Humana, athenahealth partnership to integrate payer data into EHRs

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EHR vendor athenahealth, Inc., and health insurer Humana Inc., have entered into a multi-year collaboration that will add health plan data to the vendor’s software, athenaClinicals.
The goal of the partnership is to improve health outcomes for Humana’s members by giving providers the information they need at the point of care to help them make informed decisions for their patients, Paul Brient, chief product officer at athenahealth, said via email.
“We also seek to reduce the administrative friction by automating often manual tasks such as pre-authorization,” he added.
Per the collaboration, health plan data will be integrated into patients’ medical records, providing clinicians with a view of both the patient’s clinical and supplemental data. In addition to supporting clinical decision making, access to both types of data can help providers spot gaps in care.
For example, diabetics need several annual appointments, including blood pressure screenings, blood sugar control tests, eye exams and medication reviews. The integration of Humana’s data into athenahealth’s EHR software can be used to generate automatic appointment alerts, which providers can then use to make sure their diabetic patients do not miss medical visits, Brient said.
“At Humana, we constantly strive to help providers deliver better outcomes to members and enhance our providers’ healthcare experience,” Alan Wheatley, Humana’s retail segment president, said in a news release. “Working closely with athenahealth allows us to improve care quality and simplify administrative processes for provider organizations.”
To integrate Humana’s data into its software, athenahealth will rely on its application programming interfaces.
“athenahealth is one of the most open EHRs and is built using an API-first methodology,” Brient said.
Real-time, standards-based APIs will be used for data exchange wherever possible, and where standards do not yet exist or real-time calls are not necessary, athenahealth may use non-standards-based APIs, he added.
The collaboration is a long-term one, with the initial agreement extending for five years.
“Connecting payers and providers is a vital step toward realizing our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all,” Bob Segert, chairman and CEO of athenahealth, said in a news release.
Further, the new collaboration builds on the payer’s use of athenahealth’s Real-Time Benefits Check, which enables providers to determine a Humana plan member’s prescription benefit coverage and their drug costs.
The payer has been making significant investments in digital collaborations to improve member outcomes and experience. It recently partnered with digital health startup Vida Health to offer Vida’s virtual diabetes management program to its Medicaid members in Kentucky.
Photo credit: 9amstock, Getty Images

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