The proverb, “Necessity is the mother of invention” applies well to the recent changes in the healthcare Industry. For decades, when the prevalent reimbursement model was pay-for-service, there was no incentive to change or innovate. When Centers for Medicare and Medicaid Services (CMS), the largest payer for healthcare in US, decided to change the reimbursement model to pay-for-outcomes, the need for digital transformation became a necessity. The first phase was the adoption of EHR systems followed by the meaningful use of collected data to drive system wide change. “Digital solutions that focus on clinical, operational, and financial aspect of healthcare are crucial to drive better clinical outcomes, ensure better quality of care, and reduce the cost of care,” points out Vijitha Kaduwela, Founder & CEO, Kavi Global. “Recent changes in the healthcare space have introduced revenue risks for provider organizations such ACOs, hospitals, and physician staffing organizations, incentivizing them to accelerate the digital transformation.”
The inception of Barrington, IL-based Kavi Global was inspired by the idea of bringing path-breaking products and services to the digital solutions marketplace. Today the firm provides digital solutions in healthcare focusing on three crucial areas:data integration and analytics, addressing the gaps in EHR systems for efficient medical billing processes, and fraud, waste and abuse management in Medical and Prescription drug claims. “Our answer to the digital solutions acceleration for provider organizations is comprehensive,” informs Kaduwela. “From a consulting perspective, we start with a strategy focusing on developing a vision and roadmap and then our delivery team works on the project aligned with the roadmap.” Kavi Global has a dedicated technology to accelerate the delivery—Plexa—and offer comprehensive capabilities for data acquisition, data integration, data quality management, business rules management, reporting and analytics. The platform also enables healthcare providers with big data integration capabilities and web-based visual development tools that enable them to efficiently integrate and analyze data across multiple systems. “Developing digital solutions cost-effectively and fast is crucial today and Plexa virtualizes solutions and simplifies technology skill requirements for development and deployment,” adds Kaduwela.
“Developing digital solutions cost-effectively and fast is crucial today and Plexa virtualizes solutions and simplifies technology skill requirements for development and deployment”
Designed to reduce Total Cost of Ownership, Plexa is an integrated environment and a logical framework for development and management of digital solutions throughout their entire lifecycle. With Plexa, the investments in digital solutions are safe, as they can seamlessly be migrated to new versions of underlying technologies or even to new technologies. “Plexa makes it easy to automate appropriate reporting capabilities that adhere to Physician Quality Reporting System (PQRS),” adds Kaduwela. The platform also ensures the accuracy of the data while enhancing its quality and reliability. For monitoring the patient lifecycle, data integration, and reporting are exceptionally critical.
Addressing the gaps in the EHR space, Kavi Global is in the process of developing a cloud based EHR system leveraging Plexa with a key module for billing and claims. “Legacy EHR systems are productivity killers as they eat into the physicians’ work hours that should be ideally spent overseeing patient care,” explains Kaduwela. “In the healthcare equation, physicians are the most valuable resource and it would be a sheer waste of valuable resources if we make data-entry clerks out of them.” Additionally, to proactively address the problem related to medical claims and prescription drug claims, Kavi Global has developed a Plexa-based solution that leverages Artificial Intelligence and Machine Learning to effectively identify and remediate these issues. With 15 plus innovations in Plexa pending patent, Kaduwela believes that the Plexa platform holds the capabilities to revolutionize how digital solutions are developed and deployed in the healthcare space.