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Payers and providers should come together in the cloud

by Brendon Nafziger, DOTmed News Associate Editor | June 27, 2013
From the June 2013 issue of HealthCare Business News magazine


In a recent white paper, Rizk sketched out a possible system, suggesting it would be a cloud-based one, working on servers that give joint access to payers and providers. He thought the costs for setting up the system might, potentially, even be borne jointly by insurance companies and health care facilities, or even by competing payers, willing to put aside their rivalries because of the benefits such a system would bring.

Processes are important, too

But Rizk is careful to stress that the technology is not a panacea. Any system, even one that realizes the 10-year goal of uniting payer and provider systems, is only as good as the processes that go along with it.

Rizk illustrates this with a story. Not so long ago, he took his mom to the emergency room at the Chicago hospital where he used to work and which had recently made a fuss about going “paperless,” with every department connected by fancy electronic systems. The woman in the ER who received Rizk’s mom asked her a series of questions: her name, what complaint brought her to the ER (abdominal pain), and so forth. Rizk’s mother was then passed along to another woman, who was actually standing right next to the first one, and who asked the same questions. Eventually, she was sent to triage, where — you guessed it — she had to answer the same questions yet again. It took about six hours to eventually get a CT scan, a less than 5-minute procedure that Rizk said could have happened right away.

“The ER became paperless but they didn’t change the process,” Rizk explains. “It’s just not technology that’s going to solve everything. There are process changes, operational changes. Technology’s not going to wave a magic wand and (solve everything).”


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