Healthcare: federated and distributed

Posted on Mon, Apr 26, 2010 – 05:31 am at |

Most folks unfamiliar with the administrative healthcare space imagine the transactions are much more automated than is true of the current state of affairs. One would assume that if Medtronic CEO Bill Hawkins is talking about turning pacemakers, stents, and defibrillators into tiny mobile devices–each with their attendant messages zipping to and fro–and Matt Bowman can report about how CrowdFlower powered Haiti relief by crowdsourcing the translation of text messages, that the paper chase of the business side of healthcare must be a figment of some bygone era. One would assume wrong.

Zahoor Elahi, Vice President & General Manager of Health and Financial Network Solutions, FIS Healthcare Payment, suggests a different, future scenario in which "Providers access an easy-to-use portal to manage all claim payments and receivables. Through the portal, providers register their office locations and depository accounts, authorizing payers to initiate electronic claim payments." He continues that for "approved claims, payers transmit payment and remittance details through the portal. Rather than receiving paper checks and remittance documents which can require substantial effort to post/reconcile, providers receive payments (EFT) and remittance advice (ERA) electronically." He thinks that since "status notifications are sent to both the provider and the payer throughout the process" that Providers would be "able to log-in to view, search, and download their payments and electronic remittance information (in human readable formats) and upload data back into their practice management application (PMS)."

The strange parallel is that as administrative healthcare modernizes toward the portal model, the delivery side is moving both toward portals (EHRs) and more distributed mHealth. See, for instance, the programs of the upcoming conferences Using Mobile Technologies to Improve Family Planning, Maternal Health and Newborn Services in the Developing World, May 5, and the mHealth Conference and Expo, Dubai, UAE September 14-15. You can also review FrontlineSMS:Medic, the mobile applications database and the SMS Open Source topic area. I’d encourage the medical bankers to watch the potential distributed medbanking technologies like FrontlineSMS:Credit (and here) as well. I’m pretty certain RBS WorldPay and Western Union will be.