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Assemble detailed claim amp; eligibility extract组装详细的索赔amp；资格提取物.ppt

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Assembledetailedclaimamp;amp;eligibilityextract组装详细的索赔amp;amp；资格提取物.ppt

HIT in Chronic CareReally Cool Stuff…Speeding Up a Broken Process? March, 2007Joe Gifford MD Chief Medical Officer Regence BlueShield Introduction Chronic care IT not about standards, interoperability, exchange, or RHIOs, Chronic care IT about tools to care for patients Confronts the business problem: no new money Confronts the broken health care system Introduction Broken health care system Costs out of control Wide variation unreliable quality Opportunities abound 30% of care is unnecessary 30% of the remainder is muda (waste) IT-enabled business process reengineering In the chronic care category IT-Enabled Business Process Reengineering Not a technology problem A business / system problem No new money Chicken-egg problem No new expensive toys Need IT for the reengineering Chronic Illness Business Case Major Chronic Diseases Diabetes [16 million] Heart disease (CAD, CHF) [18 million] Lung disease (Asthma, COPD) [30 million] Others Arthritis/back pain Obesity/metabolic syndrome Hyperlipidemia Depression Some cancers Total Health Care Costs = $1.7 Trillion The Vision – Star Trek Utopia (Technology is here today) Communication channels Remote monitoring devices Back-end support Decision support, data analysis Content algorithms Workflow apps, registries EMRs, PHRs, HRAs Chronic Care Applications More Chronic Care Applications System focused (parameter upload) Push F7 to upload quality data Push F8 to upload cost data Push F9 to upload syndromic surveillance The Technology Communication channels Remote monitoring devices Back-end support Decision support, data analysis Content algorithms Workflow apps, registries EMRs, PHRs, HRAs Communication Modes Synchronous cellphone, chat, video conf, walkie-talkie Asynchronous Unstructured Email (secure or not), SMS text, IM messaging Web posting Text, rich images, multimedia, video Structured Web visits requests Communication Channels Patient – care team channel Scheduling appointments Prescription