Overview
Despite substantial financial investments annually, payers are grappling with outdated methods when it comes to clinical data. It’s as if they are trapped in an operational time warp of manual processes —inputting data from PDFs into internal member systems and piecing together Excel spreadsheets from dozens of disconnected and incompatible sources, applications and vendors.
These are hardly the only problems. Core administrative systems remain siloed, single purpose and best-of-breed, and thus not conducive for integrating and creating interoperable views of members, including their relevant clinical data. Then there’s the data itself, which rarely rises to the gold standard of usability—defined as accurate, complete, timely, relevant, versatile, and formatted and ready for specific use cases and applications.