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Ep 186 – Uniting the Ecosystem: The Power of Data Interchange and Interoperability, with Venkat Kavarthapu and Dr. Summerpal Kahlon

Ep 186 – Uniting the Ecosystem: The Power of Data Interchange and Interoperability, with Venkat Kavarthapu and Dr. Summerpal Kahlon

Released Wednesday, 11th October 2023
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Ep 186 – Uniting the Ecosystem: The Power of Data Interchange and Interoperability, with Venkat Kavarthapu and Dr. Summerpal Kahlon

Ep 186 – Uniting the Ecosystem: The Power of Data Interchange and Interoperability, with Venkat Kavarthapu and Dr. Summerpal Kahlon

Ep 186 – Uniting the Ecosystem: The Power of Data Interchange and Interoperability, with Venkat Kavarthapu and Dr. Summerpal Kahlon

Ep 186 – Uniting the Ecosystem: The Power of Data Interchange and Interoperability, with Venkat Kavarthapu and Dr. Summerpal Kahlon

Wednesday, 11th October 2023
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Data interchange and interoperability are the keystones of a united ecosystem for value-based care, where information flows seamlessly, connecting patients, providers, and payers to drive better outcomes, lower costs, and improved patient experience. Overcoming siloed information is the key to breaking down the barriers that fragment care delivery, and in doing so, we unlock the potential for a healthier future for all. While health data interoperability has arguably become an industry buzzword over the past decade, the concept's importance for digital health transformation cannot be understated. The benefits of optimal interoperability in healthcare includes improved care coordination for patients and reduced administrative burden for healthcare payers and providers. Interoperability also supports public health surveillance and population health initiatives that are so critical to value-based care transformation.In this podcast episode, you will hear from two executives on a mission to unlock greater value in American healthcare by aggregating, normalizing, and unifying data.  Venkat Kavarthapu and Dr. Summerpal Kahlon are the Chief Executive Officer and Chief Medical Officer for Edifecs, a Best in KLAS interoperability platform that serves as the foundation for the solutions that eliminate stakeholder friction to overcome healthcare’s biggest challenges. We discuss how interoperability will accelerate value-based payment adoption and help providers obtain more complete and accurate care funding for alternative payment models. We cover such topics as the future of AI, the potential for automated prior authorization, how ACO REACH will drive population health management, and the collaboration that is enabled by technology.Episode Bookmarks:01:30 Introduction to Venkat Kavarthapu and Dr. Summerpal Kahlon and their company Edifecs that provides a leading interoperability platform.04:00 Industry struggles to implement interoperability requirements of the CMS Interoperability and Patient Access Final Rule.04:30 The benefits of interoperability and how it serves as a foundation for value-based care.05:30 Venkat discusses how value-based care is the only path forward in creating a sustainable healthcare system.06:30 The need for data to improve patient experience and quality of care.07:00  “True value-based care can only be accelerated if information is available to all entities in all three dimensions – clinical, administrative, and financial.”08:00 Exchanging information across organizations and between systems without friction, while ensuring privacy and security.09:00 How data siloes create healthcare dysfunction.10:00 Extreme data siloing increases data management costs (25-30% of total cost spent to ensure data accuracy).10:30 Payer-provider collaboration supports value-based care but is still limited by interoperability adoption.12:00  “Driving interoperability is not a burden on the industry, but a true competitive advantage for the industry.”12:30 How interoperability reduces administrative burden and the cost of human capital.13:45 “An interoperability framework can drive a meaningful dialogue, and communication is key to driving good patient outcomes.”14:30 Summer describes how an overly-fragmented healthcare system that still relies on fax machines contributes to data inaccuracy.16:00 Emphasizing data accuracy within an interoperability framework ensures patient safety.16:30 How Natural Language Processing and AI can provide context and improve communication at the point-of-care.19:00 CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule20:00 The need for fully automated Prior Authorization (PA) enabled by EDI processing, FHIR-based APIs, AI/ML, and NLP.21:45 Electronic PA will foster payer-provider collaboration and drive clinical decision support.23:30 PA transactions are only automated 30% of the time at present (compared to 90% or more ...

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The Race to Value Podcast

We are in a race to make health value work in the country. The imperative to drive health value is no longer an optional transition. The unsustainable upward cost trajectory of U.S. healthcare spending, coupled with declining outcomes and disparity gaps, are leaving vulnerable populations woefully underserved. To win the “race to value” we me must have disruptive innovation, spirited collaboration, democratized knowledge, realignment of the healthcare workforce towards value-based care competencies, and a collective moral purpose to reform our industry.In this podcast, leaders from the Accountable Care Learning Collaborative (ACLC) interview the top healthcare executives and entrepreneurs to discuss healthcare’s value economy. Race to Value is the show to connect you with other healthcare leaders working to create better value in health, including provider organizations —hospitals and health systems, physician practices, and post-acute providers — health plans, pharmaceutical and life-science firms, health information technology firms, medical device manufacturers, and a multitude of other stakeholders. We are the ideal resource for leaders of healthcare organizations looking to transition to and thrive in the new reality of value-based care.The race to value is not unlike any other social movement. As a nonprofit organization focused on industry transformation, the ACLC is here to catalyze a movement to value-based care. Patients are being harmed by the current healthcare system which is fraught with perverse financial incentives and structural distortions. Additionally, physicians are experiencing moral injury because they cannot care for patients in the way in which they intended when they began medical training. With its Accountable Care Atlas, a development guide for competency implementation, the ACLC is working with healthcare organizations all over the country to create the workforce of tomorrow.There is a better way. The Race to Value podcast is here to bring to you the brightest minds making waves in the industry with their leadership and innovation. Our mission is to harness their brainpower to facilitate transformation in our country’s healthcare system. Come join us to listen to these disrupters as they share their vision to reorder the healthcare universe. Now is the time to get inspired -- we can win this race to value.

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