Tennessee's Healthcare Delivery System to Be Transformed

Project aims to create a patient health record accessible to multiple providers via secure Web site.
BlueCross BlueShield of Tennessee has partnered with the State of Tennessee's TennCare Bureau to revolutionize healthcare delivery by utilizing technology to help reduce medical errors, avoid duplicate services and detect fraud and abuse.

The program, operated by BlueCross subsidiary Shared Health, creates a patient-centered community health record that allows multiple providers treating the same patient to view that patient's medical information via a secure Web site. The name of this program is Shared Health Community Connection.

A contract with the State of Tennessee was approved by the State on June 29. Shared Health will begin offering Community Connection to BlueCross' TennCare (Tennessee's managed Medicaid plan) members this summer. Eventually Shared Health services will be expanded and offered to all Tennesseans, and it will also be made available to other insurers.

Shared Health is collaborating with other health technology initiatives being undertaken throughout Tennessee. The goals are that the Community Connection services can be used by those initiatives to create a comprehensive statewide system.

"There has been a lot of attention lately devoted to the pivotal role of technology in providing more efficient, effective health care in our country," said Vicky Gregg, president and CEO of BlueCross BlueShield of Tennessee. "We believe Shared Health has the potential to position Tennessee as a successful model that will enable every state to benefit from this approach. It represents the future of healthcare."

Shared Health's Community Connection has been successfully tested over the past several months in pilot projects throughout the state. The program provides doctors and clinicians with access to relevant personal health transaction data via a secure Internet system. Information available through the system includes claims data, lab results, dispensed medications, immunization information, some Medicaid well-child screening documentation, and general information, such as the name and phone number of the patient's primary physician.

"This is an opportunity to improve TennCare patients' quality of care and provide clinical information to our provider community at the point of care," said TennCare Bureau deputy commissioner, J.D. Hickey. "Raising that bar for the rest of the state is an exciting prospect we're proud to be a part of."

Under the contract signed with the State of Tennessee, the Community Connection program for TennCare enrollees will be made available to the state at no charge for the initial year. Subsequently, there will be a charge based on the number of enrollees. Estimates are that for every dollar spent on Community Connection records, there is a savings of $3 to $4 in healthcare costs. There is no charge to providers or patients.

"This is a major part of an effort by BlueCross to continually explore and improve access, delivery and administrative processes in order to support the best possible healthcare outcomes for everyone," said Gregg. "Shared Health promises to make healthcare much more efficient, and therefore more affordable. We think this is the future of healthcare."

"We talk a lot about 'friction' in the delivery of healthcare -- such as duplication of services, the inability of providers to access and share information, and the difficulty of bringing data sources together in a secure, user-friendly system," Gregg continued. "Our estimates are that this friction adds at least 30 percent to the cost of healthcare. If Shared Health, working in collaboration with other state healthcare technology initiatives, can eliminate a part of that waste, the cost savings would be in the billions of dollars."

BlueCross plans to invest more than $25 million over the next three years, with future investments as needed. BlueCross BlueShield of Tennessee has established Shared Health as a new company that will make its capabilities available to all health insurers and health benefit administrators in the state. Shared Health is headed by Jana Skewes, president and CEO, and will receive BlueCross BlueShield corporate oversight by Dr. Steven Coulter, president of governmental programs and emerging markets. The Cerner Corp. of Kansas City is providing the application services, including software, for the Shared Health program.