When Community Health Plan of Washington implemented ZeOmega’s Jiva care management software in October 2008, the health plan saw the immediate elimination of duplicate assessments being done on the same patients by its use, disease and case management departments, said Sandra Hewett, the plan’s delegated services administrator.
Some of CHPW’s departments have since exceeded the goal of achieving 30 percent improved efficiency through the integration of IT systems, automation of processes and streamlined workflow, she said.
Now that all the data is in one place, staff members have a single, patient-centric view and as a result, all care management departments can support the same goals for the patient, Hewett said.
More people are developing multiple chronic conditions and co-morbidities, observed Lynne Dunbrack, program director for Health Industry Insights. In order for health plans to get a holistic view of their members, they are looking to combine their care, case, disease and even health and wellness programs.
“It’s definitely becoming a trend,” she said.
ZeOmega’s Jiva automated processes, which enabled Hewett to gain visibility into the volume of work and allocate staff according to the workload. “We saw huge productivity gains,” Hewett said. The same number of staff is now able to do more use and concurrent reviews per day.
Process automation has also increased CHPW’s regulatory compliance.
Communication between CHPW and its members’ primary care physicians has improved because the software generates patient discharge notifications and letters. “It used to be hit and miss with our PCP communications,” Hewett said.
Ted Ryan, vice president of sales for ZeOmega, said health plans realize the value and power of information to impact medical loss ratio, quality of care and efficiency. “Health plans are now being the driver of health management platforms,” he said.
