Electronic Data Interchange and the Healthcare Industry

One of the main issues that the healthcare industry has to deal with is certainly the fact that it has to deal with huge amounts of data. This includes emergency services records, medication data, patient records, insurance claims, and emergency services, among many others. Processing this huge amount of data can rarely be simple to do, so all you need is to find a good way to achieve those results. And that’s where Electronic Data Interchange comes into play.

Why is Electronic Data Interchange helpful in the healthcare world?

Healthcare Electronic Data Interchange systems are designed to bring in a secure data interchange between the care providers, patients and healthcare institutions. At the same time, EDI can also bring in better and also more secure data processing for everything including healthcare claims. While EDI doesn’t allow users to perform transactions, it makes things easier when it comes to managing and distributing data.

Since data distribution and management in healthcare and pharmaceutical is a huge chore for any healthcare company, using an EDI solution is helpful because this helps automate and also streamline operations. It’s also one of the better ways to lower costs too, something that will get better and better every time you use it.

The Electronic Data Interchange also covers all the ANSI and HIPAA standards. As a result, all data exchanges are performed according to the current laws and you never have to worry about any problems.

Every healthcare and pharmaceutical company can modify and customize the way EDI is used based on its own needs. And this is one of the strengths of a good Electronic Data Interchange. You can choose how and when you send the data, not to mention you can stop users from sending certain data types too. So everything is super adaptable and customizable based on the situation and requirements. That alone makes a lot of sense and it certainly delivers outstanding benefits.

You have different Electronic Data Interchange transaction sets

One of the interesting things about Electronic Data Interchange is that you have different sets specifically created for the healthcare and pharmaceutical worlds.  You have 834; EDI Benefit Enrollment and Maintenance Set, 270; EDI Health Care Benefit Inquiry, 837; EDI Health Care Claim Transaction Set, 276; EDI Health Care Claim Status Request, and many others. These EDI formats can be implemented as cloud EDI or Value Added Network (VAN) EDI. These sets come with their own set of rules and you will find it very easy to adapt them to your own requirements.

Why should you use EDI in healthcare and pharmaceuticals?

The primary benefit from EDI solutions is that the costs are a lot lower. There are some significant savings such as $1 per claim for the health plans, $0.86 for hospitals and $1.49 for physicians. And these prices are per patient, so you can imagine that healthcare companies with lots of patients can save thousands and thousands of dollars every month. Plus, the EDI solutions make it easy to send and share data fast, so there’s less time required to process everything.

On top of that, the EDI system is designed to be very secure. Whether it is healthcare EDI or pharmaceutical EDI, It uses electronic attachments and that makes the process streamlined and safer. You won’t have anyone snooping around, especially since most of the EDI data is encrypted. EDI also helps with standardization because it offers a really good way to work with electronic data. Since everything is very easy to customize, that will help you quite a bit when it comes to lowering costs and also implementing a much better value for the money every time. It’s definitely a great opportunity to keep in mind especially if you want to grow your healthcare business.

Where is the EDI market heading?

The EDI healthcare market is set to be worth around $3.77 billion in 2022, and then a lot more after that. It really goes to show that EDI healthcare solutions have a huge impact on the industry and more companies are bound to jump on the idea of getting and accessing so many amazing benefits. Plus, we are bound to see even more security-related features and improvements in regards to the EDI features specifically for healthcare companies.

Grand View Research even believes that the market will reach $5.9 billion in 2025 considering the current growth and how things evolved in the past few years. The US is dominating when it comes to countries using EDI systems, but EU countries are also quite far in this regard. It just goes to show that more and more higher tier countries are implementing this, so we are only a decade or a few decades away from making EDI healthcare a mandatory solution. Of course, there’s a long road ahead, but the current numbers are very promising and patients as well as healthcare companies are already seeing the benefits from implementing stellar EDI solutions and receiving professional support for them!