If accountable care is going to work and providers and insurers are actually going to partner to cut costs, then one of the first orders of business is to tackle the laundry list of information technology requirements needed to make it work, according to Joseph Gifford, M.D., executive medical director at Regence BlueShield in Washington.
At the AHIP Institute 2011 in San Francisco, Gifford explained how a medical home pilot program that included Regence, airplane maker Boeing Inc. and Seattle-based provider groups requires Regence to merge into the clinical care process through a series--a seemingly endless series--of I.T.-driven events. For example, the trigger for patients to be eligible for high-touch care management are health risk scores created by Regence, scores that have to be put in front of providers at the point of care. Then come pharmacy and diagnosis data, hospital admission notifications, notices of coverage changes and other bits and pieces of information that need to flow from insurer to provider.
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