Imagine your loved one has a certain chronic condition. When a doctor asks whether she’s had an MRI recently, your loved one says “no” because she doesn’t remember receiving one — even though she just had one two weeks prior at another doctor’s office across town. Let’s say there was also a prescription for follow-up care, but she never received that, either. Maybe she was also prescribed medication, but the prescription was never filled at the pharmacy. Without a centralized record, this person might theoretically receive the same test over and over without ever following up with subsequent treatment or medicine the doctor feels is necessary. She may feel she’s doing everything in her power to do what the doctor instructs, but the record may tell another story. What many healthy people often don’t realize is how much time and attention to detail it takes to manage your own health care when problems arise. It’s not uncommon for several different doctors to prescribe multiple medications, tests and follow-up care. Without a centralized medical record, many don’t even realize the treatment they’re receiving is a duplication of effort. That redundancy adds to the already high costs of obtaining health care. Information technology has the potential to give doctors and providers of medical care a much more complete picture of the patient in front of them, and patients a much easier way to access their complete medical history. That’s why Blue Cross Blue Shield of Michigan was proud to be a sponsor of the Wiring Michigan Conference, a health information technology symposium held last month in Ypsilanti. Our Patient-Centered Medical Home program is one example of how we’re persuading providers to adopt health IT. Our PCMH program, the nation’s largest at 1,800 designated physicians, encourages doctors to implement information technology such as e-prescribing into their practices as one way to improve quality, open up access to care and help manage costs. Here’s a rundown of what we’re doing to promote health IT:
- E-prescribing — The Blues have collaborated with large customers and industry leaders to lead on electronic prescriptions. Physicians who use electronic prescriptions can view patient records, confirm medications and dosages listed on formularies and know what medications have already been prescribed by other doctors. E-prescribing helps eliminate problems with illegible penmanship, reduces pharmacy staff time and avoids paper waste. Michigan ranked No. 2 nationally for the number of e-prescriptions filled in 2009, according to Surescripts.
- Electronic transactions — BCBSM since 2008 has been helping business partners and providers prepare for the 2012 deadline to implement EDI 5010, a new, federally mandated electronic transaction standard. The changes will enhance business functionality, clarify data ambiguities and support the new National Provider Identifier number required under the Health Insurance Privacy and Portability Act.
- New ICD-10 medical code set — With the rise of electronic medical records, e-prescriptions and connectivity between providers and specialists, the Blues have responded nimbly to maintain market leadership. For starters, the company is on track for early implementation of ICD-10 medical code billing standards, which will provide greater ability to measure health care services and monitor population health, provide better data and cut down on paperwork when submitting claims. Our process for associating the new codes in our systems have been featured at national forums and adopted by other insurers. We’ve also made our solution available to other health care entities to keep implementation costs down.
When approached with the subject of technology in health care, you might think of expensive diagnostic tools and cutting-edge procedures. But what you may not realize is that information technology — the kind of information systems we use at home or at work to track multiple projects or household expenses — can be used on a wider scale to make health care more efficient, safer and maybe even less expensive for everyone. Photo by Tricia Wang.