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Health Plans Modernizing Data Through Interoperability

Posted by Opala on November 22, 2022

Health Plans are Struggling with Antiquated Data Systems

The healthcare industry is becoming an increasingly competitive marketplace for software solutions that advance data capabilities.

The status quo for management of patient data has been stagnant but generally considered adequate for many decades; however, new expectations for capabilities are emerging at a rapid pace. Trailblazing health plans are taking steps to confront antiquated systems that are rigid, expensive, narrow-scoped, and unable to meet the requirements of new federal mandates for data exchange.

The old standard for storing and maintaining data is too rigid to support healthcare goals and industry requirements. Existing patient data systems aren’t equipped to handle a variety of patient health records and ultimately thwart value-based care initiatives. Storing, managing, and securing a data system that is located on-premise is an expensive burden that’s no longer necessary.

Health plans should carefully consider the exorbitant costs of building an in-house solution. For many companies, achieving full optimization of data in-house is simply too great of an undertaking. Partnering with an interoperability expert eliminates this pain point and puts power back into the hands of health plans.

Existing data systems aren’t scalable. Data has grown exponentially and has become extremely difficult, if not impossible, for healthcare companies to manage. Additionally, new data needs cannot be fulfilled because older systems are lacking the latest capabilities. Upgrading to a cloud-based system can create a scalable data solution that stands the test of time and can be customized to meet an ever-changing volume of healthcare data. Furthermore, healthcare providers will only adopt data exchange solutions that work for all their patients, so it’s important for health plans to have malleable systems in place.

Recent CMS mandates have begun targeting the existing issues with traditional data management. Health plans are required to create more standardization and accessibility of patient data. Investing in advanced data solutions keeps a health plan compliant and positions the company for future compliance requirements.

Opala Offers a Modernized, End-to-End Solution

Remaining up to date on technical solutions is difficult for health plans that have immense operational outputs and responsibilities to their members. Partnering with an expert in HealthTech, such as Opala, provides health plans with expertise and assurance about how to achieve data interoperability for today and for the future.

The Opala Data Hub is a trusted, timely, and transparent data interoperability resource for health plans. Opala removes the burden of maintaining data management solutions in-house for healthcare companies. As an alternative, Opala offers a proprietary end-to-end solution that upgrades on-premise data stores to a limitless digital data system in the cloud.

Opala is differentiated among competitors in its deep understanding of patient pain points and how they can be solved through efficiencies and collaboration between health plans and providers. Opala specializes in helping its clients skillfully streamline administrative processes, achieve scalability, and develop deeper partnerships for value-based care.

Health Plans Benefit from Modernizing their Data Systems

Leveraging an interoperability partner, such as Opala, prepares health plans to easily scale patient data. For health plans, it’s important to manage data in ways that support ever-changing patient populations. This may mean managing data for new patients, data for new providers, and even data in new formats, such as rich clinical records. In these cases, health plans need to account for data growth by preparing their data platforms to scale easily and efficiently. Opala’s robust, cloud-based interoperability platform offers that level of flexibility and scalability for health plans.

Health plans who seek best-in-class technology choose Opala as an interoperability partner and consider Opala’s platform to be a valuable and strategic business asset. The leading-edge nature of Opala's platform is evidenced through the esteemed brand partnerships supporting components of the Opala Data Hub. Opala's partnership with Smile Digital Health is one example.

Opala leverages Smile Digital Health's proven FHIRⓇ powered health data fabric platform. Smile Digital Health is a leader in health data standardization and has acheived a plethora of certifications and awards. Smile’s data fabric platform allows Opala to provide clients with an efficient, secure, and scalable interoperability solution. Opala and Smile Digital Health are compatible partners due to their dedication to industry-wide interoperability and familiarity serving Blue Cross Blue Shield Association health plan clients.

Topics: Opala Team, case study

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