We’ve all been there…sitting in the waiting room of a doctor’s office with a clipboard on our lap and a deep pile of forms for us to complete. We might be in pain or feel ill. We might be scared or anxious about our upcoming appointment. We’re trying to remember the drug name, dose, and prescribers for the medications we take. We’re looking for our insurance card, and the phone number of our emergency contact. We may be confused or unsure of what this appointment will cost or be wondering if we are even at the right care setting to get the healthcare services we need.
Despite spending significantly more than any other developed nation on healthcare (almost $11,000 per person each year), patients in the US are suffering from an inefficient and confusing healthcare system. The root cause of this underperforming US healthcare system is often inadequate information, and a few innovative companies are focusing on bringing modern data and technology to healthcare.
Founded as Project Connect in 2020, Opala has partnered with health insurance companies and provider organizations to improve information exchange. For years, health insurance companies and provider organizations have been aligning incentives around quality of patient care, patient experience, and cost of care through value-based contracts. Value-based contracts provide the economic driver, but inadequate information has been impeding the transformation required for true change.
Providers need patient information, such as all the data collected from patients on that clipboard in the waiting room. Your doctor doesn’t know every diagnosis you have received from other providers. Your doctor doesn’t know whether you are filling the prescriptions they have prescribed or whether you’ve been prescribed prescriptions by other doctors. If you’ve been hospitalized or seen a specialist, your doctor probably has little to no information about those healthcare encounters as well. Without your complete healthcare history, your doctor is likely to repeat a test you’ve already had or recommend a treatment that conflicts with other provider advice you’ve received.
Ultimately, the burden is on the patient at each doctor appointment to provide the most relevant, accurate information they can recall. Powered by opalaCORE, a comprehensive record of healthcare history, providers will be able to access real time information creating a digital bridge to improve overall patient and member experience.
Eventually, this will include information about the patient’s health insurance coverage, so doctors can recommend treatment options that will work for the patient. For example, patients state that affordability is the main reason they do not take their medications as prescribed. There are often clinical equivalents that could be offered by a doctor. Similarly, if a patient cannot find a mental health provider with available appointments, then they aren’t likely to follow through on that referral. To recommend treatment plans that work for the patient, providers need to consider cost implications and personal preferences and needs. Opala solutions empower providers with the information they need to deliver this level of personalized care.
Opala and its partners are imagining a new healthcare experience for patients that is as informed, convenient, and secure as buying a cup of coffee.
When you order your favorite latte from a local coffee shop, you easily transfer a very precise amount of money from your bank account to that business. It doesn’t matter where that money came from – it may have been deposited from your employer, maybe you made a mobile deposit earlier that week, or maybe a friend electronically transferred funds to reimburse you for a dinner date. You aren’t worried about the security of the information you shared with the coffee shop to pay for your coffee. You know you won’t get a surprise bill for an unknown balance that the coffee shop later determined that you owe for your latte. There are no delays between when you get your latte and when the coffee shop receives your payment. It’s “auto-magic,” but most importantly, it works for you, the consumer. Opala and its partners are imagining a new healthcare experience for patients that is as informed, convenient, and secure as buying a cup of coffee.
Join us for this webinar on “Improving the Patient Experience: The Value of Data Exchange in Healthcare” with Rami Rafeh, VP of Provider Strategy & Collaboration at Premera Blue Cross, Nathan Johnson, VP of Integrated Products at Premera Blue Cross, and Meghan Quint, VP of Solutions and Customer Success at Opala.