Related Items
Ramping Up The PHR Assembly Line
April 1, 2008
For three years, executives at Blue Cross and Blue Shield of South Carolina evaluated how personal health records could support their quality improvement efforts.
For example, they anticipated they could use PHRs to help disease management nurses verify members are taking their medications as directed and adhering to care plans. Additionally, executives hoped the technology could help support the care of high-risk maternity patients.
The Blues plan, however, also determined that PHRs offered a perfect mechanism for providing educational materials and care reminders to all its members, says David Boucher, assistant vice president of health services.
So when the payer finally decided to offer PHRs, executives chose to start with a big bang, offering full functionality to 1.5 million members from the get-go, Boucher adds.
“We made the decision early on that a PHR without all this information really has minimal value to our members,” he says. “And it would have a limited impact on their behavior changes.”
For Each And Every One
The Blues plan last May began working with its care management/disease management services vendor, ParadigmHealth, Upper Saddle River, N.J., to create a PHR for each of its members and prepopulate it with the last 18 months’ worth of their claims, lab results, pharmacy benefits and care management data.
Then the payer added educational content from Healthwise Inc., Boise, Idaho, to the PHRs, providing automatically selected links to relevant information based on the data in the record.
Finally, it trained nurses to use the PHRs with disease or maternity management patients and educated other employees on how to introduce the technology to members.
The PHRs went live for all members last December, and the Blues plan expected to have them fully populated by March 15.
More than 3,300 Blues members had used a PHR as of mid-February. And nurses already have integrated the PHRs into their workflow, Boucher says.
“We believe having disease, case and maternity management information, as well as claims and health care content, available in PHRs will dramatically improve care results for our members,” he says.
Second-Generation Features
A growing number of payers are adopting PHRs despite the lack of research on whether they help payers improve the quality of care or reduce costs, says Ted Chien, executive vice president at Ingenix Inc.
The Eden Prairie, Minn.-based subsidiary of UnitedHealth Group offers consulting and software. Many of these payers are launching new services—including access to care management data and targeted health care information—within their members’ PHRs in hopes of achieving the benefits more quickly, he adds.
“PHRs are now thought of as a function within a payer’s Web site,” he says. “And they don’t just present information anymore. Instead, they seek to apply it in various ways.”
Some other next-generation functions payers are adding to PHRs include the translation of claims codes into more common medical terms and the creation of reward programs where members who proactively take care of their health gain points that translate into discounts on their premiums or other gifts, Chien says.
A few payers are working with provider organizations to enable members to use their PHRs to send e-mail to physicians or offer information during future care visits that clinicians might not already be privy to, such as data from another provider, says Glenn Galloway, senior vice president at Healthia Consulting, now a business unit of Ingenix.
Any feature that creates a convenience factor for patients to use PHRs will get them hooked on them,” Galloway says.
For the South Carolina Blues plan, providing enhanced functionality, such as access to care management data, wasn’t a big task because it already was exporting the data into an application used by nurses from its care management vendor.
The vendor’s application already had PHR capabilities, so all that had to be done was design a PHR for each member and export their data into it.
The vendor also enabled the Blues plan’s nurses to use its application — and the PHRs — for care management services. Additionally, the vendor integrated the health care content directly into the PHR application.
Marketplace
- About Us
- Advertising/Media Kit
- Reprints
- Editorial Calendar
- Contact Us
- Customer Service
- Privacy Statement
©2008 HealthDataManagement and SourceMedia, Inc. All rights reserved.
SourceMedia is an Investcorp company.
Use, duplication, or sale of this service, or data contained herein, is strictly prohibited.
