Prior authorization is an important tool for high-quality, cost-effective health care. It ensures patients receive safe, necessary services when a provider recommends a procedure, medication, or device.
Unfortunately, physicians and staff spend an average of 14 hours per week – almost two work days – completing prior authorizations according to a recent report from the American Medical Association.
That’s one reason why Blue Shield of California is working to improve the prior authorization process. Through a new collaboration with Google Cloud, Blue Shield is piloting artificial intelligence and machine learning technologies to help expedite the prior authorization process and get medical decisions back in the hands of providers faster.
Lisa Davis, senior vice president and chief information officer at Blue Shield of California, recently spoke with several publications to highlight the new initiative as part of a wider effort to modernize processes and reduce administrative tasks.
“We want to help ease the administrative burden on our healthcare providers so they have more time to deliver the best care possible," Davis told InformationWeek
. "Leveraging Google Cloud technologies and artificial intelligence, we are working to ensure our members get timely access to clinically necessary care and services."
There will always be a need for humans, Davis told Forbes
: “Artificial Intelligence will never be the be-all end-all“ It is an enabler. It's a tool. You have to have people involved in the system that provide that oversight and quality of care.”
Saving time and resources by speeding up cumbersome administrative tasks also helps to reduce the overall cost of health care, she said.
“Streamlining the prior authorization process is one important part of Blue Shield of California's journey to enable more real-time exchange of data and provide more retail-like experiences,” Davis said.
Read more about Blue Shield’s collaboration with Google Cloud: