2007 TRACK SESSIONS
Opening Session
Successfully Navigating Healthcare's Ongoing 'Perfect Storm'
Gartner Analyst Team
Group Vice President, Industries Research, Gartner
Healthcare is an industry that seems to exist continually in the midst of a perfect storm. Unfunded mandates rain down from governments and regulatory agencies, waves of change impact reimbursement strategies, new consumer requirements appear to blow in from nowhere, there is a constant hail of medical advances that require adjustments to both medical treatment and reimbursement, and there is ongoing conflict between forces favoring increased sharing of medical information and those advocating stronger security and privacy of clinical data. This opening presentation of Gartner's 2007 Healthcare Summit will feature analysts providing insight and advice on some of the controversial issues and confusing situations confronting today's healthcare organizations. Some of the specific issues to be addressed include:
- How are financial institutions changing the future of health insurance?
- Why does the personal health record constitute a sham?
- Who should "own" disease management?
- How can you effectively share data and still maintain privacy and security?
»Hide description
Track A
Health Insurers: Consumer Centricity.
A1. How do Health Insurers Innovate While Keeping The Lights On?
Annie Earley, Managing VP
Pressure to become more consumer-centric which involves organizational and cultural change and technology investment requires innovation and affects every part of the insurer. How do insurers innovate at the same time that they keep their back office functions and existing customers happy? Methodologies for organizational structure, change management and technology exist. Select insurers have been extremely effective in designing and implementing innovative programs and products while keeping the lights on. This presentation will include both the methodologies to introduce and manage innovation in your organization as well as case studies of successful innovation in the insurance industry.
- What's innovation and how do you organize for it?
- What opportunities in health insurance are ripe for innovation?
- How have insurers been successful innovators - case studies?
»Hide description
A2: How Will State Universal Coverage Initiatives Challenge Health Insurers?
Bob Booz, VP Distinguished Analyst
Many states are making health insurance availability and affordability part of their legislative and regulatory agenda. For health insurers in those states, there are new challenges and opportunities created by compliance with universal coverage initiatives. For health insurers in other states, there is the chance to create contingency plans to operation in a universal coverage environment.
- What is the current state of universal coverage initiatives already adopted?
- What lessons can be learned from these initiatives and other public, government sponsored programs?
- How should health insurers prepare for the possibility of universal coverage initiatives?
»Hide description
A3: Outsourcing for Health Insurers: What to Keep and What to Delegate?
John-David Lovelock, Research Director
Can IT reduce costs and still deliver value to the organization? The Health Insurer Services Market place has a plethora of organizations offering a myriad range of products, services and expertise to do just that - reduce costs and increase value. Your job is to decide what skills, systems and technologies are truly differentiating and which are just necessary. This session reviews:
- The new core competencies for Healthcare Insurers
- What are the impacts of In-sourcing vs Outsourcing?
- What are the offering of the major companies in Health Insurer Outsourcing Services market?
- How will a Global Delivery impact these offerings?
- What health insurers need to do in order to maximize investments in Outsourcing.
»Hide description
A4: The Roadmap to Service Excellence
Joanne Galimi, Research Director
The role of the consumer has changed significantly within the healthcare industry, with many consumers using multiple channels to purchase products, manage funds (FSA, HSA's) and communicate with their health insurer. Coordinating channels and maintaining brand promise are becoming increasingly difficult with current customer service strategies. To achieve service excellence, the health insurer must support a multi-channel strategy and employ a combination of contact center technologies, customer service applications, BPM tools and service analytics.
- How will business drivers and emerging technologies affect the role of customer service in the enterprise?
- How will customer service evolve to respond to changing consumer interaction patterns?
- What technologies and applications will best support customer service strategies?
»Hide description
A5: Health Insurer Transaction of the Future: It's No Longer about Reimbursement
Bob Booz, VP Distinguished Analyst
The claim as a request for reimbursement is rapidly losing its status as the primary method to transmit financial, benefit accumulator and medical information to the health insurance payer. Driven, in part, by employee controlled medical savings accounts, regulatory changes and adoption of new data standards are also behind the transformation.
- How expansion of health insurer products to encompass employee controlled medical savings accounts as primary reimbursement affect financial, benefit and medical information capture?
- What new data standards will do to the health claims landscape?
- What should health insurers be doing now to manage these changes?
»Hide description
A6: The Health Insurer Business and IT Scenario
Bob Booz, VP Distinguished Analyst;
Joanne Galimi, Research Director
Health insurers are being forced to reinvent themselves to support the critical wants and needs of consumers. Without a series of key business and technology improvements, many health insurers will find it difficult to remain competitive in a consumer-centric world. Business and technology initiatives aimed at not just improving, but transforming healthcare financing, delivery and outcomes are critical. We will present the drivers of change and highlight the most important business and technology investments to support customer centricity. Key issues will include:
- How will the market and legislative drivers change the health insurance business scenario over the next five years?
- Which technology solutions will lag desired transformation; which will foster it?
- How should health insurers align (prioritize) IT investment with business objectives for best business value and agility?
»Hide description
A7: Fraud Detection: The Race To Succeed
Joanne Galimi, Research Director
Fraud is a serious and growing nationwide crime and continues to plague healthcare organizations and their customers. Criminals have shifted their attack vectors to the points of least resistance and least control. Do not let them infiltrate your enterprise. Health insurers must quickly counter attacks with robust fraud prevention and detection technologies. We will present the trends, IT strategies and tools for combating fraud.
- What are the trends and market dynamics?
- How can health insurers create fraud management strategies that position themselves for success?
- What type of solutions are required to detect and prevent fraud?
»Hide description
A8: Emerging BI Trends and Technologies for Health Insurers
Mark Beyer, Research Director
The BI industry is experiencing extensive innovation over the next five years in architecture, collaboration, Web services, and advanced visualization and interpretation. The future state will see BI as an augmentation of business processes - both human and machine activity will be affected. In this future state, human action is enhanced, modified and even provided with implied reactive and proactive steps within the business environment by BI analysis that is intimately participating in continuous evaluation of even distantly related processes.
- What is impact of BI/DW technology architectures evolving to become more service-oriented?
- How will BI augmentation impact your broad IT portfolio?
- How will BI technologies evolve to support future workers?
- What impact will emerging "Cool" vendors have on BI platforms and applications?
»Hide description
Track B
Healthcare Providers: Empowering Improvements
B1: Gartner's Digital Dozen "Cool" Technologies for Care Delivery Organizations
Wes Rishel, Research VP
At any time, there are dozens of new technologies trying to grab the attention of CIOs and CDO technology strategist. Here is a quick scan of a dozen technologies to watch. Key issues covered in presentation:
- What new technologies might dramatically impact care?
- What long-touted technologies will finally have impact on care?
- How will these technologies impact patients and care-givers in various healthcare settings?
»Hide description
B2: Clinical Optimization Part 1 - Reaching The Next Level
Tom Handler, Research Director
Increasing numbers of care delivery organizations are moving from the selection of a computer-based patient record system to developing plans and strategies for clinical optimization and obtaining full value from the system they have chosen. This shift has important implications for executive management, clinical leadership and IT departments alike. While technology is important in this quest, success is more often determined by an organization's ability to understand and appropriately modify its processes, politics and culture. This presentation will examine the steps organizations must undertake to successfully optimize their clinical care processes. Topics to be covered include:
- What are the opportunities, drivers and inhibitors of clinical optimization?
- What organizational approaches can help maximize optimization success?
- What are some examples of improved clinical processes using IT?
»Hide description
B3: Lessons in Revenue Cycle Management from Doing the Laundry - and Vice Versa.
Vi Shaffer, Research VP
One constant in healthcare is that the revenue cycle is unpredictable and tough to manage, but as it's often said: "no money, no mission. Shifting regulatory requirements, payer/employer demands and patient responsibilities ensure that this won't get easier anytime soon. Key issues:
- What new RCM strategies and best practices are emerging?
- How are vendors' next generation core RCM products progressing?
»Hide description
B4: Clinical Optimization Part 2 - Sustainable Value
Barry Hieb, Research Director
The advent of generation 3 CPRs is ushering healthcare into the age of sustainable automation support for evidence-based medicine. Many challenges still remain but it is now possible to use the CPR in qualitatively new ways to support traditional clinical goals such as reduced errors, improved outcomes, and more efficient operations. This presentation will analyze how the CPR can support these goals and look at some of the emerging capabilities that can be used to provide these benefits on an enduring basis. Topics to be addressed include:
- Why the pursuit of EBM represents the key to gaining sustained value from a CPR?
- What is the state of CPR systems and what technical CPR components will be most effective in supporting improved clinical processes?
- What are some examples of EBM successes?
»Hide description
B5: The Present and Future of Telemedicine
Jonathan Edwards, Research Director
Healthcare providers and payers are taking an increased interest in "telemedicine" - a broad range of technology areas that help care providers overcome the barrier of distance. Home health monitoring promises to enable patients to remain at home longer and reduce the necessity of travel. Remote diagnoses and remote consultations can allow patients in more rural areas to get access to specialist expertise. Despite the promise of telemedicine, there are significant barriers to implementation and adoption. Topics to be covered in this presentation include:
- What is the definition, drivers and inhibitors of telemedicine?
- What is the status of telemedicine applications?
- What are some examples of successful implementations, solutions and business models?
»Hide description
B6: The Patient of The Future
Tom Handler, Research Director
Historically, CDOs have not strongly attempted to restructure themselves focusing on the needs of their patients, but today's rising consumerism makes this a necessity. Patients want more options, have a higher financial stake in their healthcare and are taking a more-active role in their own health management. Patients are becoming true healthcare consumers and this impacts everything from initial contacts with the CDO through the delivery of care and ending with billings and payments. Creative use of information technology can be an indispensable aid as CDOs strive to build patient loyalty and gain customers. This presentation will examine how CDOs can use information technology to begin to advantageously position themselves to exist in a new consumer-driven market place. Topics to be covered include:
- How will patients interact with CDOs in the future?
- How will consumer-focused healthcare challenge IT?
- What steps can a CDO take today to prepare for the consumer requirements of the future?
»Hide description
B7: CIO 2.0: What the Position Will Become
John Kost, Managing VP Gartner, and
Russ Branzell, FACHE, HIMSS, CIO & VP, Poudre Valley Health System
The role played by the healthcare delivery organization's CIO still varies widely from one organization to another. With clinical automation and patient-centric initiatives underway, the CIO role is now intrinsic to the future of the organization, but the position is still high risk. Many CIOs aspire to play a more strategic role, but many behave in more reactive ways. This session will provide guidance on what organizations and CIOs can do to ensure the CIO and use of IT is most effective.
- What determines the type of role the CIO plays in the organization?
- How can CIOs gain the opportunity to contribute in the most meaningful way?
»Hide description
B8: BI's Business Value: It's All in the Wrist So What Do You Do With It?
Vi Shaffer, Research VP
Many healthcare organizations are seeking systemness and competitive advantage from their growing scale and scope of services while managing the continuing challenges or care quality and profitability. Now new attention needs to be paid to the customer experience and chronic disease management. Business intelligence - about markets, competitors and operations - is a differentiating asset, but only when it is used to effect change. Key issues:
- What are the major business needs that business intelligence systems address, and what's the ROI?
- How is the market evolving?
- How can healthcare delivery systems strategize, structure and act in order to leverage their expanding clinical information assets?
»Hide description
Track C
Emerging Technologies: IT's Invisible Infrastructure
C1: Remote Hosting and the IT Service Delivery Model
Barry Runyon, Research Director
Remote hosting options from key clinical vendors and third parties address CDO challenges surrounding infrastructure complexity, budget, staffing and project provisioning. Properly managed remote hosting can prove cost-effective and serve to establish a more agile IT services model within the CDO. Key issues:
- How is remote hosting different now then in the past?
- What vendors offer remote hosting services and how do they compare?
- Under what circumstances does remote hosting make sense for the CDO?
- What role does service level management play in a remote hosting relationship?
»Hide description
C2: Realistic Service Oriented Architecture for Healthcare
Wes Rishel, Research VP
SOA in healthcare is a good strategy and, sometimes, an excellent tactic for specific projects. Attendees will learn the strengths and limitations of the approach, what to expect from enterprise application and tool vendors and how to address the organizational challenges of SOA. Key issues:
- Why should healthcare organizations adopt SOA?
- Which are the key hurdles on the way to SOA, and how can organizations get over them?
- What is the growth path from tactical SOA to enterprise use?
»Hide description
C3: The Change Management Challenge in the CDO
Kris Brittain, Research VP
CDO IT organizations are facing consistent pressures of managing change and cost. Pressure to manage change is coming from the business and clinical side of care delivery, where time is money and high-availability maps directly to patient safety concerns. CDOs need to more effectively manage application and infrastructural change now and prepare for dynamic change enabled by virtualization and real-time infrastructure architectures. Key issues:
- What are benefits of effective change management?
- What real problems and issues within the CDO does it address?
- What strategies, best practices, and tools promote and support effective change management?
»Hide description
C4: Practical Information Lifecycle Management for the CDO
Barry Runyon, Research Director
The advance of clinical automation and interoperability initiatives are creating a requirement to store and retrieve structured and unstructured information generated by the CPR, medical imaging systems, enterprise email, etc. Without guidance, healthcare provider storage managers save everything save everything in near-term storage, forever. This is not desirable or practical. This session will discuss practical approaches to ILM and data retention. Key issues:
- What policies have to be in place to satisfy the various regulatory requirements surrounding data retention and e-discovery?
- What tools, technologies and vendors can help the CDO win the war against content proliferation?
- How does ILM contribute to the management of data retention issues within the CDO?
»Hide description