Anthem Enables Secure Exchange of Health Information to Enhance Healthcare Experience

INDIANAPOLIS–(BUSINESS WIRE)–Anthem, Inc. (NYSE: ANTM) today announced an effort to facilitate secure, bi-directional exchange of health information between healthcare providers and Anthem’s affiliated health plans, as a result of its collaboration with Epic. Increasing and improving this communication aims to better leverage data-driven insights in care decisions, simplify healthcare, and ultimately improve health outcomes.

“As an organization committed to a digital-first approach, we know that enhancing the interoperability of health data is critical in redefining the future of healthcare,” said Ashok Chennuru, Chief Data and Insights Officer at Anthem. “This effort helps bring the industry into the next step of its evolution where the right information gets to the right people at the right time – resulting in a more seamless healthcare experience and consumers receiving the care they need – where and when they need it. Our work with Epic stands to benefit more than 14.7 million consumers served by Anthem’s affiliated health plans who see clinicians using Epic’s software.”

This initiative between Anthem, an innovation leader dedicated to improving health, and Epic, a leading health information company, leverages Epic’s Payer Platform. The secure and bi-directional exchange of data using Payer Platform involves clinical data as well as admissions, discharge, and transfer data from hospital stays. Epic’s Payer Platform will be integrated with Anthem’s Health OS, which is Anthem’s operating system to enable seamless health plan-provider collaboration.

“By better bridging communications between providers and health plans, this connection is making it possible for patients to receive timely access to appropriate care,” said Alan Hutchison, Vice President of Population Health at Epic. “This effort will also give clinicians more time to focus on delivering care and improve quality for consumers.”

This capability will help close clinical and medication gaps that may exist in an individual’s care. To do this, Anthem will be able to capture consumer health information provided by clinicians, 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, resulting in higher quality care.

The increased exchange of health data will also help enhance many other aspects of the healthcare journey for providers and consumers by:

  • Streamlining administrative processes, such as prior authorization: Providers 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.
  • Enhancing care management: With near real-time access to consumer health data, clinicians 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.
  • Notifying 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

Payer Platform is available to health systems and providers who use Epic, such as an initial group of health systems that includes The MetroHealth System, an essential system based in Cleveland, Ohio, that operates four hospitals, four emergency departments, more than 20 health centers and 40 additional sites. MetroHealth’s initial focus on Payer Platform will be on care management and improving follow-up care.

“Being able to better communicate and reduce the amount of time we need to spend on administrative processes will allow our clinicians to spend more time delivering care,” said David Kaelber, MD, PhD, MPH, Chief Medical Informatics Officer at MetroHealth. “Improving exchange and interoperability of data will help us give consumers the healthcare experience they have come to expect.”

To advance digital health and as a part of its broader Health OS strategy, 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, labs companies, and other partners. This approach enables providers to have a longitudinal view of a consumers’ health, helping clinicians make more informed decisions.

About Anthem, Inc.

Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves more than 116 million people, including more than 43 million within its family of health plans. We aim to be the most innovative, valuable and inclusive partner. For more information, please visit www.antheminc.com or follow @AnthemInc on Twitter.

About Epic

Visit www.epic.com/about.