Advanced Revenue Cycle Analytics: An Overview

The five year stretch from 2011 – 2016 will forever be remembered as an era of high government regulation in HCIT.  Physician practice adoption of EHR flipped from less than 20% to more than 80% in a short period of time.  EHR companies saw sales skyrocket as a result of the Meaningful Use incentive dollars and the threat of potential future penalties.  Many practices decided they could no longer keep up with the regulatory burden and sold their practice to large health systems.

Now that the dust has settled, practices find themselves with an EHR built to comply with Meaningful Use requirements, not physician needs.  EHR vendors now position their solutions as “platforms” and are exploring opportunities to open their “ecosystem” to third-party developers.

The transition from product to platform may be new to healthcare but this is certainly not new to technology in other industries.  Now that the “Meaningful Use Era” is over, EHR vendors finally have the freedom to listen to their customers and make development decisions based on physician needs rather than government requirements.  The challenge is that there are a lot of physician needs and the EHR vendor cannot quickly deliver on all of these #1 priorities.  This is where the platform concept makes sense and provides leverage to both the EHR vendor and their physician customers.

Third-party developers can use API calls to get data in and out of the EHR.  This allows for innovation, customization, and interoperability to happen much faster than if the EHR vendor had to build all of this themselves.  There may be some EHR vendors who don’t want to play nice, but EHR certification criteria require the use of API standards.

Does all of this sound too good to be true?  Let me give you an example of the power of APIs to reduce the number of clicks for clinical staff.  A large orthopedic practice captured billing information on paper superbills.  Medical Assistants would enter the diagnosis and visit type codes into the EHR, because the physicians did not want to “do the work twice”.  Billing employees would enter the same data into the PM system so claims could be submitted.  White Plume helped design a custom electronic superbill that was fast and easy for the physicians and could automatically send the data to the EHR and PM systems.  Encounter data is captured once with minimal clicks and sent to both clinical and financial systems.

What would you want APIs to do for your physicians?  Let me know, I would love to hear your ideas!