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Background

Disease management system for the National Benefit Fund. 

The 1199 HealthCare Union’s National Benefit Fund (NBF) runs a member assistance program that includes access to disease management services. The program is based offsite in 39 clinics located around New York City. The nurses travel from clinic to clinic and use laptops to collect client consultation information.

Challenge

Develop and implement an integrated member tracking system. 

NBF needed a system (called Member Encounter Transaction System, or METS) that would support the collection of health information at a number of remote clinics while tying the information seamlessly to a main system so that administrators could have immediate access to the data.

NBF also needed a way to manage their healthcare wellness programs with automated case management and communication functions for communication with members as well as staff. The recording and management of member information was vital to the daily management of several critical areas including:

  • Hypertension, asthma, and diabetes WellCare initiatives
  • Tracking lifetime insurance maximums

In the first stage of the project, the results of these consultations were uploaded and downloaded via analog modem. Intellis deployed a wireless version in June of 2003 to the nurses to gain close to real time exchange of encounter results and updates from the member information system. As part of this deployment, Intellis was required to adhere to HIPAA standards and NBF’s VPN policies and protocols.

Intellis was asked to provide an integrated member tracking system that would:
  • Track member information for members eligible to be enrolled in the assistance programs
  • Share processed information between program staff (especially medical staff of the Hypertension program who require access to medical consultation results for their next assessments)
  • Synchronize information regularly with the Union’s Member Information System that includes information on member’s contact information and eligibility information
  • Trigger automated letters and provide reports based on events surrounding eligible members

Scope

Intellis tailored the FOUNDATION platform to create a case management system for NBF’s disease management program.

Hypertension medical staff use laptop computers and wireless communication to upload and download data. The wireless deployment provides daily updates of encounters and provides the medical team improved access to changing member information.

Intellis provided:
  • A mobile data solution for clinical data collection
  • Case management functionality based on NBF business requirements
  • Analysis and specification of system technical infrastructure
  • Design and development of the system to collect and store member encounter information
  • Data collection and retrieval software
  • State Flow engine to automate case management functions
  • Communication/notification engine to automate correspondence with members
  • Automated letter generation, including appointment reminders to members
  • Communications tailored to members with specific health results requiring follow-up care
  • Implementation and system administrator training for the member benefits program
  • Secure wireless data transmission

Solution & Benefits

Intellis implemented the FOUNDATION system, configuring it to support multi-site wellness programs, communications, and benefit tracking, and the system is extensible to accommodate future programs.

Intellis also provided near-term support assisting NBF in reaching its internal business goals while the system was still under development. This allowed the Fund to achieve some of the benefits of a fully functional system although the design elements were still underway.

Intellis subsequently helped NBF to transition to a fully functional system once the project was complete, and later, to migrate the project to a wireless architecture for greater data access and flexibility.

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