2008 TRACK SESSIONS
Track A
Health Insurers: Consumer Centricity
A1: The Health Insurer Business and IT Scenario: Successful Business Agility Starts with IT Agility
Bob Booz, Managing VP and Joanne Galimi, Research VP
New business models are emerging for health insurers, creating new business complexities and opportunities. Business and technology initiatives should not just be aimed at improving, but transforming healthcare financing, delivery and health outcomes. Responsiveness and agility have never been more important. This presentation will address:
- What are the market and legislative drivers and how fast will they change the health insurance business scenario over the next five years?
- What are the technology and operational investment opportunities?
- How should health insurers align (prioritize) IT investments with business objectives?
»Hide descriptionA2: The Disruptive Transformation of "Front Office" Customer Touchpoints
Joanne Galimi, Research VP
Business growth is dependent on marketing, selling and servicing the millions of uninsured people in the U.S. Business-growth objectives must include the automation of business processes involving "front office" customer touchpoints - such as sales, marketing and customer service - via multiple, interconnected delivery channels and integration between the front and back office. This transformation is highly disruptive but can be achieved if health insurers seek to improve strategies, processes, practices and interdepartmental coordination to promote and sell benefit plans and services. This presentation will address:
- How health insurers can segment, target and manage multi-channel marketing campaigns?
- What are the sales tactics and tools needed to automate sales processes and selling methodologies?
- What are the best practices and innovations in using customer service applications and contact center technology to achieve marketing and sales goals?
»Hide descriptionA3: Business Operations: Is Real Time a Holy Grail or a Wholly Mess?
Bob Booz, Managing VP
Health insurers have pursued the promise of real time claims adjudication (RTCA) as a breakthrough opportunity for them to restructure their claims relationships with health providers. Many health providers being told that RTCA will reduce their bad debt expense and improve cash flow. Trade associations are making RTCA a goal. Are these positions accurate and directly related to RTCA or is this a solution in search of a problem? We will examine the risks and rewards of RTCA.
»Hide descriptionA7: Risk Management: A Must For Building A More-Agile Enterprise
Maureen O'Neil, Principal Research Analyst
Risk management is emerging as a critical component of controlling health insurer's important IT and business processes. The risk management process involves the identification of risks, the assessment of their severity, the choice and implementation of countermeasures and the continual reassessment of the current risk state. Health insurers should conduct risk assessments to identify reasonably anticipated risks and establish a baseline of protection. The assessment, reporting and management of risk should be performed using consistent processes that are practical and organizationally compatible and provide actionable information. Topics to be addressed include:
- What is the best method to assess risk and controls?
- How to use key performance indicators to measure risk.
- How to quantify risk and uncertainty for executive decision making.
»Hide descriptionA8: Case Study: Planning and Execution of the change to ICD-10 for a Major Health Insurer
Bob Booz, Managing VP
The adoption of ICD-10 as the health insurance industry standard, replacing the currently in place ICD-9, is an expensive and time consuming process for health insurers. This is further complicated by mixed signals coming from regulatory bodies such as the Center for Medicare and Medicaid Services (CMS). A case study iwill show how a major regional health insurer has addressed the policy, business operations and IT effects of ICD-10 preparedness.
»Hide descriptionTrack B
Healthcare Providers: Empowering Improvements
B1: Healthcare Providers Scenario: The Future of IT-Enabled Healthcare
Jonathan Edwards, Research VP and Vi Shaffer, Research VP
Scenario planning is a powerful methodology for visualizing the future, and in this presentation we apply it to the complexities of IT-enabled healthcare. The essence of the healthcare scenario is to identify two factors that will be significantly evolving over the next ten years and to understand how healthcare automation will need to respond to those alternative futures. This analysis can be used to help prepare for what is coming even though the specific future events are not yet clear. This presentation will address:
- What are the critical uncertainties and market drivers that will change healthcare during the next ten years, and what will be the impact of IT?
- What signs can be used to predict how the healthcare provider market will evolve?
- What are the scenarios for the future?
- How should healthcare delivery organizations prepare in the short, medium, and long term.
»Hide descriptionB2: Telemedicine: Why, Where and How to Invest
Jonathan Edwards, Research VP
This presentation discusses telemedicine: the delivery of medical care at a distance. Care delivery organizations around the world are interested in the potential of telemedicine to help them use specialist resources more efficiently, better monitor and communicate with patients, and potentially to develop new service offerings. If deployed appropriately, telemedicine can enable new models of care delivery. This presentation will address:
- What is the status of telemedicine applications, and where do they fit on the Gartner Hype Cycle?
- Which organizations have successfully deployed telemedicine applications?
- What are some strategic and tactical steps that care delivery organizations can take to best exploit the potential of telemedicine?
»Hide descriptionB3: Computer-Based Patient Record Systems in 2018
Thomas Handler, MD, Research Director
Healthcare is poised to enter a dramatically new era of clinical care where prevention, diagnosis and treatment are tailored to each individual patient. These changes are placing new demands on the automation systems that support the delivery of patient care and have implications for executive management, clinical leadership and IT departments alike in terms of IT oversight and applications support. The role of the CMIO will become increasingly important in overseeing the changes needed to make automation support for personalized medicine feasible. This presentation will address issues such as:
- What is the state of CPR systems today?.
- What changes in medicine are occurring that further the transition to personalized medicine?
- How will the transformation to personalized medicine impact CPR systems?
- How is the role of the CMIO changing and how does this relate to the era of personalized medicine?
»Hide descriptionB5: Business Strategies for Providing EMRs to Physician Practices
Wes Rishel, VP Distinguished Analyst
Many healthcare organizations are subsidizing the EMRs for physician practices. This includes hospital systems, healthcare payers and even the public health departments. This session addresses the critical product capabilities and project strategies for achieving business value.
- What strategic value, if any, can a healthcare organization obtain by subsidizing EMRs?
- What are the critical capabilities of EMR products to obtaining a strategic value?
- What are the critical organizational practices that enable effective EMRs subsidy
»Hide descriptionB6: Tackling the Challenges of Information Governance
Vi Shaffer, Research VP
Investments in Computer-based Patient Records have triggered the dual demand for concurrent decision support and clinical intelligence and analytics. Establishing separate knowledge management and business intelligence core competency centers will prove inadequate and ultimately ill-advised. This session delves into a better course of action. Key Issues:
- What are the demand and supply issues around information governance?
- What are sound strategies for moving ahead?
- What are the emerging roles of the CIO and CMIO?
»Hide descriptionB7: Healthcare IT Budgets - Where Do All the Dollars Go?
John-David Lovelock, Research VP
The healthcare industry in North America can no longer operate without successful investments in IT. Gartner has predicted substantial growth in almost every aspect of healthcare IT spend. While IT budgets are on the rise, there is increasing pressure to justify the spending, benchmark against peers and reduce costs. This presentation will address:
- What are the prevailing market conditions?
- Where are healthcare organizations spending their IT dollars?
- How are the best healthcare organizations performing?
- Which other industries should healthcare look to for IT best practices?
»Hide descriptionTrack C
"Infrastructure Intelligence" - Another Unified Theory of Everything
C2: CDOs Need to Increased 'Infrastructure Intelligence'
Barry Runyon, Research VP
Healthcare provider CIOs require timely and accurate picture of the overall performance of their IT infrastructure and where potential impediments and risks to performance and availability reside. They often become aware of these details during crisis - when systems are running slow or are unavailable and after IT or vendor service levels have been compromised. The healthcare provider IT organization needs to be able to monitor and manage the relevant infrastructure and system components that support vital enterprise workflows, use cases and business services. Healthcare provider CIOs must be able to interrogate and monitor these components to collect activity data necessary to measure and enforce service levels, troubleshoot and remediate performance and availability problems, and improve end-to-end performance as well as the overall end-user experience. Key Issues:
- How will CDOs use IT to meet patients' changing service-level needs and expectations?
- How should CDOs use IT to help clinicians achieve standardization of care and improve patient safety and outcomes, and what vendors will most successfully meet CDO needs?
- How should CDOs select and succeed with critical infrastructure projects, and how should they ensure both the confidentiality and availability of personal health and business information?
»Hide descriptionC3: Application Integration Does Not Produce Integrated Applications
Wes Rishel, VP Distinguished Analyst
Forces on many sides are driving care delivery organizations towards increased applications integration, even as they try to avoid the need to buy going to "best of suite" vendor relationships. The drivers include business relationships with other care delivery organizations, growing and consumer expectations for a unified experience within the CDO and interoperable personal health records, and practical advances in SOA and "Web 2.0" technologies. IT management faces twin challenges of anticipating the disciplines needed to make this application integration successful and managing expectations down to a realizable level. Key Issues:
- What are the business and technology drivers that increase the demand for application integration?
- How can a CIO evaluate application integration challenges and manage expectations?
- What are the required skills, disciplines and governance approaches to make application integration effective?
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