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Healthcare provider networks need good data networks

Provider network management is a hot topic in the healthcare industry. However, it has little to do with network management as an IT specialist would understand the term.

And it is big business. In a recent report Research And Markets estimated the global healthcare provider network management market to be worth $US3.8 billion in 2022 and forecast it to grow at a CAGR of 17 percent to reach $US13.2 billion by 2030.

According to a digital themes glossary provided by US IT consultancy Virtusa, healthcare provider network management systems collect data from across healthcare ecosystems in order to increase operational efficiencies.

They can “provide a single point of access for information regarding fee schedules, health plans, regulatory compliance, and processes as well as other data across a healthcare organisation.”

They are underpinned by provider network management software which automates many of the processes that healthcare players must deal with daily, thereby saving time and expense compared to traditional manual procedures.

The definition talks at length about the functions and features of healthcare provider network management systems, and extols their many virtues.

–  a single point of access for information regarding fee schedules, health plans, regulatory compliance, and process.

– consolidation of patients’ data including care plans, lab results, authorisations, and medical claims.

–  provision of patient access so patients can stay up to date with their healthcare plans.

However, the definition provides scant detail of a key component. It notes that provider network management systems “also include methods for data storage and analysis,” and that “data can be gathered from a wide variety of sources.”

Data gathering, of course, requires a network, or networks, as an IT specialist would understand the term, rather than as a collective noun for the various organisations involved in the provision of healthcare.

Many data networking challenges must be overcome to support healthcare provider network management. Security, of course, is paramount: healthcare networks carry highly sensitive personal data. So too, is reliability. Virtusa talks about them providing a “single source of truth” for data and analytics. There could be times when accurate and up-to-date patient data is needed urgently to aid diagnosis and help ensure appropriate treatment.

These requirements, of course, are not unique to the support of healthcare provider network management. They are fundamental to supporting healthcare, period. And the signs are there is much room for improvement, especially after the three years of COVID-19 have put health services worldwide under enormous stress, exposing weaknesses in every aspect of their operation.

Writing in HealthManagement journal in 2022, the chief technology officer of data network equipment maker, Aruba, outlined some key challenges facing healthcare networks.

–  Outdated networks can act as roadblocks and trying to adapt them to modern demand can be more trouble than it’s worth.

–  With staff, patients and visitors constantly moving in and out of hospital networks often with multiple devices, security risks have never posed such a threat.

He argued “technology can help simplify workflows and alleviate administrative burdens, allowing for staff to redeploy their precious time and focus on patient care.”

His views were echoed by Theirry Chau, of CommScope Technologies Australia. “Healthcare networks are often constrained by inefficient, isolated legacy systems that are difficult to improve and sometimes impossible to integrate. Now that the rules of healthcare delivery are being completely rewritten [by COVID-19], those constraints are becoming more expensive and unsustainable.”

Research and Markets’ forecast quadruple increase in the value of the healthcare provider network management market by 2030 (from $US3.8b to $US13.2b) will inevitably put heavy demands on the underlying data networks that will carry the information these systems will ingest and relay between healthcare industry participants.

So, there will be plenty of scope, and demand, for investment in and expansion of healthcare data networks to meet the demands of the patients, physicians and all the myriad players in the networks of healthcare providers.

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