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Posts Tagged ‘clinical business process monitoring’

Member-centric Care: Not without Business & Architectural RoadMap

If I had a dollar every time an Enterprise Architect said, “I have a Road Map,” and handed me the future state IT architecture (which is 5 years out) and proceeded to verbalize current to future IT while I madly wrote every word down in preparation for a Business Transformation Session to prioritize/re-prioritize initiatives, well […]

Member-centric Care: Open source to the rescue?

A must read from my colleague, Martin Sizemore, entitled, “Is it time for open source in healthcare?” Wow! This Business/Process with system enablement person, me, can understand this architecture stack. Yes, now more than ever we need open source. Prototyping Open Source for testing ICD-9 to ICD-10 with on the fly remediation before going to […]

ICD-10 Revenue Neutrality Will Drive Collaborative Testing

I was reading my collegue Mike Berard’s blog, on ICD-10 Revenue Neutrality: A Strategic Approach. We have discussed the importance of testing before production between Payer and Provider (e.g., Physicians and facilities). In his 2nd to last paragraph Mike proposes the following: “The reality is that Revenue Neutrality verification is still subject to the availability […]

ACO – A Brave New Enterprise: Are you ready?

Racing towards an ACO and Population Management this year is a huge challenge. A new enterprise platform is a must for an ACO to coordinate the changing of Provider and Payer processes and behavior not to mention the Shared Savings contracts which require new measurements and reporting: a shared dashboard. Check out Martin Sizemore’s take […]

Member-Centric Care: Are we enabling the Next Generation of SMEs?

A struggle for the Payer/Provider Industry is how to prepare the next generation of Subject Matter Experts (SMEs). Now more than ever you need the experienced Medical Directors, Clinicians, and Non-Clinicians on your multiple #1 initiatives. Are you preparing your next generation of SMEs? Yes, you do need the 20-25 years EE on the project […]

Member-Centric Care: Are we working on the correct priorities?

In my previous blogs, I asked if we were missing a key player in member-centric care and then provided my opinion. Here is a recap of questions and answers I discussed, as well as some new points: Are we, business and information technology professionals, clinicians, and non-clinicians, working on the correct priorities for member-centric care […]

Member-centric Care: Missing a Core Team Member

In my last blog post I asked if we have missed a core team member in member-centric care. My answer: In Sales there are the Health, Life and Supplemental Insurance Agents for employers and members that are responsible for mentoring members on plans, eligibility and benefits as well as understanding claims. These individuals make a […]

Receiving Outcome Incentive Payments Requires more than “Outcomes” from Providers

Paying healthcare providers to meet defined quality goals has experienced an uptick in acceptance and appeal lately. Given the fact that the quality of care in the United States has been unresponsive to decades worth of public reporting and benchmarking efforts, one can’t help but to wonder if a financial incentive to providers and physicians […]

Looking Forward: Measuring Healthcare Quality

Compared to other nations, the United States has difficulty measuring up to some key areas related to health care quality. In terms of life expectancy, Docteur and Berenson (2009) contend that the United States has one of the lowest life expectancy rates and the highest mortality rate from conditions that could have been prevented. These […]

HIEs post another Win within the Healthcare Industry

One of the most costly and concerning healthcare expenditures is emergency room visits. Providers and payers are especially concerned with the uptick in ER visits, because ER visits are known to be extra costly and peppered with discressionary visits. Providers and payers have decided lowering ER useage could be done by identifying ER abusers and […]

How the Healthcare CIO Saves Lives

There are many benefits to Health IT, but when it comes to these business drivers there is one that leads the charge: increased efficiency. The motivation to increase efficiency is on the lips of healthcare executives in both provider and health plan circles across the nation. Controlling and being aware of the cost of care […]

Healthcare and Business Process Management Interview [VIDEO] at IBM Impact Trouble viewing? Check out the link to the video here Joel Thimsen, Solution Director at Perficient, was interviewed by Scott Laningham, Host of developerWorks, and Todd “Turbo” Watson, Blogger/Technology Evangelist, at IBM Impact in Las Vegas. Joel outlined Perficient’s 12 year partnership with IBM and some of the key trends he has seen when […]

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