MEDecision's Patient Clinical Summary puts payer-based patient record in doctors' hands

Wayne 14 February 2005MEDecision Inc. has made available MEDecision's Patient Clinical Summary (PCS). A health care industry first, the Patient Clinical Summary takes patient information available from a health plan and electronically delivers it to doctors when and where the patient is being treated. Doctors now have fast, simple access to patient medical histories and critical information that can improve outcomes and save lives.


The Patient Clinical Summary is the industry's first electronic health record generated for treating physicians and created by a health plan or other payer organisation. It provides a common patient view that includes a patient's historical and current medical data from doctors, labs, pharmacies and other provider organisations that have been paid for by the patient's health plan. As a result, doctors receive comprehensive, actionable intelligence about the patients they are treating when it is most valuable - when they are making treatment decisions. The first implementation of a MEDecision Patient Clinical Summary will be announced later this quarter.

"Making our PCS available to doctors at the point of care represents a turning point in United States health care. We've taken a huge step toward improving outcomes, reducing medical errors, and increasing operational efficiencies to benefit patients, payers, and providers", stated David St.Clair, chairman of the board and chief executive officer at MEDecision. "For 17 years, MEDecision has worked closely with payers, providers and other health care stakeholders to deliver the right information to the right people at the right time to improve the quality and affordability of health care."

Cynthia Burghard, research director for Gartner Inc., commented: "The ability of health care payers to leverage existing data and provide value at the point of care is a step closer to improving quality and patient safety." Added MEDecision's David St.Clair: "The industry will benefit from this and other collaborative information sharing initiatives occurring across the country."

The Patient Clinical Summary is MEDecision's response to the most pressing demands facing health care in the United States. Health care payers and emerging regional health information organisations depend on a complete health care picture of a patient to make important medical decisions, but they are often frustrated by the inability to get to the right information quickly enough to determine the best outcome.

With the PCS, payers can deliver actionable intelligence to their respective providers, and ultimately patients, through MEDecision's Transactions and Information Exchange, a powerful health care information exchange service. A component of MEDecision's Integrated Medical Management solution (IMM), Transactions and Information Exchange prepares and delivers information from a single holistic repository referred to as a payer-based health record.

This common patient view is electronically accessible anytime, anywhere in a secure and protected environment. IMM, a suite of collaborative care management solutions, retrieves information from multiple sources, including insurance claims, physicians, labs, radiology departments, pharmacies and other sources associated with the payer. It assembles the information into a payer-based health record, applies clinical and business logic from evidence-based medicine and packages the data into customized content tailored to specific audiences, such as the Patient Clinical Summary designed specifically for the provider community.

The Patient Clinical Summary can include a broad range of vital patient information including a demographic profile, health status measure, medical conditions, inpatient and emergency room admissions, monitored services, medications, specialist visits, early detection flags and treatment opportunities.

Authorized payers and providers, including hospitals and doctors, can utilize the intelligence to make timely and accurate decisions that improve quality of care, reduce medical errors and increase their operational efficiencies. The goal is to improve health care outcomes, as well as the affordability of the care.

The common patient view afforded by IMM provides a common information exchange framework that can be easily used by authorized payers and providers. This includes common patient identification to ensure data security; common data extracted from disparate health care systems to ensure high data integrity; clinically correct and commonly used nomenclature to ensure consistent interpretation of the data; and common clinical pathways validated by evidence-based medicine (EBM) to ensure the best treatment recommendations. It also provides a common structure for updating, exchanging and storing the information across healthcare delivery systems which ensures that authorized users can access actionable patient information, anytime, anywhere.

Continued MEDecision's David St.Clair: "The delivery of the electronic patient history record is essential to the future of United States health care. With today's PCS delivery, MEDecision has demonstrated its commitment and capacity for leading the health care transformation that will improve the outcome and affordability of healthcare by improving the availability, quality, usage, and exchange of actionable intelligence."

MEDecision is a software expert in collaborative care management. Founded in 1988, the company's Integrated Medical Management solutions create a seamless payer-based medical management system to analyse, apply, administer and automate management of health care programmes and provide a common patient view at the point of care. MEDecision's clients include more than half of the country's Blue Cross Blue Shield plans improving patient outcomes, reducing medical errors, and increasing operational efficiencies for approximately one in every six Americans with health insurance. More company news is available in the VMW December 2004 article MEDecision and Avidyn Health to bring Integrated Medical Management to self-funded health care market.

Leslie Versweyveld

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