Anthem and Epic team up to improve news delivery


Prior authorization process should be streamlined with more efficient data exchange

Anthem Inc. works with Epic to facilitate a secure two-way exchange of health information between providers and Anthem health plans. Over 14.7 million patients are served by Anthem health plans which see clinicians using Epic software. The data exchanged includes clinical data as well as hospital admissions, discharges and transfer data.

This collaboration will help fill clinical and drug gaps that may exist in an individual’s care, according to Anthem. To do this, Anthem will be able to capture consumer health information provided by physicians, analyze that data, and develop insights based on the data. This information can then be transmitted to the healthcare team – in near real time – to signal potential healthcare needs and inform treatment decisions.

Increased exchange of health data will help:

  • Streamline administrative processes, such as pre-authorization: Doctors will be able to send pre-authorizations through Epic instead of using the phone or fax. Health plans can then make decisions quickly and communicate electronically with the provider, reducing administrative burden and freeing up staff to spend more time in care.
  • Improve care management: With near real-time access to consumer health data, physicians will gain additional insight into preventive care recommendations and correct care gaps, such as medication adherence, to help them develop improved, proactive and personalized care plans.
  • Inform providers of important health events: Providers will be notified when their patients are discharged from hospital and encouraged to provide more timely follow-up care

Anthem will also integrate this near real-time data with the claims data and health information Anthem receives from sources such as health information exchanges, lab companies and other partners. This approach allows providers to have a longitudinal view of the health of consumers, helping physicians to make more informed decisions.


About Terry Gongora

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