The Overlooked Side of Patient-Centered Care

Posted by Lincoln Popp on May 18 2019

Over the past decade, the U.S. healthcare system has embraced the concept of “patient-centered care.” 

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Academic papers have been written on the subject, and the idea has been codified by institutions such as the New England Journal of Medicine.

Most definitions of patient-centered care focus on the clinical side of healthcare. They talk about elevating patient voice, personalizing treatment plans, regarding family members as part of the care team, and prioritizing patient comfort and well-being.

At Lumedic, we’re focused on an equally important component: the patient financial experience.

Today, patients are often confused and frustrated by the complex and often bewildering maze of administrative tasks necessary for insurance validation, billing statements, payments and reimbursements — what the industry refers to as “revenue cycle management.”

We believe patients deserve more simplicity, greater transparency and faster delivery of information about the financial aspects of their care.

Our mission is to create an entirely new process for exchanging information, based on technologies that are both new and tested, to remove the financial, emotional and physical pain resulting from healthcare administration today. We want to start fresh, from the ground up, with the patient at the center.

Virtually everyone involved in healthcare knows today’s approach is extremely inefficient. Healthcare back-office professionals, caregivers, patients and payers acknowledge the waste in the system and the need for change. And the waste is enormous, about $400 billion in 2018 alone, according to McKinsey.

One challenge is that today’s revenue cycle management system has grown incrementally, with spurts of innovation often bolted onto antiquated processes and legacy technologies — all while serving millions of patients and caregivers. Radical change has been hard to imagine, let alone execute.

Thankfully, we’re now at a moment where technology has improved to such an extent that it is both possible and necessary to take an entirely new approach to healthcare administration that truly does put patients at the center.

Using artificial intelligence, machine learning and distributed ledger technologies such as blockchain, we can streamline how payers and providers collaborate– among ever-increasing patient-centric expectations.

The Lumedic solution replaces outdated systems and data silos with new tools that create and leverage a single point of truth among all parties, drastically reducing the complexity of IT systems and data management.

How will this make a difference for patients?

First and foremost, by enhancing the “sacred encounter” between individual patients and their care providers. By simplifying the administrative processes that accompany any doctor visit, caregivers can give their undivided attention to their patients and their treatment needs when they are together.

Second, by enabling better health outcomes thanks to a streamlined process for receiving prior authorization for critical treatments. Prior authorization is a notorious pain point for patients, caregivers and payers alike, with delays sometimes resulting in postponed treatment that can cause serious harm to patients, not to mention greater costs and inefficiencies for providers.

Third, by ensuring stronger security and privacy protections for patient data. One of the great advantages of distributed ledger technologies is their ability to safeguard information that needs to be shared among multiple stakeholders, such as health data transferred between patients, caregivers and payers.

Finally, by providing greater certainty and predictability about healthcare costs. A more efficient revenue cycle management process will one day enable caregivers to give patients accurate estimates of the costs of proposed treatments as soon as they are suggested.

This is just the tip of the iceberg when it comes to the many ways Lumedic hopes to enable and enhance patient-centered care. We look forward to sharing our progress as we refine our approach over the next few years.