Priorities in healthcare technology
By Alicia Caramenico
FierceHealthPayer: How does your job as Humana CIO fit in with Affordable Care Act implementation?
Brian LeClaire: From a technology perspective, I'm responsible and accountable for all of the IT that we're putting in place to support it. I have direct line responsibility for the exchange capabilities.
Then there are efforts and investments we have made around delivering on health information technology broadly. When we talk about health information technology there are four main parts to it.
There are the clinician workflow capabilities. There also is a place to store clinical information electronically about the member, and there's a way to exchange that information so you can share it across the care delivery system for the purpose of giving improved care and leading to better outcomes for patients or members. And because you're bringing all this together in an electronic form with a lot of connectivity and consequently a lot of data, clinical analytics plays a big role in helping the caregiver administer care.
I'm also responsible for ensuring that the technology is in place to support Humana in its health plan operations and also as a provider delivery system.
FHP: What tops your health IT priority list?
LeClaire: We have six areas of focus. The first is to create a seamless integrated clinical inexperience to support both our clinicians and our members.
The second is around population health and helping our clinicians understand the clinical state of our population and how to deliver care to lead to better outcomes. We also see a move from non-risk bearing providers to risk-based providers, and we help them understand the financial elements of the risk in their space.
Third, is the differentiated consumer experience. We're making some fairly large technology investments in that space. One is our digital hub solution, which is mobile-based, web-based, social-based capabilities we would deliver to patients and members.
A fourth area of investment is really in our analytics space. We're further developing 360-degree views of our members and patients, 360-degree views of providers and, frankly, 360-degree views of our own associates to understand more around that big data space and how analytics can give us greater insight into our members.
A fifth area related to that element of analytics is insights to action. This is how we connect the dots so we're connecting with members in a more proactive and personalized way. Technology we've developed allows us to look for gaps in care, which may be a drug interaction or a particular clinical action like a mammography that a member should pursue or we should counsel the provider to be aware of. We use analytics to identify those opportunities and then we use the technology to deliver those insights back to the provider so the provider is better positioned to take action with the patient.
A sixth area is platform for innovation--investments in technology to help accelerate our business objectives more broadly. For example, we have a mail order pharmacy business and we've invested in a new operating platform for them and we're bringing other elements of their business into that platform that allows them a higher degree of flexibility in their business practices. We focus on innovation and how we innovate around the core business.
FHP: How does Humana link business and IT strategies?
LeClaire: We have a business strategy--our integrated care delivery model--and it focuses on three things. One is care delivery. Two technologies that support care delivery are seamless integrated clinical experience and population health. The middle part is member experience or engagement--that's where that differentiated member experience focus is. The third is around analytics and insights--that's where the 360-degree views and insights to action is. And across all three is that platform for innovation. That's the link between the areas of focus for IT and the areas of focus from a business strategy perspective.