Chapter 20 Health Care
In This Chapter
▶ The Medical Center of Central Georgia
▶ Independence Blue Cross
▶ Sisters of Mercy Health System
▶ Partners HealthCare
The U.S. health care industry is facing a perfect storm of challenges. The Health Insurance Portability and Accountability Act (HIPAA) and other government regulations require providers to adhere to national standards for electronic records and transactions. Health care providers and payers must cope with many other pressures, including an aging population, a growing number of people without medical insurance, falling government reimbursement rates, and a growing shortage of qualified staff members.
In this difficult environment, health care insurance companies need to manage the relationships with health care providers and consumers. Pharmaceutical companies need to leverage data and best practices successfully across the entire health care system to ensure that they develop medicines
to address emerging needs. At the center of this storm, medical costs are skyrocketing. Controlling health care costs while ensuring quality of care has become a hot issue for this industry. Service management is emerging as an important strategy for meeting these challenges. Addressing problem and change management helps to decrease the down time of critical technology that clinicians and nurses use to treat patients and manage care, for example. The hospitals and insurance companies profiled in this chapter believe that service management helps reduce costs and ensure improved quality of care. Innovation has become critical to success, so many companies are looking at ways to innovate. In this chapter, we profile four companies’ service management efforts:
✓ The Medical Center of Central Georgia is using its service management system software to automate what were traditionally inefficient and/or paper-based business processes, and to manage customer service and change management.
✓ Independence Blue Cross deployed an operations control center to help monitor its systems and predict problems.
✓ Sisters of Mercy Health System transformed its clinical processes. IT supported this initiative by creating a more responsive technology infrastructure.
✓ Finally, Partners HealthCare deployed an innovative service oriented architecture strategy and is using a service catalog to help monitor the performance of its key services.