Health IT innovators successfully collaborated to launch the first prior authorization automation solution using HL7® Da Vinci Project's FHIR standard
SEATTLE, Wash., Oct. 25, 2022 /PRNewswire-PRWeb/ -- MCG Health, part of the Hearst Health network and an industry leader in evidence-based guidance, announces the nation's first implementation of a prior authorization automation solution between a payer, provider, and technology vendor using the HL7® Da Vinci Project FHIR (Fast Healthcare Interoperability Resources) standard.
MCG and MultiCare Connected Care collaborated successfully to use MCG's interoperable application to surface and automate clinical requirements for prior authorization requests natively from electronic health records (EHR) at the point of care to payers using HL7 FHIR standards. With real-time data exchange and communications, the solution is expected to significantly reduce authorization decision times to support timely patient treatment, alleviate administrative burden for both hospitals and health plan staff, and decrease the overall costs of care delivery.
MCG and MultiCare are members of the HL7® Da Vinci Project, a national, private sector initiative to accelerate the use of HL7® FHIR to enable value-based care through interoperable data. MultiCare is utilizing the MCG Authorization application to surface transparent policy requirements and automate the retrieval of clinical data needed to establish coverage within the payer and provider workflow. MCG used the Da Vinci Implementation Guide (IG) for Documentation Templates and Rules (DTR) to accomplish the transparency and automation requirements.
"This implementation marks a new era for patient treatment and is a sterling example of successful industry collaboration," said MCG President and CEO, Jon Shreve. "Through this innovative approach, MCG can help MultiCare automate evidence-based decision-making within their existing clinical workflow. The results of this endeavor will provide far-reaching benefits to hospitals, health plans, and most importantly, the patient."
For more information on the MCG solution pivotal to this implementation, visit https://appmarket.epic.com/Gallery?id=13309.
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About MCG Health
MCG, part of the Hearst Health network, provides unbiased clinical guidance that gives healthcare organizations confidence in delivering patient-centered care. MCG's artificial intelligence and technology, infused with clinical expertise, enables its clients to prioritize and simplify their work. MCG's world-class customer service ensures that clients maximize the benefits of licensing MCG solutions – demonstrating improved clinical and financial outcomes. For more information visit http://www.mcg.com or follow our Twitter handle at @MCG_Health.
About MultiCare Connected Care
MultiCare Connected Care (MCC) is an independent Accountable Care Organization (ACO) established in 2014 as a wholly owned subsidiary of MultiCare Health System and operates as an independent entity. It is transforming healthcare as a population health engine that represents a Clinically Integrated network (CIN) of independent & MultiCare Health System clinicians services across the entire social medical model of care. Under this entity 350,000 lives are served within 30 value based contracts.
Unlike the traditional "fee for service" health care model – where each visit, service, test and procedure has a separate cost – MCC's foundation is built first and foremost on providing patient centered quality care at an appropriate cost. Specific measures are used to determine how well doctors, hospitals and other providers are keeping healthy people healthy, effectively treating illnesses, and helping people better manage their chronic conditions. In this way, all the participating providers share the responsibility of providing patient centered, high quality, efficient, cost-effective care.
MCC has established a comprehensive Clinically Integrated Network (CIN) comprised of doctors and other health care providers, as well as hospitals, clinics and other health care services, such as imaging, labs and pharmacies. The CIN includes independent health care professionals in the community, as well as MultiCare employed providers totaling over 5,100 clinicians providing services across the continuum of care.
About the HL7 Da Vinci Project
As an HL7 FHIR Accelerator, the Da Vinci Project is a private sector initiative comprised of industry leaders and health information technology technical experts who are working together to accelerate the adoption of HL7® FHIR® as the standard to support and integrate value-based care (VBC) data exchange across communities. The Da Vinci Project focuses on minimizing the development and deployment of one-off solutions between partners with a goal to help all clinicians and health plans to better deliver clinical quality, value and care management outcomes. The core focus of phase one of the project is to deliver implementation guides and reference software implementations to the public for data exchange and workflows necessary to support providers and payers entering and managing VBC contracts and relationships. To learn more about the Da Vinci Project, visit https://confluence.hl7.org/display/DVP/Da+Vinci+Welcome.
About Hearst Health
The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person's health journey. Care guidance from Hearst Health reaches the majority of people in the U.S. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase and MHK (formerly MedHOK). Hearst also holds a minority interest in the precision medicine and oncology analytics company M2Gen. Follow Hearst Health on Twitter @HearstHealth and LinkedIn @Hearst-Health.
Media Contact
Arri Burgess, MCG Health, (206) 389-5405, [email protected]
SOURCE MCG Health
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