The U.S healthcare system is comprised of many independent silos – primary care physicians, specialists, hospitals, pharmacies, labs, and more.
Add to the mix the variable regulations and requirements of workers’ comp insurance, and this complex environment makes it challenging to maintain an efficient flow of communication. Important pieces of information can be lost in the gaps between silos, causing delays, misdirected treatment, unnecessary costs, and compromised care.
Risk & Insurance® sat down with thought leaders across Healthesystems to discuss failed connections that can create obstacles to timely and effective care for injured workers, as well as the latest solutions to address and prevent information and communication gaps by driving for a more thoughtful synergy between people and technology.
Within this article, the following leaders speak to the topics described below.
Mike Theis, Director of Enterprise Analytics, discusses using technologies like Natural Language Processing (NLP) to better leverage unstructured data into analytics systems that drive claims management.
Silvia Sacalis, BS, PharmD, VP of Clinical Services, speaks to the importance of recognizing and flagging risk indicators and addressing them as soon as possible within a claim, using technology to detect those risk indicators, and to start the conversation quickly.
Stephanie Arkelian, Director of Product Management, explains why centralizing information maximizes efficiency for the adjusters managing injured worker claims, helping them to make the best care decisions possible for their patients.