Ron Rajecki

Blue Cross and Blue Shield of Minnesota’s 10,000 employees and family members are part of a new pilot program testing the insurer’s Online Care Anywhere program. The program is designed to allow patients access to medical care from home or work via computer or phone.

“Online Care Anywhere is a dynamic new tool that can be used to make health care less costly and more convenient for consumers,” Pat Geraghty, president and chief executive officer of Blue Cross and Blue Shield of Minnesota (Blue Cross), said in a 

Blue Cross is the first health plan in the continental United States to offer online care, according to the insurer. During the pilot phase of the program, the company will work closely with its employees and its partners to evaluate and refine the care model. Online Care Anywhere uses the services of regional health network Fairview Health Services and uses technology developed by American Well.

To facilitate workplace use of online care, Blue Cross has created three secured “online care rooms” at its Eagan and Virginia, Minnesota, campuses. Each is equipped with a computer; web camera; and biometric machines to record weight, body mass index, and blood pressure; and other basic diagnostic tools. Fairview Health Services family practitioners, pediatricians, and emergency medicine physicians will be scheduled and available for consultations and care.

Articles

Blue Cross and Blue Shield of Minnesota?s 10,000 employees and family members are part of a new pilot program testing the insurer?s Online Care Anywhere program. The program is designed to allow patients access to medical care from home or work via computer or phone.

Telemedicine program tested in Minnesota

Aetna and WellPoint are the first national health plans to earn certification for electronically exchanging administrative data using the 

Council for Affordable Quality Healthcare

 (CAQH) Committee on Operating Rules for Information Exchange (CORE) Phase II rules.

The plans are two of the more than 115 organizations - providers, vendors, health plans, the Centers for Medicare and Medicaid Services and other government agencies, associations, regional entities, standard-setting organizations, and other healthcare entities - participating in the ongoing development of the CORE rules. The goal of the voluntary, industry-driven effort is improved electronic provider access to patient insurance information - eligibility, benefits, patient financial information, and claim status information - before or at the time of service.

“We are investing in an infrastructure that is improving connectivity and operability among healthcare providers and payers while helping to fulfill the priorities of the national health information technology agenda,” Ronald A. Williams, CEO of Aetna and CAQH board chairman, said in a prepared statement. “This ongoing advancement can increase efficiency and quality through more timely access to key healthcare data.”

According to CAQH, the CORE rules are intended to complement the national solutions outlined by the American Recovery and Reinvestment Act and its Health Information Technology for Economic and Clinical Health Act and to help foster the development of regional and state data exchanges by pairing content with infrastructure requirements that streamline electronic patient data flow through existing information technology systems. Multi-stakeholder groups in Ohio, Texas, Colorado, and Virginia have recommended that CORE rules be implemented statewide.

More than 20 health plans, large provider groups, and technology vendors have expressed a commitment to completing Phase II certification in the coming months, according to CAQH. CORE participants currently are developing Phase III rules, which focus on improving the electronic exchange of additional administrative transactions, such as prior authorization and remittance advice.

“The CORE Phase II rules represent a significant milestone in using transparent, consensus-based, national operating rules to streamline electronic administrative transactions among providers, health plans, and vendors,” said Doug Henley, MD, FAAFP, executive vice president and CEO of the American Academy of Family Physicians, in the statement from CAQH. “Health plans that complete CORE Phase II certification can exchange data more effectively, thereby improving efficiency and freeing up time for physicians to focus more on their patients.”

A CAQH study by IBM Global Business Services issued in 2009 found that industry-wide implementation of the CORE Phase I rules alone could yield $3 billion in healthcare-related savings. CAQH reportedly expects that widespread adoption of the Phase II rules and subsequent phases of CORE will result in even greater savings for stakeholders across the industry.

Aetna and WellPoint are the first national health plans to earn certification for electronically exchanging administrative data using the Council for Affordable Quality Healthcare Committee on Operating Rules for Information Exchange Phase II rules.

Aetna, WellPoint earn electronic data exchange certification

Remote monitoring of patients in intensive care units (ICUs) was not associated with an overall improvement in the risk of death or length of stay in the ICU or hospital, according to a 

Journal of the American Medical Association

Experts recommend that intensive care physicians care for ICU patients on-site because of an associated lower rate of illness and death. “However, there is a shortage of intensivists, which has led to the use of telemedicine technology to allow intensivists to remotely and simultaneously care for patients in several ICUs, thus extending their reach,” the authors write.

Eric J. Thomas, MD, MPH, of the University of Texas Health Science Center at Houston, and colleagues assessed the effect of a “tele-ICU” intervention on mortality, complications, and length of stay in six ICUs of five hospitals in a large U.S. healthcare system by measuring these outcomes before and after implementation of the tele-ICU. The study included 2,034 patients in the pre-intervention period and 2,108 patients in the post-intervention period. Almost two-thirds of the patients in the post-intervention group had physicians who chose minimal delegation to the tele-ICU, in which the tele-ICU intervened only for patients in life-threatening situations. Physicians delegated full treatment authority to the tele-ICU for almost one-third of patients.

The researchers found that the observed hospital mortality rates were 12.0 percent in the pre-intervention period and 9.9 percent in the post-intervention period. After adjustment for severity of illness, no significant differences were associated with the telemedicine intervention for hospital mortality. ICU mortality rates were 9.2 percent in the pre-intervention period and 7.8 percent in the post-intervention period, with the difference also not significant after adjustment.

The observed average hospital length of stay among patients who survived to discharge was 9.8 days pre-intervention and 10.7 days post-intervention; the observed average ICU length of stay for the patients who survived to transfer was 4.3 days for the pre-intervention period versus 4.6 days for the post-intervention period, with neither difference significant.

“Given the expense of tele-ICU technology, the conflicting evidence about its effectiveness, and the existence of other effective quality improvement interventions for ICUs, further use of this technology should proceed in the context of careful monitoring of patient outcomes and costs,” the authors concluded.

Remote monitoring of patients in intensive care units was not associated with an overall improvement in the risk of death or length of stay in the ICU or hospital, according to a study.

Remote monitoring for ICU patients not associated with shorter hospital stays

The federal government can encourage physicians to buy electronic health record (EHR) systems, but it is the vendors and hospitals that affiliate with doctors that ultimately will determine whether they adopt them, according to a new report from healthcare market research publisher Kalorama Information.

The announcement of government incentives of up to $44,000 in increased Medicare payments to doctors for the meaningful use of EHR has created interest, according to Kalorama’s report, 

2010 (Market Analysis, ARRA Incentives, Key Players, and Important Trends),

 but these incentives represent future payouts for EHR systems that physicians have to pay for now.

“We think that hospitals and large health systems will need to have parallel incentives in order for the [EHR] concept to happen in a meaningful way,” Bruce Carlson, publisher of Kalorama Information, said in a 

Vendor actions such as “stimulus guarantees,” in which a vendor assures a customer that the system will earn stimulus incentives from the Centers for Medicare and Medicaid Services, enhance the effects of government incentives, according to the report. Kalorama Information expects vendors to go further, offering aggressive financing and/or installment of the capital outlay, especially to attract small group practices.

The federal government can encourage physicians to buy electronic health record systems, but it is the vendors and hospitals that affiliate with doctors that ultimately will determine whether they adopt them, according to a new report from healthcare market research publisher Kalorama Information.

Author | Ron Rajecki

Articles

Telemedicine program tested in Minnesota

Aetna, WellPoint earn electronic data exchange certification

Remote monitoring for ICU patients not associated with shorter hospital stays

Report: hospitals and vendors, not government, will drive EHR usage