By Jim Dougherty
Each year, people working in the healthcare industry — doctors, specialists, insurance providers, hospital administrators and everyone in between — enter, extract, and exchange millions of pieces of data. Shared health data and administrative information are crucial to delivering a quality care experience, from a patient checking-in at their appointment to the provider getting paid for their service. The administrative tasks that happen behind the scenes should be seamless, yet these are often the most burdensome and disorganized.
But, in another comparable industry — finance — things work a lot smoother. It’s been said before, and we’re saying it again: it’s time for healthcare to take a page out of finance’s book.
I’ll admit, I wasn’t convinced that we’d all have flying cars by the year 2020, but I was hopeful that healthcare would be more regulated and automated by now. Unfortunately, many of the routine administrative tasks, like filling in patient forms, managing provider data, and payer enrollments are still paper-based. The quality of healthcare across the continuum depends on the integrity, reliability, and accuracy of health information. So why are we still using processes that are slow, repetitive, and error-prone?
Prior to Madaket, I was CEO at Intralinks, which facilitates simple and secure data-sharing in the financial industry. At Intralinks we developed and deployed a fintech platform for secure document-sharing and collaboration. It certainly didn’t happen overnight, but I witnessed the finance industry embrace interoperability through automation technology. The results spoke for themselves — workplace efficiency, satisfied customers, and freed up resources.
As an innate problem-solver, I was drawn to healthcare next. Like in finance, I presumed the healthcare industry was begging for better solutions to address similar market inefficiencies.
After months of research with my colleagues, we realized that healthcare did indeed have parallels to finance, but the finance industry had done a better job of regulating and innovating. For instance, digital practices have been adopted widespread and banks seamlessly move money and data, using a universal, cooperative system called the Society for Worldwide Interbank Financial Telecommunication, or SWIFT.
Industrywide standards and practices helped form a common language and collaborative environment within the finance sector. In healthcare, we have seen similar attempts to standardize, like with the extensive rollout of EHRs and HIEs. And more recently, CMS announced the formation of the Office of the Burden Reduction and Health Informatics, an organized effort to reduce regulatory and administrative burden and part of the agency’s Patients over Paperwork initiative.
However, there are plenty of ineffective processes left to solve for. Further into our research, we learned about the inefficiencies of provider data management and the multiple pain points in the payer-provider relationship. We felt compelled to take what we did in finance and apply it to healthcare to solve something meaningful.
At Madaket, we’ve taken a convoluted set of tasks — provider enrollment and payer enrollment — that wasted hours of time and billions of dollars and created more straightforward processes that save time and money by accelerating and simplifying every step, benefiting providers, payers, and everyone in between. Our platform streamlines the complicated, slow process of managing provider data, from initial enrollment through regular recredentialing.
We did it first in finance, and now we’re doing it in healthcare. And based on what we’ve learned from our partners, there is plenty of work left to do.
Jim Dougherty is an entrepreneur and innovator, specializing in disrupting manual administrative processes by introducing new automation in healthcare and finance. As CEO of Madaket Health, Jim leads the team toward its goal of automating healthcare’s hidden administrative transactions for frictionless payer-provider relationships.