Context: Prior authorization processes often require extensive documentation, leading to administrative burden and delays in patient care. Clinicians must manually gather and submit payer-specific forms, which can be time-consuming and error-prone.
Solution: The FHIR Questionnaire API supports Da Vinci DTR workflows by retrieving payer-specific questionnaires using the $questionnaire-package operation. Clinicians can auto-populate responses from EHR data and submit them via the QuestionnaireResponse API, ensuring all required information is captured.
Outcome: Streamlined prior authorization submissions, reduced administrative workload, and improved compliance with payer requirements, leading to faster approvals and improved patient care.
2. Social Determinants of Health (SDOH) Capture
Context: Addressing social determinants of health is critical to improving patient outcomes, but healthcare providers often lack structured tools to collect and act on SDOH data. Manual surveys and fragmented data collection hinder proactive interventions.
Solution: The FHIR Questionnaire API enables providers to retrieve standardized SDOH screening questionnaires and submit patient responses to Salesforce via the QuestionnaireResponse API. This allows for structured data capture and integration with care management workflows.
Outcome: Enhanced ability to identify social risk factors, enable targeted interventions, and improve coordination of community-based resources, ultimately leading to better patient outcomes and holistic care.