What Change in RCM (Besides AI) is Happening Now that Everyone Should be Watching and Why?
Erin Weber, Chief Research & Policy Officer at CAQH
There’s so much out there about AI, but I think one thing that’s really important to think about when you think about AI is it’s entirely dependent on the data and the systems that it works with. So if the data is not accurate, the AI isn’t going to be great. Initiatives like CORE where we’re looking at creating common definitions of data whether it be in a claim transaction or the provider data that goes into a credentialing system, AI is going to be largely dependent on that information. I think I would encourage the industry to look out for initiatives that are working to improve data accuracy, which is only going to make AI function better.
I think similarly along those lines, one of the things I have seen a lot recently in the industry is concern around technology or the belief that technology is going to solve all of our problems – technology like AI, FHIR, API, etc. – but again, that underlying data is going to be so important. And it’s just not a technology problem, we have workflows, there’s people involved, and there’s behavior change involved. I would encourage the industry to look for opportunities where you can engage to create whole solutions that are looking at not just the technical challenges but the business challenges, the workflow challenges, and take that all together – organizations like the CORE initiative at CAQH are doing that.