Optimizing Provider Data Management Systems and Their Impact on Hospitals

Updated on January 21, 2024
Big Data in Healthcare and Its Impact on Patient Care

As hospitals and health systems continue to adapt to keep up with the evolving healthcare landscape, they must prioritize maintenance on the engines that keep them up and running – Provider Data Management Systems (PDMS). Although often overlooked, PDMS play a crucial role in the effective functioning of hospitals and healthcare systems, as they serve as a centralized system to link and manage provider data across the organization. For example, one effect of an inadequate PDM system is delayed credentialing, which inhibits clinicians from seeing patients, spurs security and compliance missteps, and creates bottlenecked workflows. PDMS must be optimized amongst hospitals to keep them running smoothly, while also increasing revenue and saving precious time. 

Challenges of Insufficient PDMS

Credentialing and privileging are vital functions in healthcare, ensuring clinicians meet the necessary standards and qualifications to deliver patient care. Inadequate PDMS cause delays in the credentialing and privileging processes, hindering the inclusion of clinicians in the network and ultimately disrupting patient care. Not only does this affect patients, but hospitals can face substantial financial losses. An average delay in credentialing/privileging costs health systems a staggering $9,000 per physician per day. Over the course of a year, these delays can snowball into a crushing $500,000 to $760,000 burden.

In addition to negative financial ramifications, inadequate PDMS can also inflict severe reputational damage. Outdated provider information becomes a significant liability, opening the door to security vulnerabilities and regulatory violations. Furthermore, the bottlenecked workflows resulting from subpar PDMS create an environment resembling gridlocked traffic, hindering the timely delivery of care. These issues culminate in delays and frustration and ultimately compromise patient experiences, potentially leading to legal repercussions while also eroding patient trust in the healthcare system.

Strategies for Effective Provider Data Management

Overcoming these challenges is possible, and healthcare organizations can implement several key strategies to ensure the effective management of provider data. Firstly, real-time updates and automation should be at the forefront of PDM efforts. Automation not only ensures data accuracy but also keeps it up-to-date, significantly reducing manual errors and streamlining processes. Secondly, fostering a culture of collaboration among IT, HR, and clinical teams is essential for PDMS to run smoothly. This cross-departmental teamwork breaks down any silos and enhances accuracy and organization. Lastly, harnessing technological solutions, particularly artificial intelligence (AI), can revolutionize PDMS. Recent surveys indicate that 92% of large companies reported achieving returns on their data and AI investments in 2022, highlighting the financial benefits of incorporating a provider data management system that is rooted in technological efficiency.

Effects of Successful Provider Data Management System

The advantage of a robust PDMS extends throughout the entire healthcare ecosystem, from addressing labor shortages, to bolstering revenue streams. Currently, workforce shortages loom large with the United States projecting to face a shortage of up to 124,000 physicians by 2034, according to the Association of American Medical Colleges. Effective PDMs play a pivotal role in reducing administrative burdens that contribute to provider burnout, allowing healthcare professionals to dedicate more time and energy to patient care rather than credentialing paperwork. This not only creates a healthier working environment, but it also results in increased health system revenues. For instance, symplr’s ROI calculator presents a remarkable 20% increase in revenue when these processes are optimized.

Provider Data Management Systems hugely impact the entirety of healthcare organizations and their ability to function properly. The challenges posed by inadequate systems can cast long shadows over healthcare institutions, affecting operational efficiency, finances, and patient care. However, by prioritizing robust PDMS, these organizations can ensure precise network memberships, regulatory compliance, and operational efficiency, ultimately leading to enhanced patient care and stronger institutions. Optimized Provider Data Management Systems are not just a tool, but a necessity for operational success.

William Christy
Bill Christy

Bill Christy is EVP, Managing Director of Provider Data Management at symplr.