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As health plans work to move participants to a more consumer-driven model, various technology tools are proving essential to the goal of enabling plan members to play a greater role in directing their medical care.
One factor behind the move, no doubt, is a growing expectation among consumersparticularly younger plan participantsto be able to get information quickly and whenever they choose.
"There's always going to be this generational thing with technology, and I think kids coming out of college, they're not going to put up with calling (human resources) to get a form," said Andrew Ceccon, chief marketing officer at Online Benefits Inc. in Uniondale, N.Y.
Greater, though, is the recognition of the role that personalized information plays in empowering health care consumers.
"The personal health record is in many ways the foundation for a lot of a consumer's decisions," said Bobbi Coluni, director of product innovation at health care information and research firm Thomson Medstat in Ann Arbor, Mich.
One step beyond
Beyond that, health insurers and plan sponsors need to go beyond simply providing that health record to actually providing a set of health management tools to health care consumers, Ms. Coluni said.
Among the companies with which Medstat has partnered is CapMed, a division of Newtown, Pa.-based Bio-Imaging Technologies Inc. that focuses on personal health information.
CapMed's core offering is a personal health record product, said Wendy Angst, the company's general manager. CapMed has been in the personal health record space for about 10 years, "which has really given us an opportunity to help kind of shape the space as well," Ms. Angst said.
CapMed delivers its personal health record product in three applications: a desktop version, a USB flash drive called Personal HealthKey and an online application.
The Personal HealthKey allows individuals to carry their entire medical record in their pocket. Both the Personal HealthKey and the desktop formats offer consumers full Internet connectivity, allowing them to communicate and manage their medical information online.
The flexibility offered by providing health record information in various formats allows consumers or provider customers to choose a delivery method that best fits their needs, Ms. Angst said.
Recognition of the importance of personal health records and ready access to them led to Lehigh Valley Hospital and Health Network in Allentown and Bethlehem, Pa., to decide recently to provide CapMed's personal health records to its physicians and employees.
The CapMed tools allow users to track and manage their personal health and wellness information, upload readings from home monitoring devices, link to relevant patient education, and receive personal alerts and reminders.
"The use of portable PHRs is an excellent example of how this technology can improve care by greatly increasing accuracy and timeliness of medical records and facilitating patient-physician communication," Dr. John S. Jaffe, executive medical director of Lehigh Valley Physician Hospital Organization, said in a statement.
For many health plan providers, the first application of technology is during open enrollment. Online enrollment and online calculators allow plan participants to determine what plan makes the most sense for their personal situation, according to Barry Barnett, principal at PricewaterhouseCoopers L.L.P. in New York.
Once participants have chosen consumer-driven programs, "The technology around health risk assessment, online assessment toolsthose tools are really getting more robust," Mr. Barnett said. The tools go through the process of considering the plan participant's demographic information, wellness, medical history "and give you links to information you should know," he said.
For example, a woman with a family history of breast cancer would be directed to information suggesting more frequent mammograms than would typically be recommended for her age group.
In his own case, Mr. Barnett had a stent inserted after a physical detected a blockage in an artery supplying blood to his heart. "I now get messages focused around healthy eating, diet and that kind of stuff," he said.
"Some employers start it before enrollment," Mr. Barnett said, to get plan participants accustomed to using the online health risk assessment so when the open enrollment process begins, they're already experienced with the Web-based tools.
"It's really employee self-service in a way, but expanding the service with a very robust set of tools," he said.
The online tools can also offer a way to help control health care costs by providing plan participants with information about costs of doctor visits, various medical options or on the availability of generic drugs, for example, Mr. Barnett noted.
CapMed's Ms. Angst offered a similar view, suggesting that the increased patient awareness that comes with using personal health record management systems could help reduce insurance costs in several ways, including better management of chronic diseases and reduced redundancy in tests and treatments.
The self-service aspect, particularly in terms of maintaining and finding information, is only likely to grow as consumer-driven health care gains momentum. Andrew Ceccon, chief marketing officer at Online Benefits Inc. in Uniondale, N.Y., which provides the Benergy online benefits information product, said he sees recognition of that trend among brokers and employers.
Online Benefits surveyed employers and brokers and found that the top two factors those groups see as essential to the success of CDHPs are good health plan education and plentiful wellness education information, Mr. Ceccon said.
"To me it's not just consumer-driven plans. Even if you have a traditional (point of service) plan, employees still need information about their plans+and employers can save money if employees use their plans correctly," he said.
Online Benefits was recently acquired by health and wellness content provider A.D.A.M. Inc., which brings to the company's offerings an "amazing" library of online information focused on teaching individuals about their health, Mr. Ceccon said.
A new version of Benergy, Benergy 2G, will be released soon. The centerpiece of that tool will be its Web site and the information available there, Mr. Ceccon said. "The other thing we're doing is we have modeling tools that will help employees estimate their health expenses," he said.
One area that Mr. Ceccon sees as a coming trend in online health information offerings is video. "I think where things are going is video, YouTube," he said. "More than just videomultimedia."
Online Benefits has a video library explaining "every kind of benefit program you could think of" in English and Spanish, Mr. Ceccon said.
videos empower users
There are also thousands of videos covering a variety of health issues, he said. For example, a plan participant with a sprained ankle can watch a video discussing first-, second- and third-degree sprains and determine whether the injury is one that can be treated at home or whether a hospital visit is necessary. "There are also things like Care Guides," he said.
"I think that's kind of at the heart of consumer-directed or consumer-driven health care," Mr. Ceccon said. "It's taking charge of your own health care."
Online Benefits will also offer a private personal health record through Benergy, into which plan participants can input their medical information, history, etc. "We're realistic here. I don't think a lot of people are going to jump to this immediately," Mr. Ceccon said. "But part of taking care of your health is keeping your records."