An OECD (Organisation for Economic Co-operation and Development) report from 2019 used a great term that captures the state of data regarding healthcare – “data rich but information poor.” This is a common phrase in the era we live in now as all parts of the economy try to eke out the compounding effects data can have on performance. Taking data as a dimension of digitization, it is fair to say that the healthcare industry is likely a laggard in data as McKinsey ranked healthcare as the second least digitized, just ahead of construction. Looking at how countries’ data capabilities compare across healthcare, OECD mapped data governance readiness and operational readiness. Ireland’s position (image below) shows we have a way to go before becoming information-rich.
Despite the slow start, Ireland’s position relative to other OECD countries is just that, relative. It’s not a race, it’s a journey. And Ireland is on the first leg of that journey and the first part is the digitization of the most fundamental piece of data available to medical providers – the patient’s record. As more and more providers adopt a digital-first approach to this critical piece of the journey, they need to ask how they can leverage this data for better outcomes for both the patient and the provider.
From the perspective of hospital managers, the story of the patient, as told through the lens of an EHR, provides critical operational detail that gives rise to better planning such as staffing requirements or bottlenecks in the system. The EHR (Electronic Health Record) becomes the source of truth for managers and enables better onward processes and understanding of business leakages. In the medical billing space, a system that pulls directly from the EHR ensures greater accuracy in the claim form meaning hospitals can realize greater income. Central to this question is the interoperability of systems. Onward investment from hospital managers requires them to look carefully at how the new software will communicate with the EHR and for the two systems to then become greater than the sum of their parts.
In MedoSync, we have a fully developed integration engine built in Graph QL, that integrates easily with existing patient systems. This integration automates a lot of the existing requirements for claim creation. More importantly, as the process is digitized it captures the more common errors for quick rejection and stops the claim from going to the insurer if there is any incorrect detail.
The data picture I painted at the start is stark but viewed another way, it is exciting. Those involved in the running of hospitals are standing at the precipice of the new frontier. They can make the big strategic changes that will transform how their business works and generate returns for their shareholders. There is also a benefit in going second last. They can make these choices as they look across sectors and countries to see those who have failed and, crucially, those who have succeeded.
Hospitals are losing 6-9% of their revenue due to leakages in the billing process. MedoSync stops these leakages by creating the invoice in real-time and ensures hospitals get paid in full.
I am taking more time for reflection and writing up posts related to MedoSync’s areas of expertise: medical billing, healthcare, technology, and being a start-up in that ecosystem.