"Most EHRs and medical devices are not interoperable, leading to fragmented care coordination and reliance on manual processes. Technical, socio-technical, and market barriers contribute to the prevalence of data silos and hinder the flow of information across the care continuum."

In the recent case involving Frank Lill & Son, Inc., the Connecticut Supreme Court addressed a crucial issue in workers' compensation claims: the distinction between mailing and filing notices within statutory deadlines. Despite the employer's timely mailing of the notice, the court ruled that filing necessitates actual receipt by the judge within the specified timeframe. This decision underscores the challenge of ensuring clear communication and timeliness in the industry. Introducing solutions like Swiftivity becomes imperative to alleviate such issues by streamlining claim submission processes and minimizing delays in communication between stakeholders.

Despite substantial investments from tech behemoths and a surge of interest from both healthcare and AI sectors, the gap between expectation and reality remains palpable.

In recent studies, up to 75% of healthcare workers are projected to leave the profession by 2025 due to burnout and other challenges. This staggering statistic underscores a looming crisis in healthcare. What factors are driving this exodus, and what can be done to address it? We must uncover the urgent need for action in safeguarding the future of healthcare.

The unveiling of the CMS Interoperability and Prior Authorization final rule (CMS-0057-F) on January 17, 2024, marks a pivotal moment in healthcare regulation, impacting stakeholders across the industry. Presented during the Workgroup for Electronic Data Interchange (WEDI) meeting held on April 8th, 2024, this comprehensive rule sets forth stringent provisions aimed at enhancing data exchange standards and streamlining prior authorization processes. This presentation emphasized the significance of these regulations in propelling forward the interoperability agenda within the healthcare landscape.

FHIR provides a common, standardized way for different healthcare systems to communicate, akin to a universal language for healthcare data exchange. It's pronounced "fire," and appropriately so, as it ignites a new era of interoperability in healthcare.

The overarching goal is to streamline the electronic exchange of health information and prior authorization processes for medical items and services. These initiatives are projected to save approximately $15 billion over the next decade.

For healthcare providers and those handling workers’ compensation claims, data is key. While the concept of data interoperability is not a new one for healthcare or workers’ comp industries, much progress needs to be made.

Insurance professionals — as well as the insurance and healthcare industries as a whole — all have a duty to the clients and patients they serve. Similarly, solution providers like us have a large responsibility to assist both payors and providers in their mission to deliver the most expedient, high quality service for those in their care.

The world continues to fight against the COVID-19 pandemic on multiple fronts, but perhaps most affected is the practice of medicine. Lockdowns, quarantines, and other travel restrictions have helped to spur massive growth in telehealth. Prior to the pandemic, telehealth claims grew 53% in one year, says the AMA; faster than any other sector.