Anthem and Epic team up to improve information delivery

Todd Shryock

Todd Shryock, contributing author

Prior authorization process should be streamlined with a more efficient exchange of data

Anthem Inc. is collaborating with Epic to facilitate secure, bi-directional exchange of health information between providers and Anthem health plans. More than 14.7 million patients are served by Anthem health plans who see clinicians using Epic software. The data exchanged includes clinical data as well as admissions, discharge, and transfer data from hospital stays.

This collaboration will help close clinical and medication gaps that may exist in an individual’s care, according to Anthem. To do this, Anthem will be able to capture consumer health information provided by physicians, analyze that data, and develop data-driven insights. These insights can then be delivered back to the care team – in near real-time – to flag potential care needs and inform treatment decisions.

The increased exchange of health data will help:

  • Streamline administrative processes, such as prior authorization: Physicians will be able to send prior authorizations through Epic instead of using phone or fax. Health plans can then quickly make decisions and electronically communicate back to the provider – lowering administrative burden and freeing up staff to spend more time on care.
  • Enhance care management: With near real-time access to consumer health data, doctors will have additional insight into preventive care recommendations and addressing care gaps, such as medication adherence, to help them develop enhanced care plans that are proactive and personalized.
  • Notify providers of significant health events: Providers will be notified when their patients are discharged from the hospital and encouraged to conduct more timely follow-up care

Anthem will also integrate this near real-time data with claims data and health information that Anthem receives from sources such as health information exchanges, lab companies, and other partners. This approach enables providers to have a longitudinal view of a consumers’ health, helping physicians make more informed decisions.