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Home / News & IndustryManaged Care Insight and Analysis
Updated: June 2, 2009
Humana And Wisconsin Health Information Exchange Enter Into Collaborative Business Program

Humana Inc. has begun working with the Wisconsin Health Information Exchange (WHIE) to ensurethat clinicians have access to the most comprehensive community-wide data available for emergency department patients.

As part of their on-going emergency care initiatives, Humana Inc. plans entered into a pilot program with the WHIE, the first health information exchange in Wisconsin. Health information exchanges, such as WHIE, use information technology to provide secure authorized access to clinical data, improving communication among clinicians, care coordination and reducing unnecessary duplication of services.

"I have seen the positive impact of a physician having a patient’s historical view – it reduces the chance the patient will have unnecessary or redundant tests and results in steps that positively influence the patient’s cost of care delivery," said Dr. Albert Tzeel, Humana’s regional medical market officer.

In this program, Humana recognizes the value of applying health information exchange technology, and has agreed to provide a WHIE-administered incentive to providers for utilization of the WHIE.

"We are excited to see an insurer like Humana involved with WHIE and look forward to working with Humana on these initiatives. WHIE now has more than one year of patient history data online, with 13 hospitals contributing to the exchange and five emergency departments using WHIE as a standard in patient care," said Kim Pemble, chairman of the board and executive director of WHIE. "2009 will bring continued growth for WHIE, building on this new relationship with Humana and an ongoing relationship with Milwaukee Health Care Partnership."

Additionally, as part of a complementary emergency department program, in August 2008, Humana initiated a pilot program to help members potentially seeking emergency department care. All members in the pilot program who may need emergency services at some point have received information on self-management strategies and on urgent care as a possible alternative to emergency department use.

In addition, members with two visits within a one-year period receive an age specific self-care education book promoting options for urgent and emergent care. Also, as a further service to members, those individuals with three or more emergency department visits within a one-year period receive a referral to a Humana personal nurse to help address questions on chronic conditions and potentially a referral into one of Humana’s clinical programs.

These programs seek to improve utilization by directing patients with conditions more appropriate for a primary care physician or urgent care centers away from busy emergency departments. Examples include sore throat and flu symptoms, which for a typical patient with no other diagnosed illness are easily addressed in non-emergent settings.

Addresses: Humana Inc., 500 W. Main St., Louisville, KY 40202; (502) 580-5005, www.humana.com. Wisconsin Health Information Exchange, 1009 Glen Oak Lane Suite 101, Mequon, WI 53092; (262) 240-0198, www.whie.org.


  This article was taken from:
The Executive Report on Managed Care

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