BOSTON--(BUSINESS WIRE)--athenahealth, a leading provider of network-enabled software and services for medical groups and health systems nationwide along with collaborators Availity, Harmony Park Family Medicine, and Humana (NYSE: HUM), received a 2024 Points of Light Award from KLAS. The group’s case study, “Using FHIR Standards to Streamline Prior Authorization Management & Improve Patient Care,” recognized the organizations’ work together to modernize the prior authorization process and expedite approval of prior authorization requests..

波士顿--（商业新闻短讯）--athenahealth，一家为全国医疗集团和卫生系统提供网络支持软件和服务的领先供应商，以及合作者Availity，Harmony Park Family Medicine和Humana（纽约证券交易所：HUM），获得了KLAS颁发的2024点光奖。该集团的案例研究“使用FHIR标准简化事先授权管理并改善患者护理”认可了各组织共同努力，以实现事先授权流程的现代化并加快事先授权请求的批准。。

Prior authorization is the process used to obtain insurance approval for medications and certain medical procedures before they can be performed. It is designed to ensure that patients receive timely, clinically appropriate, evidence-based care. This collaboration aims to deliver an end-to-end process that streamlines, automates, and reduces administrative burdens to the benefit of all parties involved..

事先授权是指在执行药物和某些医疗程序之前获得保险批准的过程。它旨在确保患者得到及时，临床上适当的循证护理。这种合作旨在提供一个端到端的流程，简化、自动化并减少行政负担，以造福所有相关方。。

“Our mission is to ensure that our members can get the high-quality, affordable care they need while delivering the better health outcomes they deserve,” said Angie Shaw, Humana’s Vice President of Clinical Operations Shared Services. “By partnering with athenahealth, Availity, and Harmony Park, as well as others in the industry, we are working to streamline the prior authorization process in ways that improve patient access to care and deliver better health outcomes.”.

Humana临床运营共享服务副总裁安吉·肖（AngieShaw）表示：“我们的使命是确保我们的成员能够获得他们所需的高质量，负担得起的护理，同时提供他们应得的更好的健康结果。”。“通过与athenahealth，Availability和Harmony Park以及业内其他公司合作，我们正在努力简化事先授权流程，以改善患者获得护理的机会并提供更好的健康结果。”。

Humana, Availity, and athenahealth worked together to develop an automated electronic prior authorization (EPA) process leveraging the Da Vinci Burden Reduction Implementation Guides – a set of standards designed to make the process of prior authorization in healthcare more efficient and streamlined – to expedite approval of these requests and deliver a better, more seamless end-to-end experience for patients, providers, and payers..

Humana、Availability和athenahealth共同开发了一个自动化的电子事先授权（EPA）流程，利用《达芬奇减负实施指南》——一套旨在使医疗保健事先授权流程更加高效和简化的标准——加快对这些请求的批准，并为患者、提供者和付款人提供更好、更无缝的端到端体验。。

One of the key achievements of the project was Availity creating a seamless data exchange to connect the Humana and athenahealth platforms, allowing data to be effortlessly exchanged. “Unlike many healthcare transactions, prior authorization is not always a simple query and response but can be a complex conversation, and that’s why we’re working to improve this process for beneficiaries, providers and payers,' said Russ Thomas, CEO of Availity.

该项目的关键成就之一是创建无缝数据交换，以连接Humana和athenahealth平台，从而轻松交换数据。Availity首席执行官罗斯·托马斯（Russ Thomas）表示：“与许多医疗保健交易不同，事先授权并不总是一个简单的查询和回复，而是一个复杂的对话，这就是为什么我们正在努力改进受益人、提供者和付款人的这一流程。”。

“We are proud to be recognized for our collaboration with athenahealth, Harmony Park, and Humana.”.

“我们为与athenahealth、Harmony Park和Humana的合作获得认可而感到骄傲。”。

The EPA process has saved Harmony Park 24 hours per week in manual work that can now be redirected to patient-centric activities. “With this new automated prior authorization process enabled within the athenahealth EHR, our providers now have all necessary information and requests directly within their workflow,” said Yvonne Dooley, Chief Operating Officer, Harmony Park Family Medicine, a provider in Hot Springs, Arkansas that is successfully using the tool.

美国环保局的程序节省了Harmony Park每周24小时的人工工作，现在可以将其重定向到以患者为中心的活动。阿肯色州温泉城Harmony Park Family Medicine的首席运营官伊冯·杜利（YvonneDooley）表示：“在athenahealth EHR中启用了这种新的自动化事先授权流程，我们的提供商现在可以直接在其工作流程中获得所有必要的信息和请求。”。

“This, combined with the speed and transparency we now have throughout the entire process, has greatly reduced administrative burden for our staff, and patients are able to receive care more quickly in anticipation of improved health outcomes.”.

“这与我们现在在整个过程中的速度和透明度相结合，大大减轻了我们工作人员的行政负担，患者能够更快地获得护理，以期改善健康状况。”。

Key outcomes of the collaboration, detailed in the case study, include quicker patient access to care, improved provider efficiency, and decreased administrative burden as compared to when the workflow is entirely manual. Stakeholders determined that during the evaluation period, nearly 54% of all requests per month required no authorization, and 70% of prior authorization requests processed through the implementation were instantly approved by Humana, due to the integration that enables robust data gathering and sharing.

案例研究中详述的合作的关键成果包括，与完全手动工作流程相比，患者更快地获得护理，提高了提供者的效率，减少了行政负担。利益相关者确定，在评估期间，每月近54%的请求不需要授权，而通过实施处理的先前授权请求中有70%立即得到了Humana的批准，这是由于集成可以实现强大的数据收集和共享。

These instant approvals have contributed to a dramatic reduction in turnaround time from multiple days to about one day, which far exceeds industry averages that range from days to weeks and the seven-day target established by the CMS Interoperability and Prior Authorization Final Rule..

这些即时批准有助于将周转时间从几天大幅缩短到大约一天，这远远超过了行业平均水平，从几天到几周不等，以及CMS互操作性和事先授权最终规则确定的七天目标。。

“At athenahealth, we take on and automate time-consuming, manual tasks so that practice staff can focus on supporting patients,” said Paul Brient, Chief Product Officer at athenahealth. “We are thrilled to work with our partners and customers to modernize the process associated with prior authorization.

athenahealth的首席产品官保罗·布莱恩（PaulBrient）说：“在athenahealth，我们承担并自动化了耗时的手动任务，以便实践人员能够专注于支持患者。”。“我们很高兴与合作伙伴和客户合作，使与事先授权相关的流程现代化。

This type of industry collaboration can simplify the practice of care and drive meaningful improvements for providers, patients, and payers.”.

这种类型的行业合作可以简化护理实践，并为提供者，患者和付款人带来有意义的改进。”。

The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies who have partnered to reduce costs and inefficiencies and improve the patient experience. The awards were presented at the KLAS K2 Collaborative Summit, May 14-15 in Salt Lake City..

KLAS Points of Light年度奖项旨在庆祝付款人、医疗保健组织和医疗保健IT公司取得的成功案例，这些公司已经合作降低成本和低效率，改善患者体验。该奖项于5月14日至15日在盐湖城举行的KLAS K2合作峰会上颁发。。

To learn more about the challenges, outcomes, and key lessons from this collaboration, please visit: https://www.athenahealth.com/KLAS-POL-2024.

要了解有关此次合作的挑战、成果和关键教训的更多信息，请访问：https://www.athenahealth.com/KLAS-POL-2024.

About athenahealth

关于athenahealth

athenahealth strives to cure complexity and simplify the practice of healthcare. Our innovative technology includes electronic health records, revenue cycle management, and patient engagement solutions that help healthcare providers, administrators, and practices eliminate friction for patients while getting paid efficiently.

athenahealth致力于解决复杂性并简化医疗保健实践。我们的创新技术包括电子健康记录、收入周期管理和患者参与解决方案，帮助医疗保健提供者、管理人员和实践消除患者的摩擦，同时有效地获得报酬。

athenahealth partners with practices with purpose-built software backed by expertise to produce the insights needed to drive better clinical and financial outcomes. We’re inspired by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

athenahealth与专业技术支持的专门构建软件的实践合作，产生推动更好的临床和财务结果所需的见解。我们的愿景激发了我们的灵感，即创建一个繁荣的生态系统，为所有人提供无障碍，高质量和可持续的医疗保健。

Learn more at athenahealth.com..

在athenahealth.com了解更多信息。。

About Humana

关于Humana

Humana Inc. is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell health care services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

Humana Inc.致力于将健康放在第一位，为我们的队友、客户和公司服务。通过我们的Humana保险服务和CenterWell医疗保健服务，我们使我们服务的数百万人更容易获得最佳健康——在他们需要的时候提供他们所需的护理和服务。

These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com..

这些努力正在为医疗保险、医疗补助、家庭、个人、军人和整个社区的人们带来更好的生活质量。请在Humana.com和CenterWell.com上了解更多有关我们提供的服务的信息。。

About Availity

关于可用性

Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners.

Availability是寻求从临床、管理和财务数据中实现最大价值的组织值得信赖的合作伙伴。Availity定位于提供者、健康计划和消费者健康信息的纽带，为健康计划、提供者和技术合作伙伴之间的医疗数据采集、标准化、透明度、自动化和交流开发了可扩展的创新解决方案。

As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Our suite of dynamic products, built on a powerful, intelligent platform, enables real-time collaboration for success in a competitive, value-based care environment..

作为美国最大的健康信息网络之一，Availability每年促进数十亿的临床，行政和财务交易。我们的一套动态产品建立在强大的智能平台上，能够在竞争激烈、基于价值的护理环境中实现实时协作，取得成功。。

For more information, including an online demonstration, please visit www.availity.com or call 1.800.AVAILITY (282.4548). Follow us on LinkedIn and X.

有关更多信息，包括在线演示，请访问www.availity.com或致电1.800.availity（282.4548）。在LinkedIn和X上关注我们。

About Harmony Park Family Medicine

关于和谐公园家庭医学

Harmony Park Family Medicine, located in Hot Springs, AR, is committed to offering professional, compassionate, and coordinated patient care. Harmony Park provides patient-centric care, wellness services, and a specialized chronic care management program, as well as convenient online portal access to appointment scheduling, health records and results, and online bill payment.

Harmony Park Family Medicine位于阿肯色州温泉镇，致力于提供专业、富有同情心和协调的患者护理。Harmony Park提供以患者为中心的护理、健康服务和专门的慢性病护理管理计划，以及方便的在线门户访问预约时间表、健康记录和结果以及在线账单支付。

Learn more at harmonyparkfamilymedicine.com..

在harmonyparkfamilymedicine.com了解更多信息。。