Cloud technology is fast becoming a tool used to help insurers store and analyze claims data as payers move to more nimble IT architectures.
Cloud-based storage of claims data will give payers the opportunity to strip away inefficiencies backed into legacy systems, where onerous manual processes can also lead to costly errors or lost information.
“If you’re relying on legacy systems, there is a strong likelihood of that data leaking off, or some type of data loss,” said Larry Ponemon, chairman and founder of the Ponemon Institute. “Claims data, to do it right, requires that you have a high capability for analytics and different tools available.”
Welcome to the cloud
Data leakage, or the potential to avoid it, is where cloud-based analytics can be of huge help to insurers, Ponemon explained, especially when it comes to building a history to assess the validity — or anomalies — of transactions or claims.
“Claims data can be very complex, if there’s an Achilles heel of an insurer, it’s managing the claims information,” Ponemon noted. “With the cloud, you have tools that give you the ability to look for patterns of information, which you couldn’t do unless you made a huge investment in IT.”
Cloud-based customer relationship management (CRM) platforms, for instance, can help insurers integrate claims data, health records and customer interaction tools into one platform.
These types of programs are designed to make it easier to provide patients with things like pre-authorization for a surgical procedure or real-time information on whether a claim has been paid.
“Health care has been about the need to be more consumer-oriented and responsive to patients, cloud can help health insurers engage their members the way the best consumer firms do,” explained Jeff Rivkin, IDC research director of payer IT strategies.
Yes, you have to think about security
When it comes to the issues of privacy and security, Rivkin explained because every claim has personal health information (PHI), as well as personally identifiably information (PII) like patient addresses, there was initially a lot of fear around keeping this information in the cloud.
“In healthcare, we all know protecting PHI is of the utmost importance,” Rivkin said. “But the cloud offers significant security benefits not typically available for on-premise solutions.”
He said because it is a more current technology, cloud technology developers are also aware of more current security threats.
Rivkin pointed out common security controls in the cloud include systemic security services that guard against attacks, data encryption, access controls and access logging, built-in backup and redundancy, scalability and high availability.
“These are all compelling features of the cloud that have become widely standard for cloud-based offerings,” Rivkin said. “All of these measures protect your data from natural disasters, sharp demand increases, and malicious actors.”
Ponemon said the fact that the cloud is not owned by the insurer can indeed raises issues of data control and security, but a lot of those issues can be worked out contractually with the cloud provider.
“Even for companies who could build their own infrastructure,” Ponemon said, “they realize they can now build in controls if they’re worried about data ownership.”
Nathan Eddy is a healthcare and technology freelancer based in Berlin.
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.
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