Plans, PBMs step up infotech initiatives

Over the next three years, large and small health plans and PBMs that are currently involved in emerging health information technologies are going to focus on increasing disease management programs and on providing personal digital assistants (such as the Palm) to physicians, according to a report by the Foundation for Managed Care Pharmacy, the educational arm of the Academy of Managed Care Pharmacy.

"The benefits these technologies will deliver will be an enhancement of quality care for the patient and an increased efficiency in the system. Emerging technologies will take some of the administrative costs out of the system — once the technology is up and running," says Cynthia J. Pigg, executive director of the foundation. In particular, DM programs' use of predictive modeling will increase.

These patient-oriented technologies seem to be on the horizon because early electronic efforts were focused on paying the provider, says Pigg. She adds that "Pharmacy claims have used electronic billing systems since the 1990s, and improvements to create greater efficiency have been made along the way." Once the challenges associated with billing are overcome and the "system made more efficient, then the focus shifts to patient care," says Pigg.

The report, "Benchmarking New Frontiers in Managed Care Pharmacy — Emerging Trends Research with Managed Pharmacy Experts," found that only about half the respondents had begun the process of designing or implementing electronic prescribing technologies, but for those that had begun, more than 20 percent were within a year of implementing a program. About one third of the largest organizations had an operational system in place, and another 13 percent were nearly there.

Which will be operational within three years?

Note: Respondents could select all that apply

Source: Foundation for Managed Care Pharmacy


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