Health Care

Key Trends and Issues

The health care industry is under constant pressure to streamline operations and cut extraneous spending while providing quality care to patients. Many health care organizations are forced to close because the incoming funds are exceeded by the cost of day-to-day operations. Regulation and intensified competition require business process reengineering for many healthcare organizations. With the pressure to deliver quality care under the constraints of time and money, providers are turning to information technology (IT) to gain a competitive advantage and to create a leaner operation.

HIPAA, the Health Insurance Portability Act, also is providing some of the need for organizations to modify their IT infrastructure. The requirements of HIPAA would ensure a standard for patient information privacy and security as well as improved health care through more efficient administrative processes. This initiative also forces health care organizations to embrace IT solutions that will not only save money in the long run, but also bring them in compliance in order to avoid costly fines.

Strategy for Success

The ultimate goal is to deliver the best care possible to the patients. The sharing of relevant patient information such as medical records, diagnoses, and health plans is crucial for quality medical care. In addition, providers need to reduce operations cost and eliminate inefficiencies in internal administrative systems. The solution is an IT infrastructure that would integrate existing disparate sources of information; connect different branches and offices; and provide easy, consistent access via intranet, extranet, or internet.

Structure of healthcare resists innovation

Hospitals and IDNs (integrated delivery networks) have been slow to embrace web-based and web-enabled applications. Their reluctance to bring any changes to mission-critical systems is well justified. Replacing legacy systems is very expensive, time-consuming and can be risky. In addition, organizations are faced with the challenge of training personnel to use the new technology. Having invested all that time, money, and training on the current system, people are often resistant to change. Furthermore, many organizations that already have some sort of an electronic data interchange system (EDI) are concerned about re-engineering the system to fit HIPAA regulations because this would require enormous commitments of time and money. Ongoing compliance with regulations may require constantly re-writing all internal existing systems and applications.

Crystal Point Solution for Health Care

Crystal Point offers solutions that extend and add functionality to time proven legacy systems that maintain the mission-critical applications for health care organizations. Applications and systems residing on NonStop, AS/400 and IBM mainframe back ends that are normally viewed through a green screen terminal can be presented as graphical user interfaces viewed through a web browser. The reliability and scalability of the original applications are maintained, and there is no threat to the host application since no changes are made to the underlying code. Not only does this Web-to-Host technology enable the legacy back end data to be accessed through the web, it also can integrate information from disparate applications and systems throughout the organization as well. Crystal Point Web-to-Host solutions allow organizations to leverage their current technology, which is an affordable option, rather than investing in a complete overhaul of the IT infrastructure.

Crystal Point offers two different implementation architectures to meet the customer's individual host-access requirements.

AppView: This is an intranet and extranet solution. AppView features a true terminal emulator. Legacy system green screens are web-enabled and rejuvenated, and viewed using a web browser.

AppViewXS: The AppViewXS solution allows remote access to legacy data via the Internet. AppViewXS can be utilized for self-service portals for customers, partners and employees.

With Crystal Point , the information system is integrated with uniform access to the health care organizations' critical applications. Furthermore, the access can be extended to a hospital intranet or an Internet self-service portal. With this added functionality, the uses are numerous. The following are some examples:

Health care Insurance

Facilitate claims processing. Claims processing and resolution can be real-time. Customers can access and use health care insurance applications authorization, eligibility verification, and claims resolution through an Internet self-service portal. Eligibility, claims, referrals, records and processes become integrated and streamlined.

Health Care Supply Chain

Link hospitals and offices across the country or around the world with extranet access to your systems, including the data on your legacy back end.
Health care vendors can allow hospitals and doctor's offices to order supplies through an Internet self-service portal.
Establish EDI (electronic document interchange) - eliminates manual procedures such as handling referrals, treatment authorizations, etc.

Hospital Care

Hospital staff including floor nurses, emergency room personnel, attending doctors, and primary care physicians can place orders electronically or enter medical chart information via an intranet website.
Access to patient medical records at point of care, i.e. history and physicals, OP reports, consultations, etc.
Enter medical chart notes real-time
Physicians can send prescriptions to a pharmacy during a visit eliminating the need for handwritten prescriptions that are often difficult to read.
Order labs and review labs when available (i.e. check CPK levels for patients who are admitted for suspected myocardial infarction)
Paramedics can capture vital trauma data at the source via laptop devices that can be viewed by the ER staff upon arrival.

Benefits of the Crystal Point Web-to-Host Solution

Facilitate claims processing. Real time claims resolution and processing. Customers can access and use healthcare insurance applications authorization, eligibility verification, and claims resolution. Integration of eligibility, claims, referrals, records and processes.

Improved customer service. Patients are checked in faster. Transactions are quicker. Customer questions and concerns are addressed expediently. Customer representatives can deal more efficiently with client inquiries, claims, billing, and reimbursement issues. Service representatives are more flexible and responsive to customer needs.

Greater efficiency and productivity through cooperation and sharing of information among different branches and offices of IDNs and the health care supply chain. Helps IDNs function as a connected unit delivering faster services. Standardization of data input. Workflow automation. Streamlining the operation by integrating and simplifying internal administrative processes.

Securing data access. For the purposes of protection of sensitive information, different parts of the same record can be made visible to different users: the primary care physician, the specialist, the laboratory, the nurse, and the billing department.

For example, if an insurance company can extend the claim submission and verification application to the hospitals, they will be able to key in the information directly. This would significantly speed up the processing times and guarantee greater satisfaction, while saving money and staff time as well as eliminating errors. The customer will be notified immediately if they key in the wrong information, and their claims will be processed immediately.

Call center representatives are more responsive because they can obtain information faster and easier. Doctors can make better-informed critical decisions with greater confidence and speed. They can check and update the patient's medical records with diagnoses and treatment regimens at bedside. Emergency personnel can complete the forms for admission from the patients' homes or in the ambulance.

By extending the functionality of legacy applications to an extranet, hospitals and offices across the globe can be linked with access through a web-browser. A health care vendor may open its order entry application to a hospital. The hospital staff will place orders electronically without the hassle of handwritten prescriptions. Orders will be processed faster, improving quality of care. Most importantly, patients get the care they deserve.