Case One: Opening the Blocked Entryway
Problem: A major health insurer was losing applicants to online insurance companies. Why? The insurer only had paper applications. Paper applications took days to process and resulted in poor customer service. The insurer decided to launch a project that would accept online applications from brokers. The online form would pre-clean the applications, eliminating errors and omissions, and saving time, effort, and money. However, the project had missed major milestones and was a year late. When it went live, it failed to meet the needs of internal brokers and external brokers simply didn’t use it. Meanwhile, the project team had disappeared.
Action: Judy reset the project. She worked with executives, the development team and vendor to bring the project scope under control and managed the implementation.
Result: Judy eliminated its array of problems, reduced security risk, and completely satisfied both the internal and external brokers. Overall, she prevented $11.5 million in potential lost revenue from 5,300 contracts.
Case Two: Opening Access to Records
Problem: A well-known insurer had merged with two others and they spoke different technical languages. Benefit administrators needed access to all the records, yet the project to convert to a single standard had stalled. The inability to merge was costing them customer satisfaction resulting in a poor marketplace reputation. There was no centralized control and the project had been without a manager for a year and a half.
Action: Everything had to be done at once. Judy pulled the groups together, facilitated their communications and reset deadlines. She continually made it clear what the other groups were doing and how they all interrelated.
Result: The benefit administrators gained much better support and could be more responsive and customer-friendly. They more effectively served the company’s large number of corporate clients, who pay the insurance for their employees.
Other Successes
Problem: Community health clinics had no method to evaluate the capability of EHR vendors to meet their needs.
Solution: Criteria and a rating system were developed to qualify EHR vendors for these clinics.
Problem: There was no information on whether technology had an impact on quality measures.
Solution: A study was conducted to determine the effect of physicians equipped with technology on HEDIS measures. This research was used to determine factors in physician pay-for-performance programs.
Problem: The National Center for Quality Assurance (NCQA) wanted a trusted third party to certify organizations that met HIPAA requirements.
Solution: Judy became a certified technical and administrative reviewer for its HIPAA security plans.
Problem: A healthcare community wanted to know if it could exchange information on patients and improve healthcare as a result.
Solution: A strategic plan was developed to exchange information between physicians, hospitals, and laboratory for an Internet-based network.
Problem: The government’s electronic record system for Indian community clinics was outdated and support for was being discontinued.
Solution: Users were interviewed for input to determine the requirements for replacing a practice management system and electronic medical record system for clinics.
Problem: Purchasers of EMRs could not tell if or to what extent vendors were compliant with HIPAA rules.
Solution: A website was created to compare vendor products on HIPAA compliance using a standard profile making it easy for purchasers to clearly see features and functions.
Problem: A large healthcare organization needed to know the gaps in its HIPAA compliance.
Solution: A HIPAA privacy assessment was performed that included conducting interviews and reviewing processes to determine gaps in policies.
Judy also:
Founded the Beta Partner Technology Program©, a technology partnership program for physician groups and vendors. AMGA, NIPAC, Bloodhound Software, and Sullivan Luallin were program participants.
Served as an advocate for IPA interests at CALINX, a California information system standards project.
Developer of HIPAA seminars for CIOs of physician groups in California.