CAMBRIDGE, MA – Harvard Pilgrim Health Care (HPHC) is leveraging healthcare IT to help achieve its integrated care management vision.
HPHC is deploying ZeOmega’s Jiva to integrate data from multiple sources and share data with members through member-preferred communication channels.
Data integration and data mining help identify, evaluate and stratify members for care management, said Judith Frampton, HPHC’s vice president of medical management. With Jiva, HPHC can create interfaces that aggregate data from multiple department systems and design algorithms that build registries of at-risk members for specific conditions, she said.
Payers are bringing their care management programs in-house to better manage their members’ conditions in one place and with one point of contact, said Sam Rangaswamy, ZeOmega’s CEO. It requires IT solutions to integrate all programs across the care continuum. Jiva’s care analytics identifies and stratifies members based on their clinical conditions rather than actuarial models, he said. “We provide better accuracy on who to focus on, not from a cost standpoint but from a clinical standpoint,” he said.
HPHC anticipates that data integration will deliver greater process efficiencies and productivity from its case managers in terms of increased case load and active care plans created for each member.
HPHC is incorporating social networks so members can learn from one another and understand health issues that impact their lives. “It’s helping people change and learn new behaviors is an untapped resource that we are tapping big time,” Frampton said.
Social networking is still relatively new for payers, said Lynne Dunbrack, program director for Health Industry Insights. To stay ahead of the curve, payers need to adopt social networking technologies and services, commonly referred to as Health 2.0, to engage members, provide differentiation from competitors, and establish and sponsor a community for payers’ constituents, among other things, she said.
HPHC is doing just that with its sponsorship of the community site www.wellthen.org, said Frampton.
