Elation Health integrates Ribbon Health's provider directory data to streamline the referral process

Elation Health is partnering with Ribbon Health to integrate Ribbon’s API data insights into Elation’s primary care electronic medical record system.

More than 24,000 clinicians who use Elation’s EHR will gain access to Ribbon’s provider directory data used to inform referral management and decrease administrative slog and subsequent provider burnout. Elation users will have access to insurance plan information and provider affiliation data including demographic information and clinical focus areas. The duo predicts the move will increase the cost efficiency of care and increase patient satisfaction and trust.

“Primary care is one of the most underutilized levers in U.S. healthcare to improve patient outcomes and manage costs. As we work with some of the most innovative groups on this front, the importance of referral management consistently comes up as a need and challenge,” Elation's co-founder and CEO Kyna Fong told Fierce Healthcare.

“One of the most important roles of an effective primary care relationship is quarterbacking the patient's experience throughout the healthcare system, and who they see from a specialty and facility perspective are really important decisions, not only for cost and what types of contracts they've negotiated with payers, but also, importantly, quality," Fong said.

Ribbon Health will contribute its comprehensive provider directory along with cost and quality data that Elation integrates into the point of care. By providing insurance information and objective quality indicators, patients can be sure they are receiving the best bang for their buck, executives said.

By integrating granular subspecialty information, patients can also be sure they’re not wasting time and money going to the wrong provider. Over half of records in electronic provider directories have at least one inaccuracy, according to a study from the Centers for Medicare & Medicaid Services (PDF).

As a result of the collaboration, during doctors' appointments, patients and providers can know information like risk-adjusted mortality rate along with broader composite scores that assess providers across many metrics all at once, Nate Maslak, co-founder and CEO of Ribbon Health, told Fierce Healthcare.

Maslak said Ribbon Health will be working closely with Elation Health to tailor the type of display offered to providers at the point of care.

“Because the level of sophistication of understanding this type of data varies across the industry, and rightly so if I think about a patient trying to find a doctor, they don't necessarily want to see 57 different scores,” Maslak said. “Just because, without context, it's hard to know what to do with that information. However, maybe in the primary care referral setting, I'm going to want to see that additional information.”

Ribbon Health can provide things like pre-negotiated rates so providers can do the rollout themselves. “So our goal is to provide all the information necessary, as well as some of those rolled up bundles of information,” Maslak said.

Providers and payers are showing interest in evolving value-based payment models, and Fong says Elation Health is meeting that need with the evolution of referral management. By providing robust data, she believes the duo can be a part of maturing value-based payment models.

The path between providers, patients and referral is eased, Maslak said, when information regarding referrals is correct. Ribbon Health works to make sure that’s the case. Profitability of value-based care expands when less time is spent on administrative components like double-checking that the phone number, address or specialty of a referral is correct, he said.

“When you double click into value-based care, there's been a lot of growth over the last couple of years towards payment incentives being fully aligned and they free up the physician, especially primary care providers, to make the right decisions for the patients in a way that that is aligned with their financial incentives as well,” Fong said. “After you get the incentives aligned, the next thing that's incredibly important is data.”

Basic data can better inform PCP decisions so barriers to health like predictability of cost, location, languages spoken, cultural sensitivities and ineffective care are avoided and trust in healthcare is fostered. Patient anxiety is diminished and access is increased, Maslak said.

With primary care providers needing 27 hours a day to meet guidelines-based care, Fong compares the work in primary care clinics to a microcosm of the larger healthcare system where technology can fill the gaps of a complex system demanding more administrative work.

“We're heavily investing as a company in the ability to actually close the loop,” Maslak said. “So taking action on data, which means either completing a referral via the API or allowing a patient to book their own appointment. It's a hard thing to do at scale and it's going to take time for us as an industry to get there but that’s where we see this going in terms of being able to make providers lives easier and not having to send faxes back and forth and create a world in which that referral process gets easier and easier and faster and faster.”

Ribbon Health also partnered with Turquoise Health this summer to provide better cost transparency by integrating Turquoise Health's 1 billion records of pricing data from 4,500 hospitals into its system. With providers and facilities still lagging when it comes to price transparency regulations, Ribbon sees its technology as supporting all parties in the healthcare system.

Elation has boasted recent partnerships including with medical group Galileo with the goal of rolling out Elation’s EHR into Galileo’s practices in all 50 states. The EHR provider also paired up with Dock Health to automate downstream clinical trial tasks and address provider burnout.