CVS Health’s Next Big Goal: Solve Interoperability

CVS Health has never been shy about having lofty goals to reshape health care. So, when news broke recently that the mega retailer plans to invest $20 billion in technology over the next 10 years to deliver a more consumer-centric health experience by improving interoperability of health tech systems, it’s reasonable to wonder if the company may be biting off more than it can chew.

The investment, Yahoo!Finance reported, will impact more than CVS’ vertically integrated businesses like its pharmacy, Oak Street health providers and insurance arm Aetna. It also will allow competitors and other health sector players to plug into the CVS system.

Whether a retail business, even one as large as CVS Health, can deliver on the promise of getting the various parts of health tech systems to integrate effectively — and ideally through a single patient record — remains to be seen. And it should be noted that the report was scant on details about how CVS will achieve its vision.

But, if successful, CVS would accomplish something no other health care organization, governmental body or other entity has been able to achieve.

Tilak Mandadi, CVS Health’s chief experience and technology officer, previously held executive roles at Disney and American Express and will be leading the company’s efforts to achieve interoperability. Here are some key areas Mandadi says the company will be focused on:

3 Key Goals CVS Health Hopes to Achieve

1 | Modernizing the Patient Dashboard

The aim is to give physician offices and CVS pharmacies a complete picture of what is going on, rather than isolated events for an interaction such as a physician office visit or picking up a prescription.

2 | Creating a More Proactive Communication System for Patients

The goal will be to make it easier for consumers to get information about claims status and billing without burdening them to place follow-up calls for care or deciphering bills. For example, if a claim is being processed and a potential problem is flagged with the claim, the patient also would know rather than having to find out after it is adjudicated.

3 | Developing Guardrails for Artificial Intelligence (AI)

Mandadi notes that CVS will never use AI for clinical diagnosis or for prior authorization or claims denials, or to prevent human touch in the patient experience. The company does, however, use AI to streamline back-end functions like pharmacy voicemail processing.