HCSC Uses New Analytics to Identify Health Risks

CHICAGO (March 16, 2010) - Health Care Service Corporation (HCSC) is offering physicians and healthcare facilities access to a new tool that will assist them in identifying health risks for 9 million patients across the country. The CareProfile® is an electronic health record (EHR) created with the collaborative input of MEDecision, Availity and HCSC's Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas. 

"Other companies have offered electronic health records, but this is the first that includes a health status measure in addition to compiling all of the critical information relevant to a patient's care," said Paul Handel, M.D., HCSC's chief medical officer.  "The information can help doctors identify situations such as clinical gaps in recommended care services, missed prescription refills and possible drug-to-drug interactions."

The CareProfile is created with health plan data that HCSC collects from physicians, pharmacies, labs and other health care providers.  MEDecision then applies robust clinical intelligence and analytics to the data and summarizes into a report that highlights treatment opportunities and includes a health status measurement score that identifies a patient's likelihood for serious health complications. Availity displays the information in the form of a user-friendly EHR through its web portal.  Because the portal is web-based, it can be easily accessed by any authorized physician or facility at the point of care. 

"We have spent many years working to connect the best experts in health insurance, analytics and provider portals.  This milestone success is a significant achievement for us as well as the entire health care industry," said Pat Hemingway Hall, president and chief executive officer of HCSC.  "In addition to helping physicians and patients make safe, informed health care decisions, this EHR brings efficiencies and cost savings to the health care system."

Other information contained within the CareProfile includes:

  • Demographic patient information, including date of birth, address and phone number.
  • Information about the patient's current primary care physician (PCP), if applicable, and other providers visited in the past 24 months.
  • Diagnoses and procedures submitted and reflected in the claims records.
  • Professional, hospital and emergency room services reflected in the claims records.
  • Prescriptions filled, including the class of the drug, total fills, and last date filled.
  • Radiological and laboratory services reflected in the claim records (test results will be included in a future release). 

The CareProfile is provided to physicians and provider organizations free of charge, and may be accessed on the Availity portal at www.availity.com.  In addition, HCSC's members may access the information under "My Care Profile" in their Personal Health Manager. The availability of information between patients, providers and HCSC gives all a common view of the patient, promoting a collaborative approach to health management to ensure the best outcomes for HCSC members.  

Media contact for more information or a demonstration of the CareProfile:

Ross Blackstone, HCSC (972-766-1735, [email protected] 

About Health Care Service Corporation

Health Care Service Corporation is the country's largest customer-owned health insurer and fourth largest health insurer overall, with 12.4 million members in its Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross and Blue Shield Association. HCSC has a rating of AA- (Very Strong) from Standard and Poor's, A1 (Good) from Moody's and A+ (Superior) from A.M. Best Company. For more information, visit www.HCSC.com.

About MEDecision

MEDecision offers collaborative healthcare management solutions that provide a simple and smart way for payers and providers to harness the power of knowledge to enable the best clinical decisions and improve health outcomes. Designed around a patient-aware health management philosophy, MEDecision's solutions include Alineo®, a collaborative healthcare management platform for delivering outcome-driven case, disease and utilization management, Nexalign®, a collaborative healthcare decision support service that fosters better payer-patient-physician interactions and InFrameTM, a collaborative health information exchange service that connects care delivery organizations with one another and their patients. For more information, visit http://www.MEDecision.com. 

MEDecision is a trademark of MEDecision, Inc. The MEDecision logo and product names are also trademarks or registered trademarks of MEDecision, Inc. Other product and brand names are trademarks of their respective owners.  

About Availity

Availity optimizes information exchange between multiple health care stakeholders through a single, secure network. The Availity Health Information Network encompasses administrative, financial, and clinical services, supporting both real-time and batch electronic data interchange via the web and business-to-business (B2B) integration. For more information, including an online demonstration, please visit www.availity.com.