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TriZetto Announces New Feature for Personal Health Records – Auto Populated for the Consumer But Payer Access for Eligibility Qu

Posted Oct 23 2009 10:02pm

I hope I am reading this correctly, you get the benefit of an auto populated PHR, but in essence it is not private as payers will have access?  This is image slated to roll out by the year end.  Not too long ago I posted about HeatlhVault working with TriZetto.  TriZetto is business intelligence for risk management in healthcare. 

TriZetto Agreement with Microsoft HealthVault – Consumers Managing their Own Healthcare

Again, if I am reading this correctly, you get an automated PHR, populated for you so no leg work on your part, but you give up some privacy is appears along the way.  Health insurers will need to be using their proprietary business intelligence software to participate.  Earlier this year, TriZetto was purchased by Apax Partners, a London based private equity firm for 1.4 billion so somebody wants a return on their investment somewhere along this line.   They also have a large agreement in the Netherlands for processing claims and other financial interests.  Just a few days ago I posted about the Netherlands and problems they are having collecting from their insured as people are not paying, but under the law they can’t be cancelled there like we are here.

The company also has partnerships with Dallas based company TeleDoc. 

With the current HealthVault agreement and working with their PHR, this is interesting to see how this will all play out.  Do you get a PHR to use whether you want one or not?  If you do have to enroll it sounds like all your information is then available to payers?  Again, this is very confusing here and for me, I’ll stay with my HealthVault account where I feel I have control, since they are not in the insurance business.  

image

i did watch the video and the message to me was primarily “power to the payers” with the focus on algorithmic formulas that are proprietary and who knows how they calculate.  I still believe we need a “Department of Algorithms”.    When you stop and think of how far behind we are with some consumers barely even able to do email and the screens and so forth on the demo, we are in big trouble, intelligence taking advantage of ignorance once more.   I’m coming back to the “real” world and I can barely even think of many providers (many of whom do not even us an EHR yet) who could navigate all those screens and some hospital CEOs for that matter, life in the real world of humans that don’t scale.  BD

One Hell of a Training Program Needed

Press Release:

Auto-Populated, Portable PHR Includes Care Information From All of a Consumer's Providers

NEWPORT BEACH, Calif. - October 22, 2009 - The TriZetto Group, Inc. today announced additional features and functions of its new personal health record (PHR), which at year's end the healthcare IT firm will make available free of charge to health insurers that use its Facets® enterprise administration software and in early 2010 to payers using its QNXTTM application. The PHR will be free, as well, to the providers and consumers who use the electronic record.

When health plans deploy TriZetto's PHR, consumers will have immediate access to their pre-populated record and may designate family members who can access their record. When physician staffs request eligibility confirmation, payers will be able to provide a concise summary of relevant facts from the patient's PHR.

"Unlike hospital electronic medical records and physician office electronic health records, TriZetto's PHR will include information from all of the doctors and facilities that treat a patient over time," said Dave Pinkert, senior vice president of product management at TriZetto. "Further, only our PHR, populated by the rich repository of digital benefits and care information already in the systems of healthcare payers, are ready now for deployment to nearly half of the nation's insured."

Health plans that use TriZetto's enterprise administration systems provide medical benefits to 106 million Americans.

"The TriZetto PHR will automatically populate and update with clinical information that doctors and hospitals provide when they submit claims to healthcare payers," Pinkert explained. "This pre-population is completely unique in the market, especially when combined with the opportunity for consumers to add or supplement information to this PHR. It will help ensure consistent care and the most informed decisions between a patient and his or her multiple providers."

Fully supporting industry interoperability and security standards, TriZetto's PHR will enable a patient to give a provider a fully digital record of his or her health history. The record will include the following information from the healthcare payer's claims system:

  • Procedural history, including
    • Lab work
    • Exams
    • Surgeries and other treatments
  • Diagnoses
  • Healthcare providers who have treated the patient

"TriZetto's PHR will be portable," noted Pinkert. "So even as consumers change health plans, we'll make it easy for them to take their health record with them."

As a consolidated record of a patient's care by multiple providers and facilities, Pinkert added, TriZetto's PHR will support the "medical-home" approach to care. Under the medical-home approach, a personal physician takes the lead on coordinating integrated care for a patient by multiple providers who all share a complete record of the individual's health, medical conditions and treatment.

Members will be able to access their PHR on-line, with the ability to add or supplement information about:

  • Family history (e.g., diseases and medical conditions of parents, siblings)
  • Emergency contacts
  • Medications and dosages
  • Allergies
  • Claims
  • Immunizations
  • Personal details, such as preferences and behaviors that can affect health status.

"Using TriZetto's PHR, consumers will be able to actively participate with their doctors in maintaining or improving their health," Pinkert said. "For instance, at a doctor's direction, a patient might regularly record his or her blood pressure in the PHR. Then, at the next office visit, the patient and doctor can evaluate the new data and discuss treatment options together."

TriZetto's PHR will be managed by consumers and populated by the large volume of digital benefits and care information in the systems of healthcare payers. "We have great expectations for this new solution," said Pinkert. "TriZetto's new PHR will bring a huge and immediate improvement to the efficiency and quality of the U.S. healthcare system."

About TriZetto

image

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare ManagementTM, the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.

TriZetto Announces Features and Functions of Personal Health Record, on Track to Debut at Year`s End | Reuters

Related Reading:

CareMore Live On TriZetto's Clinical CareAdvance System Algorithms - Healthcare Business Intelligence

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