WellPoint Q&A -- Page 3

AZ: So, it sounds like switch between, at least the perception of, health plans saying to doctors, "You'll do what I say," to "We're going to give you a great service, and that's why you're going to work with us."

JJ: Well, let me change that a little bit. I think health plans were each individually trying to do what they thought was best for the provider, and say "Look, we've got an easier way to do it," [or] "No, look, we've got an easy way to do it." But when you have 10 to 15 health plans doing that, they're not putting themselves in the shoes of the doctor's office who's saying "Look, you're all trying to be easier, but it's really hard to deal with all of you." So, that would be a little different than the "Do as I say." I think the intentions were noble, but what we're saying is "Let's work together, guys. Let's put some of this stuff one way and put ourselves in the providers' shoes and the way that they would look at it would be "I want to deal with one work station all day long."

AZ: As we all know, billions of dollars are being handed out to convince doctors to invest in EMRs, and that's going to be a real attention grabber; it's going to be very complex, difficult, competitive and all that stuff. Even though this sounds as simple as can be, do you think those pressures are going to effect adoption of this system?

JK: Actually I think that the incentives going to doctors are just a complement to what we're adding. One of the Availity health information networks capabilities include a health record that is initially based on health plan data that already sits in their systems that we plan to share through Availity back to the provider, including medications history, test orders, results, what happened to them at the hospital, what the doctors' phone numbers are across town. So, we're planning on sharing that data that comes out of the health plans' data bases together in a consolidated record back to the provider office, and then they can choose to download that to their own electronic medical record if they have one. And if they don't, this provides a lot of data that they wouldn't otherwise have access to. And if you think about it, they don't usually have access to anything that happens outside of their office. So, Availity will provide that.

AZ: It sounds like you're describing what people are calling a personal health record.

JK: Sometimes in our jargon it's called a payer-based health record. I know we're going to be working with WellPoint to even provide more than just data, but actually provide information that will allow them to make better healthcare decisions at the point of care.

JJ: Right, we want to provide clinical messaging, so that when you go to see the doctor that day, and their registering you, it'll let them know, "Make sure that this patient gets a diabetic retinal exam today," [or] "Make sure that Anne gets a mammogram because she's due," and it could also message you, as well. The information is getting to the doctors' hands at the point of care, which is what is probably going to be most effective.

AZ: What's your vision for where this portal will take you in the next three to five years? Where do you see all this going?

JJ: I see it as transformational for healthcare. What happens is, we can take millions of dollars out of time and effort spent making phone calls, waiting on hold, faxing things back and forth, by just simply applying technology to, first of all, just plain old administrative transactions and making them continually simpler and easier, so that the exchange of information between health plans and doctors is not a burden, and is very, very easy. Now, once that happens, then the ability to exchange clinical information continues to improve; the technology improves so that as you are getting ready to go to the doctor's office, you know exactly what medicines you're on, where you've been, what's going on, the doctor knows when you walk in, and there's intelligence that's mining that data, that's messaging the doctor and messaging you in order help really bring evidence-based medicine into real-time use so that it doesn't have to rely on the doctor remembering something they read a month ago about this drug interacting with that drug, and so on, so that we've actually improved clinical care....It's a noble thing, but it's something we have to do.

JK: We ultimately see that providers and hospitals are going to to say, "You know the health plans are easy to do business with today, and we can spend more quality time with our patients and less time on paperwork. We're able to deliver better quality care at a reduced cost, and ultimately give better outcomes that are measurable to our patients and our members. So, I think that's what it's all about.