It wouldn’t be an emerging industry if Microsoft missed the boat. To wit, Microsoft has launched a new healthcare offer called Knowledge Driven Health Plans, “the company’s shared vision and solutions framework for the health plan industry.”

Microsoft hopes Health Plans will apply their software and experience in the business environment to drive “better-informed decisions across members, providers, employers and industry partners. In this collaborative environment, people across health plans are empowered to drive innovations and business efficiencies that can ultimately improve accessibility and affordability of high-quality healthcare.”

WHAT'S IT MEAN?

Microsoft promotes Health Plans as a framework that “enables seamless business transformation.” It is nice that they’ve put this into real plain working language instead of using phrases like “solutions framework”, “seamless business transformation” and “shared vision.” In other words, they’re reselling their business software and applications like BizTalk® Server to the healthcare industry.

“The need for health plans to innovate is more critical today than ever before in the face of rising healthcare costs and a system that is shifting consumers toward the center of the decision-making process,” said Dennis Schmuland, M.D., industry director for health plans at Microsoft. “Microsoft and its industry partners are delivering technologies and solutions that enable health plans to substantially improve the health and experience of the consumer while holding costs down.”

MS PARTNERS

Microsoft’s Knowledge Driven Health Plans initiative is being launched with the support of 22 leading industry partners to provide a solutions framework that targets improved business and health performance. Health plans adopting Microsoft-based solutions can benefit from the company’s established consumer community; the cost and maintenance advantages afforded by its technology platform, applications and online services; and the flexibility built into Microsoft’s technology.

The solutions framework developed for the health plan industry harnesses the strengths of Microsoft’s proven and integrated technology systems, including its .NET Framework, BizTalk® Server, Windows Server System™, Windows® Communication Foundation, SQL Server™ and the 2007 Microsoft Office system. Built on open standards such as Extensible Markup Language (XML) and Web services, Microsoft technology enables seamless integration with legacy systems and facilitates business agility, which is critical as health plans undergo significant business transformation in response to a rapidly changing industry landscape.

“Technology continues to be an integral driver in helping health plans adapt to changing market dynamics,” said Cynthia Burghard, research director at Gartner Inc. “In using technology that is based on open standards, health plans benefit from greater flexibility, allowing for integration with existing IT investments and adoption of new technology frameworks like service-oriented architectures.”

EMPLOYEE FOCUS

Under Microsoft’s vision and solutions framework, health plan employees are able to connect islands of information for improved collaboration and knowledge delivery, driving more informed decisions. The solutions based on this framework span key business areas, including care management to business intelligence, enterprisewide project management to risk management and risk compliance, and member-centric communications. Industry customers around the world are realizing business success under the Knowledge Driven Health Plans vision and solutions framework.

An independent licensee of the Blue Cross Blue Shield Association in New Jersey, Horizon Healthcare Services Inc. (Horizon) recently deployed Microsoft BizTalk Server to provide translation and orchestration services for its provider portal applications and HIPAA transactions. With Microsoft’s technology in place, Horizon has achieved improved visibility into transactions, increased first-call resolution of support requests, and it projects a 50 percent reduction in cost of ownership.

An independent licensee of the Blue Cross Blue Shield Association, Premera Blue Cross provides health coverage and benefit services to a broad range of clients, from individuals to Fortune 100 companies including Microsoft. Working with Microsoft technology, case managers at Premera have developed new tools to coordinate complex patient treatment programs. The tool helps case managers set their priorities, track their work and show outstanding tasks more efficiently. The solution has realized a 25 percent increase in efficiency and a 17 percent increase in case manager job satisfaction. It has also expanded case-management capacity worth $9.6 million (U.S.) and helped Premera improve support for patients with complex medical needs.