Managing provider data has become one of the most pressing challenges in healthcare. On December 4th, Virsys12 and Becker’s Healthcare hosted a webinar, “Conquering the Provider Data Issue in Provider Lifecycle Management,” featuring leaders from Jefferson Health Plans, Paradigm, VillageCare, and CareFirst Blue Cross Blue Shield.
Panelists shared how they’ve transformed their provider lifecycle management processes and offered actionable insights for health systems and plans aiming to tackle the complexities of provider data management.
Key Takeaways from the Panel Discussion
1. Breaking Free from Legacy Systems
Outdated systems and manual processes create barriers to effective provider data management. For Jefferson Health Plans, managing provider data across multiple disconnected systems led to inefficiencies and roadblocks during a significant network expansion.
“We come from an environment where we are working on very archaic platforms for contracting and credentialing…[and] a homegrown data management solution that ultimately feeds our claims system, our care management system, and our authorization system. None of them speak to each other.” – Michael Krusen, VP of Provider Network Operations, Jefferson Health Plans
This lack of integration spurred Jefferson Health Plans to seek a fully automated and integrated solution, enabling growth without repeating past challenges.
2. The Power of Centralization
For VillageCare, transitioning from spreadsheets and manual processes to a centralized system revolutionized their approach.
“When we started, everybody had these manual trackers, everything was on Excel spreadsheets… The ability to task someone to do a process…has been mind-blowing to everybody and allowed them to do their work so much better.” – Ku’uipo Fales, AVP of IT Cloud Products and Special Projects, VillageCare
The new system also provided real-time updates, enabling immediate corrections to provider data and reducing manual intervention.
“Now, anyone can jump into [V12 Network], update the information, and the directory will be updated in real time.” – Ku’uipo Fales, VillageCare
3. Overcoming Data Migration Challenges
Data migration remains one of the most significant hurdles in implementing new systems. For Paradigm, consolidating multiple legacy systems into one enterprise repository was a daunting yet crucial task.
“We underestimated the complexity of this task. Before we could migrate the data, we had to spend numerous hours cleaning up the data… With Virsys12 and additional support, we divided the project into parallel workstreams, focusing on both data cleanup and migration logic. This approach kept us on track despite resource constraints.” – Thao Tu, VP of Strategic Initiatives & Execution, Paradigm
4. Building Trust in Data
Unified systems are only as valuable as the data they manage. For CareFirst, consolidating provider data from over 20 systems resulted in improved standardization and downstream integration.
“Rather than having all of these systems cobbled together, it’s really one interface that everyone can consume. The ability to have faith and trust in the quality of the source data is critical.” – Bob Heyl, CTO, CareFirst Blue Cross Blue Shield
5. Envisioning the Future
The panel also discussed how emerging technologies like AI and interoperability will shape provider data management.
“We are starting to learn what the potential is for generative AI to help broker the changes of data, upkeep of data, and maintenance of data with a lot less human intervention.” – Bob Heyl, CareFirst
Your Next Steps
The challenges of managing provider data are significant, but as the panelists demonstrated, they are surmountable with the right strategies and technology. If you missed this insightful discussion, the webinar recording is available.
Ready to streamline your provider lifecycle management? Explore how solutions like V12 Network and V12 PDE can help you conquer the challenges of managing provider data. For additional insights, check out our customer testimonials and explore our demos to see our solutions in action.
