evaluation process and provides immediate access to performance metrics and comprehensive analytics.
According to Clarify, health plans can use the information to minimize wasteful expenditure, evaluate competing networks, reroute recommendations to highly performing specialists based on thorough cost and quality measures, and maximize provider performance.
