Healthcare networks allow medical professionals to share information and resources more easily. This can help them deliver better patient care, reduce costs, and boost negotiating power. Health plans should track and analyze referral patterns. This can help them avoid over-referring patients to specialists for conditions that could be handled in primary care clinics.

Access to Medical Files

Increasingly, healthcare providers offer patients access to their medical files via smartphone apps and other digital tools. These tools are incredibly data-intensive and require a high-performance wireless network. Visibility and management solutions are essential to optimizing the web, as they help to eliminate problems like unusable connections and delayed access to medical records.

In addition to these network optimizations, changes to the software used internally are also of paramount importance. For instance, implementing robust laboratory information systems, like the NovoPath LIS (Laboratory Information System), can significantly help to streamline data access and enhance the overall efficiency of the healthcare services being provided to patients. This is primarily done by upgrading the systems in which reports and records are compiled and updated, allowing for more staff to access documents and deliver them to where they need to be. This optimisation delivers powerful results, and any healthcare organisation wishing to improve will see the best results by implementing this type of software.

Healthcare networks that are well-optimized are one of the single largest levers available to payers for improving member outcomes and reducing costs. Payers must prioritize provider network optimization to improve member outcomes, bolster revenue growth, and achieve strategic business goals.

One of the lowest-hanging fruits for network strategy teams is to track and analyze referral patterns at a granular level to identify and shift utilization from low-value specialists. Equipping physicians with data-driven insights and providing periodic nudges can be an effective way to help them move their referral habits. One such program led to an 18% improvement in high-value referrals by primary care practices.

Real-Time Data

Real-time data is valuable for any industry, and healthcare is no exception. With real-time data, you can quickly and accurately track patient care, identify inefficient practices, and implement changes that benefit your organization and patients.

For example, tracking patient referral patterns can help you reduce network leakage and prevent the over-referring of patients to specialist physicians. Inappropriate specialty referrals cost between 12.4% and 30% of total healthcare spending, and networks can save money by identifying and targeting these patterns. Healthcare network optimization also provides more detailed access information than traditional catchment methods.

Optimization models allow a more nuanced approach to access and can easily be adapted to measure accessibility over different provider types or capacity constraints. This allows for more fine-tuned interventions to improve access rather than increasing distance or reducing congestion. Moreover, optimization models are useful for estimating user choice over the network, a key element in designing and evaluating a change to the network.

Better Patient Care

Healthcare networks need to advance, not hinder, healthcare directives and promote better communication between practitioner, patient and payer. That requires networks that are secure and convenient. Patients want to be able to access their medical files anytime and anywhere. And they don’t want to be stuck in a waiting room reading outdated magazines and paying exorbitant fees to see their practitioner.

Healthcare network optimization allows insurers to measure and analyze data to understand how and where to improve network performance. It activates the single largest lever available to payers for bottom-line improvement. Creating high-performing networks through effective payer contracting is an investment, but the payoffs are huge. Using an optimized provider network helps payers provide better service to their members, attract new ones and deliver cost savings.

Enhanced Communication

Effective communication is a core tenet of good patient care. But when healthcare networks lack efficient communication systems, it can stall medical advancement, waste funding and worsen outcomes. This is why healthcare organizations need high-bandwidth technologies to communicate and collaborate effectively internally.

In addition, a robust network can support new technologies on the back end, such as automation and machine learning, which help improve efficiency for front-end applications. For example, one bioinformation company uses its network to translate DNA from crime scenes and internationally into usable information that police departments can use.

Purposefully developing provider networks takes time and resources, but it activates the single largest lever for bottom-line improvement available to payers. Using analytics, network strategy teams can track and understand specialist referral patterns to ensure they are high-quality and cost-effective. For example, equipping physicians with data-driven insights and periodic nudges to change their referral habits resulted in an 18% increase in high-value referrals from primary care clinics.