Trust, Data Transparency Needed to Strengthen Payer-Provider Collaboration in Oncology: Vishnukamal Golla, MD, MPH

Significant work is needed to reduce data fragmentation and increase transparency in oncology, which will require providers and payers to build trust and co-governance around their data, said Vishnukamal Golla, MD, MPH, vice president of clinical technology and performance at Evolent, in an interview at the Patient-Centered Oncology Care® conference in Nashville, Tennessee.

Watch part 1 to learn about the frustrations payers and providers face with the utilization management process in oncology, as well as the strategies they use to collaborate and make the process smoother.

This transcript has been lightly edited; captions were auto-generated.

Transcript

How can technology be leveraged to improve payer-provider collaboration in oncology?

I think the important part in terms of technology here is really understanding that there are data silos that still exist. I think that area is improving; the technical rails have been put up. There's APIs [application programming interfaces] now, we have FHIR [Fast Healthcare Interoperability Resources] standards, we have value-based contracting that is pushing transparency, and we have interoperable platforms that we didn't have 5 years ago. All of these components allow us to bring together these siloed views that we currently have.

Providers and clinicians have a view of the patient treatment nuances and patient distress that, say, a payer doesn't have. But payers have, sometimes, many times, a longitudinal view that a provider doesn't have, which are claims, pharmacy, and social determinants of health. When you have interoperability and data transparency sharing, you're able to bring those pieces together.

I think the important part there is you're telling a story together, both the clinician and the payer, and are able to support the patient. Right now, that doesn't happen to the best of its ability.

What areas still need the most improvement in payer-provider collaboration? What steps should be taken?

Speaking to the earlier point about data, I think there still needs to be significant work in terms of being able to have less fragmentation and more transparency, frankly. The work setting forth is building trust. It makes a lot of sense that providers are sensitive about the data they have about their patients. Payers are sensitive about their data in terms of its accuracy.

How do you build trust and co-governance around this data piece in order to be able to move forward, build a relationship, and really drive some of the outcomes that we want?