InterSystems, a global vendor of health information technology, is collaborating with US-based health insurance provider, Premera Blue Cross, to bring together clinical data from health information exchanges, electronic medical records (EMRs) and medical claims to build a complete picture of each of its members.

The collaboration will enable healthcare providers to view the combined clinical and claims data to better understand their patients’ health in real-time.

According to Director of Corporate Data and Analytics at Premera, Colt Courtright, they will use InterSystems’ unified health record product, InterSystems HealthShare®, to manage risk and utilise data to support their customers’ healthcare management.

“For example, a doctor knows what prescriptions have been written, but not if they have been filled. Combining clinical and claims data in real-time fills that gap and gives doctors a much more complete picture of their patients’ health, empowering a richer care experience,” said Courtright.

As pointed out by Vice President of HealthShare at InterSystems, Don Woodlock, disconnects between healthcare providers and patients have always been, and will continue to be, a huge pain point in any healthcare system.

“Bringing together clinical and claims data provides Premera greater insight into their customers and allows them to innovate in new and exciting ways. This allows them to be better partners and collaborators with their network of healthcare providers which leads to better outcomes for everyone,” said Woodlock.

When the initial partnership began in 2017 HealthShare was used to connect 150,000 patient records from across Alaska. Premera then expanded the service to their Washington-based customers followed by customers in 11 other US states. To date, Premera receives Inpatient and Emergency Department (ED) alerts from contracted data sources from more than 400 EMRs.

“We are only scratching the surface when it comes to utilising Big Data to its full potential in healthcare. We are working with InterSystems as part of Premera’s strategy to leverage data in a meaningful way that provides direct benefits for our customers. Since implementing HealthShare, Premera has the potential to better evaluate health risk, and support patients with higher-level care needs,” said Courtright.

This new collaboration is an example of how the South African government can partner with the private sector to effectively and securely collect, manage and utilise patient data under National Health Insurance (NHI). Being able to electronically pull together patient data will be essential in ensuring the NHI vision of patients receiving cradle-to-grave care irrespective of which healthcare facility they visit.

“Health Minister Dr Aaron Motsoaledi’s recent unveiling of the NHI Bill means that as a country we are one step closer to implementing universal health coverage (UHC), i.e. affordable and quality healthcare for all. This is without a doubt a necessity, however realistically speaking there is still a lot of work that needs to be done and issues that need to be ironed out, including a strategy for using patient data for quality healthcare improvement,” said Country Manager of InterSystems South Africa, Henry Adams.

“InterSystems’ partnership with Premera in the US provides a real-world example of how our HealthShare solution is connecting healthcare providers, patients and medical aid schemes through a unified health record and analytics that span the care continuum. HealthShare brings together information from across the entire healthcare system in real-time highlighting any gaps in care or expensive duplication, such as medical tests or even prescriptions. All of these points are invaluable in creating effective care plans and ultimately the success of NHI,” concluded Adams.

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