on Saturday about a personal healthcare social networking program set up by WellNet, a health management company. I'm not clear on how WellNet is set up; it doesn't look like an HMO, but rather an information management company that helps employers understand and manage employee health plan costs. But it also has a "network of 300,000 primary care providers." I'm assuming that's a typo, there are 300,000 beneficiaries managed by WellNet; I'm not sure there are 300,000 primary care doctors in the country.
Anyway, the network is designed to link your doctors together and move the patient/PCP/specialist connections into an online arena, so that a patient can make appointments and potentially get consultations online, rather than in person. The advantage to the employers who contract with WellNet is that WellNet mines the data, potentially in real-time, and can tell employers if their workforce seems to have too many people with a particular illness, too many getting a particular treatment, employees who don't seem to be buying their prescribed medicines, etc. WellNet says they deidentify the information before giving it to the employers, and I believe that. However, it would certainly be possible that the employer could determine with some certainty the identity of a particular outlier, especially if the information is given real-time (i.e., I know that Joe is out of the office right now at a doctors appointment, and someone just got a bad diagnosis).
One example of why this would be a good system: if it appears that many of the employees are diagnosed with a particular issue, but there's not a corresponding level of purchase of the drugs for that issue, the employer might realize that the copay for that drug is too high (the price point is preventing employees from getting the drugs they need), and lower it. I don't need to give you examples of the potential pitfalls here.
Cut out the employer feedback, and the concept has some real merit.
Neil Adler of DMNGood (which I take to be the PR firm for WellNet) sends along the following press release:
Healthcare Interactive, WellNet Unveil Point to Point Healthcare
August 18, 2008 — A game-changing tool for the health-care field is ready for introduction.
Healthcare Interactive, a Glenwood, Md., a software company, and WellNet Healthcare, which has eight U.S. offices, today announce the launch of Point to Point Healthcare, a technology and administrative platform that the companies’ leaders expect will transform the health-care industry by eliminating rampant waste and excessive medical-benefit costs.
When the businesses that pay the majority of insurance costs for their workers have access to their own analyzed and interpreted medical and pharmacy data, this information is used to avoid risks and save health plans hundreds of thousands to millions of dollars.
Point to Point’s HIPAA-compliant software platform allows these plan sponsors to receive pharmacy and medical claims information on their computers and, once there, evaluate this data using predictive modeling technology, while keeping patients’ identities private. Forecasting health risk to determine cost-saving methods for employers, such as proactive disease and care management, will enable plan sponsors to make better business decisions and steer clear of excessive medical expenses before costs surface.
Combined with an online health-care social network, members are able to stay in sync by working with, and communicating privately and securely with, all of their care providers. Results include improved efficiency that saves both the plan sponsor
and the member money.
“From the beginning, we noticed that basic comparisons with regard to health-care costs were unavailable or difficult for the business community to understand. Employers became more frustrated and confused, which led them to seek the standard remedies, such as beating up vendors to obtain better pricing, adjust the plan design to shift more of the cost to employees, or reduce benefits altogether,” says Keith Lemer, WellNet’s president.
“Medical benefits are not that complicated,” he says. “But outsiders want it to appear this way. They make benefits seem difficult so employers won’t stand up and question the annual double-digit cost increases they face. These choices do not expose the real issue: Without data, employers can’t manage or measure their employees’ health-care benefits.”
Healthcare Interactive developed Point to Point. WellNet, a data-analysis and health-management company, is Healthcare Interactive’s majority investor. WellNet’s clients are Healthcare Interactive’s first customer base to use Point to Point.
“Point to Point will, without question, revolutionize the health-care industry,” says Henry Cha, Healthcare Interactive’s president. “We’re approaching the management of medical benefits from every key perspective – the employer, its employees, providers and insurers.”
While other companies such as Google and Microsoft are offering Web-based electronic health records, Point to Point brings together all the health-care stakeholders in one HIPAA-compliant workspace. This type of connectivity is required to significantly improve patients’ health, lower administrative costs and reduce overall health-care claims.
“Working together, employers may incentivize their members to use less expensive medications and improved standards of care,” Lemer says. “Education and engagement about disease-management and wellness programs, all based on rules designed around the medical-benefit coverage, lead to healthier employees and less costly health-care plans.”
The Veterans Administration Health System, part of the U.S. Department of Veterans Affairs (VA), uses a system known as VistA for all its doctors to communicate in an online, private and secure setting when caring for the VA’s 3 million members. VA statistics have shown a more than 30 percent decrease in health-care costs per patient through the use of VistA, as members are more engaged, timely care is provided, and unnecessary tests and treatments are avoided.
Point to Point provides plan sponsors with a similar experience, delivering a complete medical-benefit file to every patient, not just an electronic health record. Having all the information at their finger tips in a simple and easy-to-understand software platform allows patients to better understand cost factors based on coverage issues, conveniently direct questions to administrative support staff, and more accurately exchange medical information with their providers.
The health-care social network seamlessly links patients to, among other things, their utilization data and medical records, schedules, a concierge-based account management and customer service chat, industry research, provider networks, pharmacists and any other entity involved in the care continuum.
“We all see multiple doctors, but everyone is working in silos. Information is difficult to obtain and often not shared,” Cha says. “The only way to measure and manage medical benefits is with credible data, and Point to Point provides an avenue for collecting and analyzing this critical information. It’s a common sense business approach to slashing expenses and getting people healthier.”
In addition, Healthcare Interactive has launched a developer network where outsiders are able to build their own applications that will reside on the Point to Point environment. “We have developed Point to Point on a platform called HealthSpace designed for developers to rapidly create software services that interoperate in a standard method,” says James Birger, Healthcare Interactive’s chief information officer. “We believe this platform ultimately simplifies a highly complex health-care system for the end user in a single interface.”
Currently, Point to Point is available in beta form to WellNet clients, which number more than 100,000 lives. Healthcare Interactive will make Point to Point available to the entire business community and its members in early 2009.
About Healthcare Interactive:
Healthcare Interactive, founded in 2007, is a privately held software company commercializing innovative technologies for health-care administration and insurance. Based in Glenwood, Md., Healthcare Interactive has developed an information portal and intelligence technologies to enhance existing health-care products that focus on predictive modeling, information sharing and Web services. The company’s signature product is Point to Point Healthcare (www.pointtopointhealthcare.com).
To learn more about Healthcare Interactive, please visit www.hciactive.com.
About WellNet Healthcare:
WellNet, founded in 1994, is a privately held company that designs, implements and administers employer-sponsored health benefits that save businesses money and improve member health by giving plan sponsors unprecedented understanding and control of their medical-benefit expenses. With nearly 50 employees, WellNet has U.S. offices in Philadelphia, Washington, D.C., Atlanta, Chicago, New York, Cleveland, Portland, Ore., and Trenton, N.J.
To learn more about WellNet, please visit www.wellnethealthcare.com.
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