Downloads: 2 | Views: 91 | Weekly Hits: ⮙1 | Monthly Hits: ⮙2
Review Papers | Information Technology | United States of America | Volume 14 Issue 3, March 2025 | Popularity: 5.5 / 10
Innovation in Whole-Person Health: A New Era in Medical Benefits Management
Raghvendra Tripathi
Abstract: In the rapidly evolving healthcare landscape, the concept of whole-person health signifies a transformative paradigm shift towards integrated care that comprehensively addresses the multifaceted needs of patients. This article, titled "Innovation in Whole-Person Health: A New Era in Medical Benefits Management, " presents a ground-breaking approach designed to enhance data integration for pre-authorization processes within healthcare and benefits management. The novelty of this method lies in its ability to facilitate seamless and automated matching of patient benefit information during provider inquiries, drastically improving the efficiency of pre-authorization workflows. To realize this innovative solution, we employed cutting-edge technology such as Kafka-based real-time data streaming and scalable cloud-based services that guarantee robust data availability and accessibility. These advanced solutions enable instantaneous updates and efficient data handling, leading to a significant transformation in operational effectiveness. Our findings reveal remarkable advancements in automation: prior to implementation, the automated matching accuracy for benefit information was a mere 21%. After deploying our state-of-the-art data provisioning system, this rate soared to an extraordinary 89%, illustrating a substantial 68% improvement. This enhancement not only streamlines processes for healthcare professionals but also ensures timely insights and data-driven decision-making, empowering them to deliver tailored and personalized patient care. This comprehensive medical benefits management approach underscores the importance of whole-person health by encompassing all dimensions of a patient's well-being-physical, mental, and social. By leveraging advanced clinical guidelines, integrated care pathways, and sophisticated analytical tools, healthcare service providers can optimize care coordination and foster seamless collaboration among care teams. This article highlights the critical role of innovation in reshaping the future of medical benefits management, driven by an unwavering commitment to holistic patient care. Through detailed insights into data architecture and operational strategies, it showcases how these advancements not only revolutionize the healthcare experience but also contribute to a more sustainable and effective health ecosystem. The future of healthcare resides in a comprehensive, data-driven approach that effectively addresses the full spectrum of patient needs, marking a significant evolution in the domain of medical benefits management.
Keywords: Whole-Person Health, Integrated Care, Healthcare Data, Affordable Healthcare, Real-Time Data Provisioning, Cognitive Computing, Operational Efficiency, Personalized Medicine, Smart Utilization, Data Governance, Clinical Guidelines, Patient-Centered Care, Healthcare Analytics, Data Integration
Edition: Volume 14 Issue 3, March 2025
Pages: 282 - 288
DOI: https://www.doi.org/10.21275/SR25305163227
Please Disable the Pop-Up Blocker of Web Browser
Verification Code will appear in 2 Seconds ... Wait