July 10, 2008
Parkview Health Expands Partnership with ikaSystems to Encompass Integrated Medical Management
Successful Replacement of Legacy Claims System Leads Health
Plan to Implement ikaSystems’ Full Medical Management Product
Suite
Southborough, Mass., Parkview Health, a not-for-profit,
community-based health system serving northeast Indiana,
western Ohio and southern Michigan, has selected
ikaMM,
ikaSystems’ full medical management software suite, to support
the medical management initiatives of its health plan,
Parkview Health Plan Services (HPS). HPS, which achieved an
autoadjudication rate of 86 percent within a month of
implementing
ikaClaims, ikaSystems’ next-generation claims
system, will build on its existing relationship with the
company, a premier provider of enterprise-level Web-based
technologies for the payer market, to better integrate the
information and people involved in its care management
programs. As a result, HPS expects to improve the quality of
care its members receive while expanding the services it can
offer.
“Our success with
ikaClaims and the degree of trust we have
developed in ikaSystems led us to explore the company’s
medical management offerings, which run on the same technology
platform and offer the same power to automate manual processes
while improving the flow of information to everyone involved
in care management decisions,” said Philip Henneman, RN,
director of HPS Clinical and Technical Operations. “As we look
to offer additional services to our members, a key priority is
making sure our extensive physician network has important,
usable information at their fingertips, plus the ability to
more easily collaborate with care managers and members to
achieve the best results.”
ikaMM provides a secure environment for payers, providers,
care management staff and members to communicate and
collaborate on the Web. Because all ikaMM modules draw upon a
single, comprehensive data warehouse for financial and
clinical analyses, everyone shares the same version of “the
truth,” information that is updated in real time or near real
time. Armed with more timely, complete and accurate
information, physicians and other caregivers can proactively
uncover opportunities to close gaps in care or offer services
that keep members healthy. In the process, health plans can
significantly improve their HEDIS and other quality scores and
more precisely determine the types of programs that will
benefit their membership.
“Everyone engaged in care management knows that retrospective
information, although helpful, cannot significantly influence
physician or member behavior because it isn’t truly
‘actionable’,” explained Robert S. London, M.D., ikaSystems’
general manager and a nationally recognized expert in
healthcare management, benefits design and medical
informatics. “The challenge has always been to provide data
that allows physicians and others to respond proactively —
before a test is missed or an important warning sign becomes
more serious. To date, ikaSystems is the only vendor in the
market that has managed to tap the potential of real-time
quality metrics to influence the quality and cost of care
across the healthcare continuum.”
In addition to ikaDWH, ikaMM’s underlying data warehouse of
claims, laboratory, pharmacy, encounter data, practice
management, and electronic medical record information, HPS
will implement the following ikaMM modules:
- ikaDM, which connects disease and case managers, physicians
and patients on the Web for optimal information sharing and
collaboration while providing powerful identification,
stratification, enrollment, monitoring, alerting and
self-management tools, including health risk questionnaires
and patient-centric tools such as personal health records (PHRs)
-
ikaProHEDIS+, which gives health plans unprecedented ability
to proactively monitor and share quality data with staff,
physicians and members, supporting HEDIS® and other quality
programs with timely and actionable information and
easy-to-use tracking tools
- ikaProfyle, which reliably measures and compares the
performance of primary care physicians, specialists, hospitals
and networks using concurrent data and case-mix adjusted
methodology for economic medical performance and quality of
care
- ikaUA, which delivers comprehensive analytics and reporting
for executive management, actuarial, underwriting, financial,
quality and medical management decision-making
“Parkview Health has been our valued partner for over two
years, and we are committed to their success with this latest
initiative,” said Ravi Ika, president of ikaSystems. “Our
clients are embracing the new technology paradigm that
ikaEnterprise represents, adding new modules with greater
frequency and building the strong and agile technology
infrastructures that help improve quality of care and market
responsiveness while reducing administrative, medical and
information technology expenses.”
About Parkview Health
Parkview Health is a not-for-profit, community-based health
system that serves northeast Indiana, western Ohio and
southern Michigan. Parkview is home to the region's only
Verified Level II Adult and Pediatric Trauma Center.
Additional services include the Samaritan Flight Program,
Parkview Heart Institute, Orthopaedic Hospital, a Certified
Stroke Center, Women's & Children's Hospital, Outpatient
Services Center, and Comprehensive Cancer Center. Employing
more than 6,000 full and part-time staff, Parkview Health’s
mission is to provide quality health services and improve the
health of the communities it serves.