Healthcare IT News - January 2009 - (Page 22) 22 Healthcare IT News January 2009 ■ www.HealthcareITNews.com NEWSBRIEFS BCBS moNtaNa BooStS ItS CuStomER SERvICE Blue Cross and Blue Shield of Montana is boosting its customer service with technology from Cambridge, Mass.-based Pegasystems. BCBSMT has selected Pegasystems’ Customer Process Manager for Healthcare to optimize its customer service, sales, and process efficiencies. Pegasystems’ technology will streamline customer phone inquiries resolving many questions within the first call. The insurer plans to roll out the new technology in early 2009. Pharmacists boost patient care programs By PaTTy ENrado, Contributing Editor NEW YORK – ShaREd hEalth INtEgRatES data, ImpRovES WoRkFloW Shared Health, one of the largest public/private health information exchanges (HIE) in the United States, is using technology from Santa Monica Calif.-based Orion Health to integrate data and improve workflow. Shared Health will implement Orion Health’s Concerto Physician Portal to enable an integrated electronic health record system and provide access to patient data from disparate systems. Orion Health North America President Paul Viskovich says Shared Health is the first HIE to leverage Concerto’s strengths in integrating health data and workflow applications in a unified, patient-centric view. ateness, she said. Reduced hospital utilization using a The Asheville Universal American’s Chronic Care Coordination program Project and the members enrolled in its Medicare Ten City Challenge, Advantage plan that carries the 14% comprising 10 comCommunity CCRx Prescription Drug munities across the Plan will be able to participate in a country, illustrate new patient care program. Base = 100 patients the successful proThe new program speaks to an grams taken on by emerging trend of pharmacists parself-insured employticipating in collaborative care moder groups and health els across many settings, said Anne 2.4% plans in which pharBurns, vice president of professional macists play a critical role, she said. affairs for the American Pharmacist Usual Care Chronic Care Patients Coordinated Medication therapy management, disAssociation. e With Medicare patients on com- ● Connect: GraPHS 0109 SOURCE: HEAlTH WORkFORCE SOlUTIONS llC 2008 ease state management and immunization services are examples of the value pharmaplex medication regimens and seeing multiple providers for their chronic diseases, healthcare teams need cists provide to improve health outcomes and reduce healthcare PHarMaCy see page 23 medication therapy expertise to review all medications for appropri- IT improves efficiency, quality of care By PaTTy ENrado, Contributing Editor SAN ANTONIO - WellMed Medical Management is implementing ikaSystems’ ikaEnterprise to create a system that will interface with all its clinical tools and best processes and strategies. By automating processes, WellMed will be able to deliver administrative efficiency, lowered business risk and improved quality, said Bill Connolly, senior vice president of Shared Services for WellMed. T h e p hy s i cian-owned practice management company serves Medicare Advantage patients and is Don Bonacci its own health plan. Don Bonacci, WellMed CIO, said the company’s focus is upmC addS mEdICal maNagEmENt tEChNology UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, has expanded its partnership with Southborough, Mass.-based ikaSystems to improve quality and cost containment. UPMC will add Webbased integrated medical management solutions to its existing ikaEnterprise modules underlying its portal strategy, allowing the plan to enhance healthcare quality for its members while supporting providers with performance information. FCSo EmployS NEW REImBuRSEmENt SyStEm First Coast Service Options (FCSO), headquartered in Jacksonville, Fla., is working with Alexandria, Va.-based Burgess, a Medicare reimbursement solutions provider, to support a new Medicare contract awarded recently by the Centers for Medicare & Medicaid Services. Under this new contract, FCSO will resolve reimbursement disputes beginning Jan. 1, 2009, between healthcare providers and organizations offering Medicare Private Fee-for-Service plans. FCSO will license and employ the Burgess Reimbursement System to compute accurate pricing associated with disputed claims. More at HealthcareITNews.com e Connect: PaYerS 0109 WellMed can continue to grow with the same level of staff to maintain administrative efficiency with ikaSystems platform, which will be integrated with WellMed’s practice management and electronic ➔ thE NEWS: WellMed is medical record investing in a system that will systems. interface its clinical tools. “Our intent ➔ What It mEaNS: The in this environinvestment will improve data ment and in analysis and reporting and boost the future is to disease management. grow,” Bonacci said. “This “The design and integrity of ika- product, and when carefully Systems is conducive to meeting implemented, will deliver great total cost of ownership.” our goals.” The University of Pittsburgh ikaSystems’ suite of Medicare applications will enable WellMed Medical Center, or UPMC, a to improve its data analysis and long-term ikaSystems partner, is experiencing a minimum reporting, Bonacci said. While the company has 30 percent growth per year in excelled at business processes Medicare members, said CIO and strategies, Connolly said WEllMEd see page 23 on ensuring that its patients are getting healthier. “We want to make sure that we’re getting the necessary information on patients and bringing it back to the providers,” he said. Small payers leverage IT By PaTTy ENrado, Contributing Editor WASHINGTON – DC Chartered Availity expands patient profile Interest in care profile is growing because of its ability to integrate data, say company officials. By PaTTy ENrado, Contributing Editor JACKSONVILLE, FL ● – Availity, provider of EDI (electronic data interchange) clearinghouse and health information exchange services, will expand its Availity Care Profile in the first half of 2009 on a region by region rollout. Interest is growing for the profile because of its ability to aggregate data from payer-based health records, electronic medical record systems and patients’ personal health records, or PHRs, said CTO Jon McBride. Availity is responding to a request for information from the state of Florida, which is interested in this type of functionality, he said. The profile, piloted in May 2006, is available in Florida and Texas, which has more than 16,000 provider sites. Availity, formed as a joint venture by Humana, Blue Cross and Blue Shield of Florida and the Health Care Service Corp., will also conduct independent ROI studies in the first half of 2009, he said. The profile’s integration of Initiate Systems’ record locator service, or RLS, and Enterprise Master Person Index, or EMPI, will enable accurate patient identification and return of multiple data sources. McBride pointed out the importance of connecting and synchronizing data streams from ProfIlE see page 23 Health Plan has begun implementing MEDecision’s care management technology to service its growing Medicaid population. With co-morbidities of DC Chartered’s members stretching its clinical capabilities, the Alineo Collaborative Health Care Management platform will enable the private managed care company to better manage its 80,000 members, said CEO Karen Dale. The platform will turn paper-based processes into electronic ones. “There are a lot of efficiencies we’re hoping to gain in a streamlined operation,” Dale Karen Dale said. “The outcomes are not changing, but we have to do more with less.” Alineo’s disease management piece will enable DC Chartered to plug members to the appropriate disease management program. The care management piece will integrate components of care and allow care managers to document and view in one place. “Every contact with members needs to be maximized,” dC see page 23 http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/news/payers-news-briefs-15
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.