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PHR in an Integrated Clinical Engagement model  Saji Salam MD,MBA Clinical Transformation Group Cognizant Healthcare Practice TEPR Conference May 20, 2008, Florida
  Integrated Clinical Engagement model
Key Drivers Integrated Clinical Engagement Model Employers Health Plans Providers Members Industry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Demand for better “consumer experience” CDH pushing for more responsibility for healthcare to members
Integrated Clinical Engagement-Data model Clinical Data Repository Payer / Purchaser Info Pharmacy  Data Encounter/Clinical  Data Labs / Imaging Data Family/Social History/ Demographic data Provider quality/cost data Medical Management Info  (HRA, DM, CM etc) Claims  Data
PHR
PHR in an Integrated Clinical engagement model
Member/patient view ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Challenges
AHIP- BCBSA Implementation guide:   P(B)HR Data transfer between health plans Not Included HL7/ASTM CCD Plan of care  Not Included HL7/ASTM CCD Alerts  Not Included HL7/ASTM CCD Health Risk factors Not Included HL7/ASTM CCD Benefit information Not Included NCPDP Immunization Not Included HL7/ASTM CCD Physiological information  Not Included HL7/ASTM CCD Family History  Included ASC X12 N Subscriber information Included ASC X12 N Health Plan information Included ASC X12 N Facility Included ASC X12 N Provider  Included NCPDP Medication Included ASC X12 N Encounter Included  ASC X12 N Patient Information Plan to Plan transfer Alignment with existing standards PHR data domain
Way forward? Source:  Dr.William Gerardi  - HCSC
Q & A Contact:saji.salam@cognizant.com

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PHR In an Integrated Clinical Engagement Model

  • 1. PHR in an Integrated Clinical Engagement model Saji Salam MD,MBA Clinical Transformation Group Cognizant Healthcare Practice TEPR Conference May 20, 2008, Florida
  • 2. Integrated Clinical Engagement model
  • 3.
  • 4. Integrated Clinical Engagement-Data model Clinical Data Repository Payer / Purchaser Info Pharmacy Data Encounter/Clinical Data Labs / Imaging Data Family/Social History/ Demographic data Provider quality/cost data Medical Management Info (HRA, DM, CM etc) Claims Data
  • 5. PHR
  • 6. PHR in an Integrated Clinical engagement model
  • 7.
  • 9. AHIP- BCBSA Implementation guide: P(B)HR Data transfer between health plans Not Included HL7/ASTM CCD Plan of care Not Included HL7/ASTM CCD Alerts Not Included HL7/ASTM CCD Health Risk factors Not Included HL7/ASTM CCD Benefit information Not Included NCPDP Immunization Not Included HL7/ASTM CCD Physiological information Not Included HL7/ASTM CCD Family History Included ASC X12 N Subscriber information Included ASC X12 N Health Plan information Included ASC X12 N Facility Included ASC X12 N Provider Included NCPDP Medication Included ASC X12 N Encounter Included ASC X12 N Patient Information Plan to Plan transfer Alignment with existing standards PHR data domain
  • 10. Way forward? Source: Dr.William Gerardi - HCSC
  • 11. Q & A Contact:saji.salam@cognizant.com