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Microsoft Unveils New Health Plans Blueprint to Better Connect Industry to ‘Where Consumers Go’


Today’s healthcare payers are faced with three common challenges – rising costs, inconsistent quality and the uninsured. With each passing year, these seem to grow larger and stronger. In addition, poor health habits contribute to the growth of chronic disease and are a key driver behind the rise in U.S. healthcare costs, that outpaces U.S. GDP growth by 2 to 3 percent year-over-year. Health plans are being challenged to provide their members with better and information and tools than they have today to take better care of themselves and their health finances.

To engage consumers, health plans must “go where consumers go” by integrating incentives, insights, guidance and information into the digital lifestyles of consumers. Today, at one of the leading forums for the health plans industry, America’s Health Insurance Plans’ (AHIP) Annual Meeting, Microsoft is unveiling the Connected Health Framework Reference Architecture and Design Blueprint for Health Plans to help organizations get there. To learn more, PressPass spoke with Dennis Schmuland, health plans industry solutions director, U.S. Health and Life Sciences Group at Microsoft.

PressPass: What is Microsoft announcing at the AHIP annual meeting?

Schmuland: Our biggest announcement centers upon the launch of the Microsoft Connected Health Framework for Health Plans. The Connected Health Framework is part of our initiative to provide healthcare organizations with an open, extensible foundation at no charge to drive out the costs and complexities of connecting their core systems, service channels, consumers, devices and business partners. In a highly competitive market that now centers on the consumer rather than administrative transactions, health plans need a much more adaptive IT infrastructure that also costs less to run. Today we’re launching a complete open reference architecture and downloadable code – an accelerator of sorts – that is available for health plan organizations to use with Microsoft technology or legacy systems at no charge.

This Connected Health Framework is important because service-oriented architectures are critical to breaking down the barriers between the information systems used by providers, health plans and life sciences firms. With this reference architecture, the Framework can help health plans quickly create solutions that make this kind of empowerment possible without the need for expensive, lengthy or complicated consulting engagements. This is essential if we want to empower employees with the right information at the right time, and empower consumers to take control of their own healthcare experiences.

PressPass: What makes the Connected Health Framework unique compared to other prescriptive approaches in the industry today?

Schmuland: Our solution shows the breakthrough advantages that Microsoft’s “real world” approach to services-oriented architecture (SOA) brings to health plans and developers. The Connected Health Framework for Health Plans is a shared vision, strategy and solutions framework that enables payers to rapidly transcend their traditional transaction-focused model in favor of a business that’s customer-centered, highly collaborative and knowledge-driven.

The framework is made of foundational building blocks like Microsoft Office SharePoint Server (MOSS) 2007, Infopath 2007, Groove 2007, and Microsoft Dynamics CRM that give developers a 60-80 percent head start toward building and upgrading high impact software solutions that address critical business issues and opportunities. Microsoft’s goal is to enable vertical solution developers like OTB/Calypso and customers like Independence Blue Cross to bring more adaptive and affordable vertical solutions to market more quickly. This is primarily because, with 2007 Office system now an application development platform, developers can now easily build solutions on top of the 2007 system, rather than hard-coding the entire solution from the ground up.

PressPass: What are the biggest challenges currently facing the health plans industry today – and how will technology play a part in solving them?

Schmuland: Today, healthcare payers are faced with three common challenges – rising costs, inconsistent quality and the uninsured. And, with each passing year, these seem to grow larger. In addition, consumers’ neglect of health screening, smoking, unhealthy diets, lack of physical activity and other factors are also increasing the prevalence of chronic diseases, which currently account for more than 75 percent of medical costs.

Health plans are challenged to provide their members with better and more easily accessible information than they have today to make value-based decisions. However, better information alone won’t solve the problem. That’s because, in the context of reducing disease prevalence, information itself is only valuable to the extent that it enables sustainable behavior changes among consumers. And we all know from personal experience that information alone has never been sufficient to change stubborn unhealthy habits.

To engage consumers, health plans must “go where consumers go” by integrating incentives, insights, guidance and information into the digital lifestyles, devices, homes and personal channels of consumers. Microsoft is focused on providing health plans with the tools to get there.

PressPass: What is the significance of the Consumer Engagement Reference Architecture, the first module being released under the new blueprint?

Schmuland: In a world that’s increasingly interconnected and always on, many organizations are evaluating ways to leverage technology to better engage consumers in a way that enables them to change their behavior in the direction of better health. However, high-impact customer service, wellness and disease management services aren’t scalable. Customer service, care management and lifestyle management service models today are labor intensive and non-scalable. Engaging consumers to use the health information, PHRs, tools and guidance in their portals is harder than it looks.

The Consumer Engagement Reference Architecture will enable health plans to overcome this challenge, allowing health plans to position employees as health advocates and provide members with the tools to self-manage their conditions, proactively improve their health habits, easily interact with the health care delivery system, and make informed financial and clinical decisions.

PressPass: What are the benefits of Windows Vista and the 2007 Office system for health plans?

Schmuland: These new versions of Windows and Microsoft Office will benefit health plans by simplifying how employees and customers communicate, helping to protect sensitive information and amplifying the impact of people, teams and partners. Because Windows Vista and 2007 Office system can help streamline the collection of data and eliminate the barriers between clinical systems, they will play a significant role in making information easily and instantly accessible to end-users working for health plan organizations.

They’ll also change the way people communicate and collaborate around healthcare. Windows, Microsoft Office and Exchange deliver communications capabilities that can make it much easier to manage and control all forms of communication, and they provide new collaboration features that will transform the way health plans share information with provider organizations and work in teams.

Protecting customer privacy is also a critical imperative, and these products will provide health plans with reduced business risk and increased compliance by better protecting member health through features like User Account Control, which limits access by unauthorized users and applications.

PressPass: How is Microsoft investing in the health industry overall?

Schmuland: Microsoft has been focused on the healthcare industry for more than 10 years, growing from a team of six to a global team of more than 600. Our team includes physicians, nurses, pharmacists and other clinical staff with experience working for healthcare and life sciences organizations. The Microsoft healthcare and life sciences group is made up of five subcategories to better address the specific needs of each key industry: providers, health plans, pharmaceuticals, biotechnology and medical devices.

The Connected Health Framework for Health Plans is an example of the continuing and expanding investments being made by Microsoft in healthcare. This is a platform that enables health plans to securely collaborate with members as well as with providers wherever they’re working. CHF delivers on the promise of extracting data from the myriad of systems that exist in today’s complex healthcare environment and it presents that data in a common, easy-to-read and familiar format regardless of the device used to view the data.


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