EHRfor electronic health record, and
PHRfor personal [electronic] health record.
Business process engineering will be a critical component. Before IT can change, a clear understanding of existing or
as is process modeling, and a new
to be, or future state vision, must be determined. As you can imagine, if health care claims are currently being processed via paper, and in the future you expect to process them electronically, the workflow of health insurance company staff, as well as health providers and patients will have to change. The ability to facilitate meetings with key stakeholders and produce Process Models that enable simulation and what if scenarios are key competencies to help health insurers meet this challenge.
Emergence of a Retail Market in Healthcare
With healthcare spending rapidly approaching 20 percent of the U.S. Gross National Product, healthcare has reached a crossroads. Either free-market forces will solve the current affordability crisis or the federal government may impose a solution. If the industry hopes to solve the affordability crisis, healthcare payer organizations will have to rethink their roles and fundamentally change the way they provide value in the supply chain. To sustain their role at the center of the healthcare supply chain, payers must lead the industry’s transformation by deploying solutions that enhance their revenue growth and improve the customer experience.
The Need for Innovation in Health Care
Integrated Healthcare Management (see IHA) is the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. No World Borders applies our talent and process knowledge to help improve the flow of information from doctors to payers and funds from payers to doctors, in partnership with leading health care solutions firms.
U.S. healthcare includes significant variability in how healthcare is delivered and in the results it achieves, largely due to divisions among the constituents in the healthcare supply chain: the consumers who use the system, the providers who give care, the employers and consumers who purchase healthcare, and the health plans that pay for services.
Integrated Healthcare Management is a framework that connects all of the healthcare supply chain constituents so that they can collaborate on and coordinate benefits and care.No World Borders is partnering with companies to provide its consulting services to give payers the software, services, and blueprint required to power Integrated Healthcare Management, and lead the transformation of healthcare.