Health Insurance Plans Are Pioneering New Approaches

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Health Insurance Plans and IT

Health insurance plans are advancing the horizons of information technology (IT) on many fronts, and in the process are achieving impressive results in health care quality, service, cost, and efficiency. "Innovations in Health Information Technology," a new report from America's Health Insurance Plans (AHIP), profiles more than 40 innovations in the use of health IT that address a variety of needs in our nation's health care system with effective new solutions.

"Clearly, America's Health Insurance Plans are investing in the innovations in information technology included in our new report because they recognize the improvements that can be achieved," said AHIP President and CEO Karen Ignagni. "Advances in information technology can help ensure that the best of the U.S. health care system will also be its norm."

The health insurance plan community has a tradition of sharing information about emerging and best practices that can spur others in the field to continue to raise the bar. In addition, the industry plans to circulate the report to policymakers, colleague organizations, and providers of health care.

The companies profiled in America's Health Insurance Plans' report have applied information technology to a wide ranging set of challenges and opportunities:

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A Florida health insurance plan located in a community with a shortage of critical care physicians has established an electronic intensive care unit (e-ICU) in its three participating hospitals. This advanced technology system allows specially trained critical care physicians and nurses to monitor ICU patients on a 24/7 basis from a remote location. The system alerts onsite medical teams of potentially detrimental changes so they can intervene immediately to avert crises. In its first year of operation, the program saved lives, fewer ICU patients experienced cardiopulmonary arrest, and the risk of mortality among ICU patients fell.

Three health insurance plans in Massachusetts have joined forces to jump start the use of e-prescribing technology by physicians throughout the state. A handheld device enables physicians to access patients/ medication histories, check for potentially harmful drug allergies and adverse interactions, and create and renew prescriptions electronically. The program promotes patients' safety and helps avoid errors caused by illegible handwriting.

A Nevada health insurance plan has implemented a digital radiology program that capture x-rays in digital format rather than on film and makes them immediately available for its medical group's doctors to review and evaluate. X-ray images are accompanied by radiologists' note, which are transcribed electronically with a voice recognition system and stored in Word documents for easy viewing. Physicians can access the X-rays they have ordered, along with radiologists' assessments, within hours instead of days, thereby improving their ability to make timely and informed treatment decisions.

Perhaps no IT initiative offers more promise or has acquired more urgency in the wake of recent events than the development and implementation of electronic personal health records (PHRs). A PHR is an electronic record of an individual's health and care that compiles information across time and providers. Today, an individual may receive care from a number of different providers in a variety of settings, and for most consumers, no system is in place to coordinate and summarize the information from these disparate health care encounters. PHRs can aggregate an individual's personal health information for them into a coherent and permanent record of care for their use.

A number of pioneering approaches to PHRs are profiled in a section of the new health IT report, looking at how health insurance plans are developing PHRs and other forms of electronic health records, and finding that they have great potential to improve health care quality, reduce costs, and increase consumer satisfaction.

A link to "Innovations in Health Information Technology: Effective New Solutions from American's Health Insurance Plans" follows, with information on how to contact the companies about their unique programs and the results they have achieved.

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