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The Sentry Series

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Wednesday, December 2, 2009

10:45 AM - 11:30 AM
Track: General Sessions View Track

KEYNOTE 2: EXPERTS PANEL: 360 DEGREE VIEW OF MEMBER

Moderator: Aaron Zornes, Chief Research Officer, THE MDM INSTITUTE
Diane Body, Director Technology for ETS Consumer Services, STAR E&B, WELLPOINT
Panelist: Mark Hill, EIS Specialist, HEALTH CARE SERVICE CO.
Pete Storer, Information Lead Architect, BLUE CROSS BLUE SHIELD NC

According to a recent research report by the Healthcare Information and Management Systems Society (HIMSS), “The U.S. healthcare delivery system remains fractured:  90% of healthcare transactions are conducted via mail, fax, or phone. Pertinent patient data is undeliverable in 81% of the cases in outpatient clinics. Patients are interacting with multiple providers in multiple settings that are not connected, and the results are alarming in terms of avoidable medical errors and costs.”  It is an understatement to assert that telcos, airlines, and banking, etc. do a much better job of segmenting and marketing populations than does the healthcare industry. 

During 2009-10, market-leading healthcare payers must add MDM capabilities to their list of “strategic IT investments”.  Healthcare payer MDM solutions must support the customer lifecycle by including eligibility management, provider data management, claims management, identity management, as well as campaign management (marketing and wellness campaigns).  The healthcare payer’s master customer data must be the most accurate, up-to-the-minute source of customer information and must feed downstream systems (e.g., claims processing) as well as external vendors.

This panel of MDM healthcare pioneers will provide best practices insights into EMPI, HL7, and other healthcare industry trends concerning the digitalization of health care in North America.  Panelists will focus on the MDM goals of improving efficiency, quality and decision making – by sharing and integrating member information within the healthcare payer. Topics to be discussed include:

  • Beating the competition by improving quality of service while concurrently reducing costs – both back-office & front-office
  • Enhancing customer service by empowering purchasers & members – i.e., by reducing clerical errors while improving retention rates of both individual members & purchasers’ plans via improved benchmark results
  • Increasing levels of regulatory compliance & financial transparency

 

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