Payers aren’t always in the loop when physicians and patients get together to map out a healthcare regimen. IBM is looking to the clouds to change that.
The Armonk, N.Y.-based technology giant announced on Aug. 5 a collaboration with one of the nation’s largest payers to launch a cloud computing and clinical decision support solution that links physicians – whether they’re in a hospital or their own clinic – with patients and payers. The new platform is designed to help round out the patient’s electronic medical record, giving physicians the information they need at the point of care and helping patients and payers make sure that care is properly administered and billed.
Executives from IBM and ActiveHealth Management, a New York-based, independent subsidiary of healthcare insurer Aetna, unveiled the Collaborative Care Solution. The solution combines IBM’s cloud computing platform with ActiveHealth’s CareEngine clinical decision support system to pull together not only medical records, medication and lab data, but claims information as well.
Among the first health networks to make use of the new platform is the Sharp Community Medical Group, a San Diego-based network of more than 210 primary care physicians and 600 specialists who provide care for more than 146,000 patients.
“The relationship among Sharp Community Medical Group, IBM and ActiveHealth is really about transforming how we deliver patient care,” said John Jenrette, MD, Sharp’s CEO. “The current state of medicine today is one of paper records, fragmentation and lack of patient information at the right location and at the right time. Unfortunately, this is medicine’s current state in most organizations and physicians offices. The patient is not engaged in their own healthcare and not connected to their clinical information and doctors in an effective manner."
"The work we are undertaking will create a system that is patient centric," he said. "It will provide the connection among primary care physicians, specialty physicians, hospitals and patients to achieve improved clinical outcomes while reducing costs.”
Officials say the coordination of care on a cloud-based platform will help healthcare providers better coordinate care for their patients, especially those with ongoing or chronic conditions like asthma, diabetes and heart disease. Adding insurers and health plans to the mix ensures that care plans are managed and followed, and that bills are properly routed and paid. In addition, officials say the Collaborative Care Solution will help providers achieve NCQA Level 3 patient-centered medical home status and move toward becoming an accountable care organization – two initiatives included in President Barack Obama’s healthcare reform efforts.
According to a recent Thomson Reuters study, about $800 billion is wasted in the United States each year on ineffective care, ranging from duplicate or unnecessary tests or medical appointments to inappropriate diagnoses based on incorrect information to unnecessary or incorrect prescriptions.
“Our healthcare system needs solutions that can help physicians collect, connect, analyze and act on all the information available to improve a patient’s health. Our solution makes this possible in real-time at the point that care is delivered,” said Greg Steinberg, MD, CEO of ActiveHealth Management.
“The healthcare industry is under tremendous pressure to reduce costs while improving quality of care,” added Robert Merkel, vice president and healthcare industry leader for IBM Global Business Services. “Collaborative Care assists in achieving these goals by providing advanced clinical services that complement EMRs and removing the infrastructure costs by delivering these services through cloud computing.”
