Blue Cross and Blue Shield of Illinois (BCBSIL) and MEDecision, Inc. have teamed with Pronger Smith Medical Care to create an Electronic Health Record (EHR) system for Pronger Smith patients as part of their patient-centered medical home initiative to improve health outcomes. This innovative EHR system centralizes the timely, critical clinical information physicians and consumers need to proactively address health problems and support the best clinical decisions.
The system pulls timely clinical information from Pronger Smith, along with the BCBSIL claims-based medical record, and displays this information in a secure, web-based EHR portal. Through the portal, Pronger Smith patients and physicians gain access to patient health information, medication lists and lab results and are able to electronically request prescription refills, schedule appointments and send secure messages. The system also grants access to hospital emergency room staff, so they can rapidly see the patient’s health background and medication lists, regardless of time of day.
“By collaborating with Blue Cross and Blue Shield of Illinois to create an EHR system, we are arming physicians with better information to help care for their patients, which can lead to healthier lives. We are confident that by centralizing communications with providers of care, at all levels, within a medical home this will result in better outcomes for patients,” said Dr. Alan M. Roman, Managing Partner, Pronger Smith Medical Care.
The EHR also creates an environment of proactive care by encouraging caregivers within a medical home program to reach out to individuals before health problems emerge. Patti A. Pyka, BSN, RN, Director of Pronger Smith’s Clinical Services, said, “In our medical home model, we have leveraged our EHR, outreach and other technologies with one-on-one nurse case management to better manage and track our patients across a continuum that includes prevention, acute and chronic care.”
“In the PCMH, the EHR improves care coordination for all patients by partnering with and helping them achieve health and wellness goals. This is done by automatically sending messages to patients, prompting them to follow-up with their physicians, who, if necessary, will initiate exams, tests, procedures and treatments,” said Dr. Roman.
In August 2009, Pronger Smith partnered with BCBSIL to launch a patient-centered medical home program to enable more coordinated care between its 18 primary care physicians and 27 specialists. In a patient-centered medical home model, primary care physicians and their staffs monitor and coordinate most aspects of their patients’ primary, specialty and other medical care to enhance quality and improve overall medical management by creating a more complete patient picture.
“As the leading health plan in the state, BCBSIL has traditionally worked within our communities with local independently contracted providers to enhance the quality of care,” said Karen Atwood, BCBSIL President. “BCBSIL is an innovative company that is leveraging our data to help improve the medical management program in the clinical community. This collaboration wouldn’t work if we hadn’t established great relationships with our contracted providers, where all parties work together to solve problems. In the end, we believe this will have a positive impact on the quality of care provided to members.”
The BCBSIL/Pronger Smith EHR system is powered by MEDecision’s Nexalign® Health Information Exchange (HIE) technology, which pulls together patient clinical data from multiple sources, transforms this information into comprehensive, valuable insight and delivers it directly to the point of care in the form of Nexalign® Clinical Summaries. These are the basis for the EHR system’s rich, 360-degree view of the patient.
“Our mission has always been to improve collaboration among patients, physicians and health plans by placing valuable, actionable health data into the appropriate hands at the point of care,” Deborah Gage, MEDecision President and CEO said. “Our technologies power the BCBSIL/Pronger Smith EHR by gathering data from multiple sources through a health information exchange, transforming it into valuable clinical information through analytics and delivering it quickly and efficiently to improve patient care.”
David G. Seaman, Chief Executive Officer of Pronger Smith Medical Care states, “the refinement and fusion of information between providers is the first of many steps that our health care system must deliver if we are to be successful partners in improving the quality of our healthcare delivery system – we owe this to our patients and to our nation. We appreciate Blue Cross Blue Shield’s willingness to step up and provide the leadership necessary to make this a reality.”