Current Situation

  • Providers submit financial/administrative transactions directly to payers.

  • Patient data is in the Provider’s EMR and cannot be shared.

  • Regulatory bodies have limited insight into transactions and are challenged to enforce rules and regulations



  • Providers submit information using non-interoperable codes and formats.

  • Physicians have a digital unified 360 view of patient health record including all encounters from facilities a patient has visited.

  • Regulatory bodies can set policies and monitor adherence across facilities and payers.

Future Situation 

  • Advanced clinical registries to track and monitor patients with chronic conditions.

  • Identification of at-risk patients and use of predictive analytics to take preventive actions.

  • Regulatory bodies are able to model policies before rollout; increase automated enforcement of rules and regulations Centralized actions on financial / administrative transactions reducing overhead.