The American Recovery and Reinvestment Act has given the health IT industry a pretty good idea of what will be expected from it once a more formal health care reform plan is released in the fall. The industry has already begun to mobilize in anticipation, and it’s been interesting to see some of the activity that has taken place. There has been some movement in the way of new products, plans or services intended to get a head start on the collaborative approach that will undoubtedly be necessary to meet the goals of the reform bill. Just last week one company announced that it will empower some of its payer customers to make claims data available to providers free of charge. The belief is that doing so will help improve the coordination of benefits and care.  

It’s tremendously encouraging to see growing enthusiasm for openness, cooperation and collaboration. Without a doubt, this is precisely the spirit that will be necessary for health IT to fulfill the expectations of reform and, ultimately, to improve the system for all. MEDecision has advocated this approach since its inception in 1988 and we’ve been proud to have taken some pioneering steps with it throughout that time. It’s very rewarding to see the whole of the industry appreciating the potential we’ve long believed this concept holds. Similarly, we hope the discoveries we’ve made on our journey can expedite progress for the entire system.

What began as an innovative way to automate case, disease and utilization management two decades ago ultimately led us to the development of the integrated medical management model several years ago. However, it has become obvious to us that fostering collaboration and integration within the walls of the payer organization simply isn’t enough. The government’s reform efforts are necessitating that we further develop that approach to foster increased collaboration among all stakeholders. And this is precisely what our newest innovations – Alineo and Nexalign – are designed to do: enable the open, bi-directional flow of data between all health care entities. Market needs are calling for us to replace the transaction-based health care management model of the past with a richer and more rewarding interaction-based approach.

While furnishing users with raw claims data is a well-intentioned step in the right direction, our experience over the past two decades has shown that it’s simply the first rung on a very high ladder. Today more than ever, our industry needs to focus on putting smart data into the hands of users; data that offers clinical decision support, highlights gaps in care and intuitively leads users to the best possible care options for each individual patient. And we must be able to deliver this data where people need it, when they need it and through whatever platform they wish to receive it. This is where MEDecision’s long journey has led and it is exactly what ARRA is relying on the industry to do. We’re very proud to once again be at the forefront of this type of innovation. The best news is that this isn’t some futuristic, long-term concept. This is what MEDecision is offering today. And we have plans for some very exciting additional enhancements — think real-time diagnostic imaging data — in the very near future.

I’ve stated in several recent blogs that the next few months will be both intriguing and exciting for HIT. If the previous few weeks and present times are any indication, they may be even more worth watching than I thought.

With health care reform coming ever closer to reality, industry events such as the recent AHIP (America’s Health Insurance Plans) Institute in San Diego are taking on even more significance. Indeed, one couldn’t help but sense the palpable energy and enthusiasm permeating this year’s AHIP; the themes of change and reform were very apparent throughout the event. Personally, an AHIP highlight for me was the enthusiasm with which MEDecision’s Alineo™ 2.0 was met by both our existing and prospective customers. Alineo 2.0 is a very exciting new release of our already-powerful Alineo product — a collaborative health care management platform for case management, disease management and utilization management. With the new 2.0 release, Alineo is even better equipped than before to help health plans meet the challenges of the changing market. It gives them a powerful, yet simplified resource that is specifically designed to support business growth by streamlining operations, controlling medical and administrative costs and strengthening business processes while improving the overall quality of care.

There was convincing evidence at AHIP that health care "reform" and "transformation" are far more than the latest buzzwords. It’s becoming clear that after many years of speculation and debate, it’s really happening. This was uniformly apparent in the discussion lines of the outstanding presentations I attended. Among the recurring themes that stood out most for me was the idea that the system needs to be rebuilt. Not tweaked, not revised, but built anew. I also resonated with the sense of urgency that was consistently reflected; a feeling that we must initiate reform efforts now because further delay would bring additional severe detriment to the already seriously ailing American economy. Finally, there was the fundamental and pervasive recognition that reform is incredibly important. No one is taking this lightly, and rightfully so, since its outcome will impact the very quality of life in America, our economy and our standing in the world. Those are some pretty high stakes.

Thankfully AHIP was also abuzz with the sense that we can get this done. I think most in the health care sector are eager for beneficial change and to find meaningful ways of materially improving the system. This is certainly the case in health IT where, as we experienced at AHIP, organizations are actively seeking partnerships and collaborations in order to innovate and produce robust solutions to support reform. Just as the whole of health care is readying for change, health IT is clearly ready to do its part. It will be particularly fascinating and especially energizing to participate in developments during the coming months.

Health Industry Insights (HII), an IDC Company, recently published a report called “Technology Selection: The Evolving Care Management Model to Address the Healthcare Crisis.” In essence the report looks at how care management technologies must evolve to accommodate the changing market, namely, “the mounting disease burden” brought on by the increase of chronic conditions in our aging population. Among its many worthwhile findings, the report suggests that integrated technologies such as payer-based electronic health records and those that provide a single source of comprehensive patient information are those that will enable health care payers to best meet the demands of their employer customers while also helping payers themselves maintain costs and improve care. I felt the following quote from the study summed things up rather nicely: “The increasing prevalence of chronic conditions and an aging population is driving a more holistic approach that contemplates the whole person and not one specific disease state or acute episode…”

The HII report resonated deeply with us here at MEDecision because it validated a philosophy we have held for some time. We have long promoted the notion that the next logical step for health information technology is to create a complete and comprehensive view of the individual patient that each stakeholder can both access and contribute to in real-time. It must provide actionable data with up-to-date clinical decision support and gaps in care information to furnish users with a streamlined and simplified resource for managing both populations and individual patients. And it must interface easily with existing systems so the best possible clinical information can get into the hands of those who need it, when they need it and in the format that best suits them.

This is precisely what we have designed our Alineo™ and Nexalign™ products to do, so the HII report indeed corroborates our vision for the future of the industry. It’s no wonder that these products gained so much attention and enthusiasm when we showcased them at the recent AHIP Institute and HIMSS conference. Potential partners and potential users alike have begun to see the value in technologies that can integrate, automate and collaborate. With health care reform poised to kick into high gear in the coming months and the patient centered medical home model continuously gaining traction, I think we’ll see what we once considered the future of health IT become reality a lot sooner than we once anticipated.