What the future of provider data means for care – and innovation

Stephanie St. Thomas
August 17, 2020
Along our healthcare journeys, we face question after question related to provider data: Which health plan should I choose? Where should I go to see a specialist that is right for me? Is this doctor taking new patients? What is the status of my deductible?

The answers to these questions are complex, fast-changing, and as unique as the needs of every patient. Yet, as many of us have experienced, it can seem impossible to find all the information we need to inform our most important care decisions, let alone all in the same place.

It’s undeniable that healthcare has a provider data problem. Provider data – from their location to specialties to insurance networks – is disjointed, changes frequently, and lacks a single, centralized source of truth or a reliable framework to access. Specialty information is stored separately from information about the locations at which they practice or whether they’re in-network or not, and it requires endless searching to find all the answers.

The result is a healthcare system in which patients carry the burden of finding accurate and relevant information.

If that information is not readily available and accessible, we find ourselves making decisions in a vacuum, which can lead to wasted time, inappropriate care, and surprise bills — to name just a few — hurting everyone in the long run.

In the last twenty years, healthcare-focused technologies have grown in leaps and bounds with innovations in medical devices, therapeutics, remote care, and even things like medical records and filling prescriptions. But these technologies have not delivered on their promise to simplify care, largely due to disconnected, inaccurate information and delivery systems.

The information we need to make the proper care decisions feels light-years behind, and provider data is key to creating a simpler — and improved — healthcare experience.  

At Ribbon Health, our mission is to power every healthcare decision to be high-quality, cost-effective, and convenient. We’re breaking the long-standing barrier that is disjointed and inaccurate provider data by identifying and delivering the most accurate, comprehensive provider information in the industry. We’re creating more than “just” a provider directory — we’re laying the groundwork for next-generation advancements in digital health by reimagining the potential of provider data.

We see the future of provider data as more than just a list of data points. Instead, we envision provider data as a useful experience that informs healthcare decisions at every step of the patient journey through a centralized, easily accessible source of truth.

Already, Ribbon Health is expanding the scope of provider data. By building detailed information on providers, facilities, network, cost, and quality, clarifying the nuances and eliminating redundancies in each category, Ribbon sheds light on how these pieces relate to each other to provide an in-depth view on available care.

However, more information means nothing if it’s outdated or incorrect. We’re also continuously expanding and refreshing our data with an intelligent validation process that includes direct provider outreach, machine learning models, and firsthand client contribution — all updated in real-time to ensure the highest accuracy at any given moment.

Lastly, we’re building the critical infrastructure needed to seamlessly deliver and integrate our trusted, real-time data. Given the siloed yet frequently changing nature of data across the healthcare industry, our approach is to build a nationwide utility with pathways of information between isolated data stores and standard commands through which they can be used. With our API framework health organizations can flexibly access and customize views to ensure that provider data is available anywhere it’s needed with minimal resourcing commitments.

Ultimately, Ribbon is bringing clarity and reliability to the complex web that is provider data.

For patients, this means finding an in-network provider in your area that specializes in your unique needs. It means knowing how much you can expect to pay for an outpatient surgery. And it means the information on your network’s website is the same as the information at the doctor’s office, and still the same on your bills and prescriptions.

For health plans, healthcare providers, and digital health companies, being keyed-in to a seamless layer of accurate provider data means being able to create a simpler, more connected healthcare experience. Health plans can offer cleaner, up-to-date directories, provider offices can refer patients with confidence, and digital health companies can help consumers navigate to the right, in-network care for them.

Here at Ribbon, we understand that building a single source of truth and a simple framework to access it can improve so many aspects of our care. At the same time, we know that provider data can also power so much more. Getting it right means opening the doors to the next generation of advancements rooted in digital health.  

Equipped with deep experience in building successful utility solutions across diverse industries, the Ribbon team is working to create a foundation for the transformation of the patient journey as we know it. By fulfilling the potential of provider data, we’re unlocking innovation across the healthcare system and making it possible to develop and scale solutions to our most pressing health needs.

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At Ribbon, our mission is to simplify healthcare