Supporting patients is key for payer success

With boots-on-the-ground experience, Sedgwick SVP Andrea Buhl said her provider experience has helped her as a payer.
Sedgwick SVP Andrea Buhl

Andrea Buhl got her start in healthcare as a nurse, seeing firsthand the ins and outs of patient care. Now the SVP of medical programs at Sedgwick, she has worn a lot of hats during her career — hospital nurse, family nurse practitioner and finally executive in the claims management space.

But she said her experience as a provider has helped shape her perspective in her current role.

“At Sedgwick I primarily work in the worker’s compensation space, so I deal with people who have had work-related injuries,” Buhl told MobiHealthNews. “My background in healthcare and being a nurse practitioner, being a prescriber and actually being the nurse, has really allowed me to see things from all different angles. So to be the healthcare provider and be on the payer side now … has really helped round my perspective on the type of experience people have when they enter the healthcare system.”

That human touch is important in her role, she said. In fact, Buhl said that in the future she sees the payer becoming more involved with supporting the patient.

“Recently, there has been a huge shift in the area that I work in, in patient advocacy and healthcare advocacy. You can imagine in the workers comp system, a lot of employers look at it kind as an adversarial approach,” Buhl said. “So they are looking at it like this person has a claim, checking to see if they are malingering, or trying to not go back to work. … But what we have found is there is this big shift to a more patient-centered and more patient advocacy approach, where we are understanding that by ensuring that people get the best healthcare at the right time [it] helps those people to have a positive experience, despite the fact they have had this terrible thing for them.”

Looking to the future Buhl said tech could help play a major role in getting patients support at home, as well as helping clinicians and payers figure out what the patient needs to succeed. For example, Sedgwick has teamed up with PeerWell to give members who are going to undergo surgery a new resource.

The pair's app gives users counseling about what foods they should be eating, and exercises they can work on. It also uses artificial intelligence and augmented reality to detect any falling risks that the patient may have in their home.

“The great thing about the app is the nurses send it out and they get feedback from the information the patient entered in the app, which indicates if there is an area of concern that they need to address with that patient,” she said. “It is very engaging and allows people to take a more active part in their healthcare.”

As the industry continues to morph and include more technologies, she said creativity is key for young people looking to enter the health IT space.

“Especially for women, now is a great time to enter this field. There is a tremendous amount of opportunities. I think women posses this unique ability to analyze information a little bit differently than men,” she said. “So I think we need to see more women in the healthcare IT realm and we just need that creativity and bringing in different ideas. That is what is going to continue to improve this area.”

Twitter: @lauralovett7
Email the writer: laura.lovett@himssmedia.com

Stay Informed

Susbscribe today to receive our FREE monthly e-newsletter