InRule for Microsoft Dynamics for Patient Case Management

PF

Peter Fudalej

09/01/2020

I don’t particularly enjoy going to the doctor. As a healthy individual, I generally find it to be a waste of time and money. Yes, I realize how privileged I am to be able to make that statement. But hear me out. I go to a hospital, which is already on the list of my least favorite places, and check-in for my appointment. The receptionist asks me to fill out a bunch of forms and provide answers to questions I’m not 100% confident in, all the while wondering why they need to know this information – how annoying. Then once I turn those forms in, I get to wait for 30 to 60 minutes, wondering what the point of an appointment is if they don’t see me on time. At this point, I’m super aggravated and I haven’t even seen the doctor.

Waiting for Doctor

I finally get called in; the doctor asks how I’m feeling, checks my blood pressure, listens to my heart and lungs, and after about ten minutes says “great, you look healthy, see you next year!” The receptionist asks to schedule me for an appointment next year and promptly charges me $50 for the 10 minutes I saw the doctor. Surely, if they checked my blood pressure at that point, it would be sky-high.

As a result, it’s been some time since I’ve been to the doctor, probably about seven years. My wife, who ironically is a recently certified Nurse Practitioner, put an end to that this year. I saw the doctor, and the experience was just like I remembered: brutal. Since it had been a while, the doctor recommended getting blood work done. I obliged and got the lab work done since it could be done that day in the same building. I received the results about a week later, good to go! I started to think “maybe these guys are figuring it out, that wasn’t so bad.”

Fast-forward a month later, I get a bill from someplace I don’t recognize. I give them a call and they say they’re the people who took my blood. When I ask them why I owe them more money after already having paid, they say they bill separately. If I want, I can give them my insurance and maybe the cost will decrease. I again mention that I had given it already; they remind me they’re separate… for some reason, for which was still unclear. Okay, fine, take my info. Fast-forward a couple more weeks, a reduced bill. Wow, how irritating.

What if I had a significant procedure or test done, or had to see multiple doctors, how much more complicated would that have been? You’d think my hospital would have a better way of managing patients, a better way of keeping all their information together. I’m talking about a system that could keep track of all the patient’s info, including info from their primary care physician, specialists, labs, hospitals, pharmacy, billing, insurance, and so on.

Patient Medical Billing

Systems, Systems, and more Systems!

Well, as it turns out, the provider and medical networks do have systems; in fact, they have too many systems. Networks have multiple systems, each office usually has their system, and they often don’t all entirely connect or share data. That’s part of the problem; the other part of the problem is that offices have different procedures for handling billing and insurance. Each office has a different cadence of sending their bills – some send invoices immediately and others wait for the final total. There are often delays due to offices sending insurance companies bills late or forgetting to send invoices. Finally, patients sometimes give incorrect information or do not fill out forms correctly. All this leads to several bills all coming well after the patient’s visit. While a quality technology solution cannot completely solve the problem, it can do the majority of the heavy lifting.

A Better Solution

Recently, InRule has seen an increase in interest by healthcare providers looking to overcome this exact issue. These providers are seeking a solution for better patient care management. By combining InRule with Microsoft Dynamics 365 and Power Platform, medical providers and networks can provide more customer-centric patient care.

By using Microsoft Dynamics 365 as their system of record, medical providers and networks can house a great deal of patient data in a centralized location. Networks can store all their medical data and remain HIPAA compliant by leveraging a Business Associate Agreement (BAA) with Microsoft. Using Microsoft Power Apps, a component of the Power Platform, providers and networks can extend the use of Microsoft Dynamics 365 by allowing developers to create cross-platform applications that share the data from Microsoft Dynamics 365 to numerous other applications. The best part of Power Apps is that it is a low-code solution that allows developers to work quickly. By sharing data across and connecting multiple systems, patient care data is connected, and developers can create functions such as prescription recommendation management, rebate management, health care team integrations, drug interaction automation, or fraud detection.

Providers and networks can also automate a lot of their work. By using Power Automate, another part of the Power Platform, users can create workflows to automatically route information, actions, and decisions to the right place effortlessly. For example, a workflow could be designed and automated to suggest, approve, and schedule a medical procedure, resulting in faster service without the need for human interaction.

This system sounds nice, but it’s rather reactive. For me, the exciting part comes when the systems we create are proactive. A proactive platform that sounds like we’re talking about InRule. In addition to collecting and analyzing data, InRule can help providers and networks make sound, automated decisions for the next step in a patient’s medical plan; this helps provide the best possible care for patients. InRule can be used in alignment with practice policies and regulatory guidelines and applied consistently and accurately every time. The system ensures safe and effective patient care.

InRule enables users to author, manage, and execute business rules and decisions without having to write code. InRule for Dynamics 365 integrates with Microsoft Dynamics 365 and the Power Platform to provide decisioning capabilities. InRule’s allows subject matter experts to author and test directly with Dynamics 365 data. InRule also supports the integration necessary to execute rules and decisions directly from within these powerful Microsoft platforms.

By using the combination of Microsoft Dynamics 365, Microsoft Power Platform, and InRule, medical providers and networks can create cross-platform systems that share data and automate workflows, providing highly personalized and patient-centric decisions in real-time.

More to Come

So if you’re like me, and hate going to the doctor for all the reasons I mentioned above, don’t worry, InRule is working to make the experience better! If you are interested in learning more about InRule for Microsoft Dynamics for Patient Case Management, I encourage you to check out our most recent white paper, Better Business Apps with InRule®, Microsoft Dynamics 365, and the Power Platform.

In the paper, we go into much greater detail about how InRule, Microsoft Dynamics 365, and the Power Platform work together to enable consistent design and automation of complex decision-based workflows and use patient care management as the primary example.

For anything else, feel free to leave a comment below!