Alistair Erskine, MD, the first-ever chief information digital officer of Pittsburgh-based Highmark Health, aims to bridge the many gaps between payers and providers — both within his health system and industrywide — through digital tools and AI.
Dr. Erskine took on the inaugural role in August, hoping to better digitally merge Pittsburgh-based Allegheny Health Network, the payvider’s provider arm, into the broader Highmark Health portfolio — while improving digital communication between health systems and payers in general.
“I really see myself as trying to blend the two organizations together towards reaching the ideal of what a value-based care organization should be mindful of,” he told Becker’s. “You want the best quality [care] that’s affordable.”
Dr. Erskine was previously the chief information and digital officer of Atlanta-based Emory Healthcare, chief digital health officer of Somerville, Mass.-based Mass General Brigham and CIO of Danville, Pa.-based Geisinger (which also has a health plan).
At Highmark Health, he oversees the digital teams at payer Highmark and Allegheny Health Network, a 14-hospital system, while reporting to the CEO of enGen, the $29.4 billion organization’s health tech subsidiary that sells software to other health plans.
In his new role, Dr. Erskine aims to incorporate reminders from the health plan, like population health outreaches, into the clinical workflow — as patients are often more willing to engage with their healthcare provider than their insurer.
He gave examples of some possible digital “nudges”: evaluating patients for palliative care in advance so they aren’t hospitalized unnecessarily at the end of life, prioritizing skilled nursing and rehab facilities based on insurance coverage, and better managing hypertension.
The digital payer-provider synergies that Dr. Erskine builds at Allegheny Health Network could then be spread to other Highmark health system clients — Allegheny Health accounts for only about 5% of Highmark members — as well as other Blue payers.
“How do we understand the provider better? What can we use Epic to be able to do for the provider?” he said. “How can we push order sets and alerts and nudges and care plans and so forth?”
Highmark could financially incentivize health systems that adopt the applications, Dr. Erskine said.
He also looks forward to the opportunity to work with healthcare AI company Abridge on developing a tool that uses ambient AI to automatically adjudicate prior authorizations during the course of a patient visit.
“I’m totally thrilled about this payvider space. A lot of what is driving frustration is costs and lack of trust, and I want to make that better,” he said. “I’m happy that Highmark took a bet to see if we can make this better, and it’s up to me to make sure it does.”
