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The Payer Perspective: Re-Defining Data to Connect Millions

Staff, Appian
September 14, 2015

Healthcare-oriented wearables are most commonly part of a disease management program or as a personal health device. However, wearables on the provider side are just half the story of why healthcare is on the cutting edge of the newest wave of technology innovations. Forward-looking health payer organizations are adopting similar mobile strategies to take advantage of the wearables phenomenon.

One of the United States' leaders in health care solutions for the underserved and chronically ill has deployed an enterprise-wide transformational program for managing all operations associated with provider enrollment and provider data maintenance. These areas are of strategic importance to the business, as provider data informs the organization's relationships with all of its customers. The organization's first application gives Account Executives a native mobile, integrated solution to facilitate required inspections of provider offices to ensure they meet regulatory standards. While the scope of the entire transformation program is large and multi-faceted, this "mobile-first" quick win was used to start driving immediate value in accelerating provider on-boarding and compliance.

With razor-thin margins and high regulation, health payers must operate with efficiency and accuracy to avoid spikes to insurance costs. Elements of wearables and enterprise mobility present a tremendous opportunity for these organizations to leverage mobile devices to collect data from providers looking to partner with payers to offer top-end healthcare solutions. For this organization, the mobile inspection application presents a perfect opportunity for a wearable device.

Having the application run on a smartwatch would allow the payer to easily assess and collect data on the health center under review to decide whether they are a candidate for a partnership. Removing manual upload or spreadsheet management of data would drastically reduce the time for a health institute moving from under review to up and running and offering patient services.

While the onset of wearables and smart devices in the healthcare industry is exciting, its potential value goes far beyond novelty. The data itself, not the device on which data is collected and transmitted, holds the transformational gains wearables can bring to worldwide health initiatives.

The advent of wearables and smart devices in healthcare means a tremendous increase in how much data is out there to potentially be used. The crucial issue is how to make use of that data to accelerate positive health outcomes, operate efficiently to reduce cost and improve margins, ensure compliance, and improve the consumer experience. Both on the payer and provider side, organizations must be able to easily gather and interpret data to quickly turn knowledge into action to ensure optimal care.

-Mike Ingrisano, Media Relations Manager