U.S. Health Executives Highlight Move to Personalized Health Care

2005-05-09 - Cleveland, OH, USA: The Managed Care Executive Group (MCEG), a lobby and networking group for information services executives in the U.S. Health sector, has released a list of the top ten issues facing managed care information technology executives in America. The list was developed at MCEG's annual meeting held April 25-27, 2005 in Tucson, Arizona, and is interesting in the way it shows customization and personalization trends more familiar to hi-tech industry becoming established in health care.

MCEG membership includes executives from leading managed care and health insurance companies from across America. "This year's conference focused on the drivers of a changing healthcare market. Those drivers lead to demands on the information technology infrastructure, requiring successful organizations to deliver those changes in an increasingly timely and efficient manner," said Alan Abramson, president of the MCEG. "Our members, representing some of the most strategic health players in America today, reflect the national reaction to today's market place."

According to the MCEG survey, the Top Ten trends and issues requiring nimble and creative responses are:

1. Consumer-Focus. Health plan products featuring choice, customization, flexibility, and direct involvement by individual members in their care will drive I.T. investment toward support for personalized processes and away from "one size fits all" processes of the past.

Such mass customization will drive large data warehouse implementations and the integration of them and multi-threaded customer-facing applications.

2. Collaboration with Providers. Prior authorization and utilization reviews are fading, and in their place is a more collaborative model based on access, quality, safety, effectiveness and patient centeredness. Health plans will increasingly encourage provider investments and/or jointly invest in clinical automation, CPOE, networks, and revenue cycle enhancements to further automate the care process. National initiatives such as NHII will provide stimulus to this effort.

3. Providing transparency to health plan data and operations.

4. Investment in Real-time Infrastructure. Innovation in business process continues to yield returns in customer satisfaction and increased revenue. CIO's know that business process fusion requires a robust and scalable Real-Time Infrastructure, and are investing accordingly. In addition to high availability processors, storage redundancy and alternate path networks, this infrastructure includes advanced monitoring software to aid in the discovery and removal of bottlenecks and to continuously tune the technology environment for optimal performance.

5. Retention and use of clinical information as it impacts:
A) Predictive Modeling
B) Disease Management
C) Health Outcomes

6. Managing all the health information needed by members, employers, providers and other stakeholders to maintain and improve health.

7. Impacts and movement to services oriented architecture (SOA)

8. Nimble, Speed-to-market solutions (tie). Fast, focused and results- driven projects will be required to address the rapidly changing product portfolios and changing demands of the market. These I.T. projects will need to fit within overall standards and architectures to avoid rework and too-early replacement later.

9. Impact of Medicare Reform Legislation (tie). Recent Medicare reform both extends the role of health plans and introduces new elements of competition.

10. Rapid product development to meet changing demands of members.