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a patient-centric care-management platform that would: ductivity and improvements in turnaround times, Hewett

integrate its work fl ows, such as UM, CM, DM, appeals reports, as CHP increased its utilization-management ef-
and grievances, across all lines of business; be confi gurable fi ciencies with a 47 percent increase in its caseload per
to enable CHP to meet not full-time equivalents.
For more information on only current, but also future CHP realized further gains in February 2009 when
ZeOmega solutions:
business requirements; pro- it implemented batch integration between its external
vide robust data collection, claims processor and Jiva. The additional integration

tracking and reporting; increase effi ciencies and reduce allowed CHP to further increase the number of cases

errors through automation; enable CHP to comply with handled by case managers by 25 percent. A similar per-
the various regulatory and accreditation requirements; centage increase was noted in the number of UM reviews

and be intuitive and easy to learn and use. completed by the CHP staff.
After a thorough evaluation of leading solutions, CHP
selected Jiva, an integrated care-management software
solution from ZeOmega. Hewett was charged with over-
CHP was able to integrate information across
seeing the implementation. In 2008, CHP deployed Jiva’s claims, labs, pharmacy and other internal
integrated UM, CM, DM, appeals and grievances work
systems and across different work fl ows. CHP
fl ows centered on an assessment-driven care plan.
“We used Jiva to aggregate data such as claims and
staff is now able to see a consolidated view of
pharmacy from other systems and integrate evidence-
patient information.
based guidelines into its decision-making processes,
as well as influencing case-finding activities,” says
Hewett. “We realized additional benefi ts in areas of employee
In a second phase in 2009, CHP introduced additional productivity and expanded market presence,” Hewett
features that fi ne-tuned its system and optimized work says. “Because Jiva is a Web-based integrated care-
fl ow. management platform, we are now able to provide se-
Through Jiva, CHP was able to integrate information cure access for staff to CM, DM, UM and other patient
across claims, labs, pharmacy and other internal systems information through our Web browser from a remote
and across different work fl ows. CHP staff is now able location. This has created remote work opportunities
to see a consolidated view of patient information. CHP for care-management staff, thereby improving employee
also achieved its goal of deploying a patient-centric care- satisfaction.”
management solution, enabling care managers, providers This remote-access capability also led to the launch of
and other stakeholders access to patient information a satellite CHP offi ce in Spokane, expanding the health

from multiple points. This allowed clinicians to access plan’s customer service to both members and providers.
and complete patient information with real-time data. Additionally, the satellite offi ce strengthened CHP’s
Through Jiva, they were able to use integrated evidence- already tight linkage to its community health centers,
based guidelines during the decision-making process, Hewett says, thus strengthening a key strategic goal of

thereby ensuring consistency in the application of ben- the health plan.
efi t determinations. As a result, CHP continues to see “We were able to transform our fragmented care-

improved patient care and outcomes. management environment into a proactive, connected

According to Hewett, Jiva enabled CHP to realize healthcare ecosystem,” she says. “Real-time access to
signifi cant effi ciencies through its streamlined work member health-risk assessments, clinical pathways and
fl ows, business rules-driven processes, and automated/ other patient information enabled us to more quickly
scheduled reporting and correspondence, as well as other identify at-risk members and create customized care
capabilities such as alerts and schedulers. plans and management strategies, reducing medical costs
and enhancing outcomes.”
Improved effi ciency, cost savings CHP plans to offer its vision of a delegated care-
Nelson Publishing
Prior to deployment, CHP performed a detailed management service model at its community health cen-
analysis that established expected cost savings and ef- ters by deploying the Jiva Provider Portal in early 2010.
2500 Tamiami Tr N
fi ciency gains from deploying the software. According to “The portal will allow the patient’s entire healthcare
Nokomis, FL 34275
Hewett, an increase in case-management effi ciency of 30 team, across the provider network, to collaborate and
percent has yielded a corresponding increase in referrals participate in the management of the patient; enhanc-
to case management. This has resulted in more proactive ing the patient experience, improving the health of our
management of patients’ needs, she says. population and reducing preventable medical expenses,”
Utilization management also saw an increase in pro- says Hewett. HMT HEALTH MANAGEMENT TECHNOLOGY February 2010 41
HHMT1002 ZeOmega FINAL.indd 41MT1002 ZeOmega FINAL.indd 41 11/25/2010 2:23:22 PM/25/2010 2:23:22 PM
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