Blue Cross Blue Shield of Illinois, Pronger Smith Medical Care and MEDecision Create First Electronic Health Record Used in a Medical Home Program

Oct 20, 2011, 17:03 ET from Blue Cross Blue Shield of Illinois

System Improves Patient Care Coordination and Enables Proactive Care Management for Better Health Outcomes

CHICAGO and WAYNE, Pa., Oct. 20, 2011 /PRNewswire-USNewswire/ -- Blue Cross and Blue Shield of Illinois (BCBSIL) and MEDecision, Inc., a leading provider of collaborative health management solutions, have teamed with Pronger Smith Medical Care (Tinley Park/Blue Island) to create an Electronic Health Record (EHR) system for Pronger Smith patients as part of their patient-centered medical home (PCMH) initiative to improve health outcomes. This innovative EHR system centralizes the timely, critical clinical information physicians and consumers need to proactively address health problems and support the best clinical decisions.

The system pulls timely clinical information from Pronger Smith, along with the BCBSIL claims-based medical record, and displays this information in a secure, web-based EHR portal.  Through the portal, Pronger Smith patients and physicians gain access to patient health information, medication lists and lab results and are able to electronically request prescription refills, schedule appointments and send secure messages. The system also grants access to hospital emergency room staff, so they can rapidly see the patient's health background and medication lists, regardless of time of day.  

"By collaborating with Blue Cross and Blue Shield of Illinois to create an EHR system, we are arming physicians with better information to help care for their patients, which can lead to healthier lives. We are confident that by centralizing communications with  providers of care, at all levels, within a medical home this will result in better outcomes for patients," said Dr. Alan M. Roman, Managing Partner, Pronger Smith Medical Care.

The EHR also creates an environment of proactive care by encouraging caregivers within a medical home program to reach out to individuals before health problems emerge. Patti A. Pyka, BSN, RN, Director of Pronger Smith's Clinical Services, said, "In our medical home model, we have leveraged our EHR, outreach and other technologies with one-on-one nurse case management to better manage and track our patients across a continuum that includes prevention, acute and chronic care."

"In the PCMH, the EHR improves care coordination for all patients by partnering with and helping them achieve health and wellness goals. This is done by automatically sending messages to patients, prompting them to follow-up with their physicians, who, if necessary, will initiate exams, tests, procedures and treatments," said Dr. Roman.

In August 2009, Pronger Smith partnered with BCBSIL to launch a patient-centered medical home program to enable more coordinated care between its 18 primary care physicians and 27 specialists. In a patient-centered medical home model, primary care physicians and their staffs monitor and coordinate most aspects of their patients' primary, specialty and other medical care to enhance quality and improve overall medical management by creating a more complete patient picture.

"As the leading health plan in the state, BCBSIL has traditionally worked within our communities with local independently contracted providers to enhance the quality of care," said Karen Atwood, BCBSIL President. "BCBSIL is an innovative company that is leveraging our data to help improve the medical management program in the clinical community. This collaboration wouldn't work if we hadn't established great relationships with our contracted providers, where all parties work together to solve problems. In the end, we believe this will have a positive impact on the quality of care provided to members."

The BCBSIL/Pronger Smith EHR system is powered by MEDecision's Nexalign® Health Information Exchange (HIE) technology, which pulls together patient clinical data from multiple sources, transforms this information into comprehensive, valuable insight and delivers it directly to the point of care in the form of Nexalign® Clinical Summaries. These are the basis for the EHR system's rich, 360-degree view of the patient.

"Our mission has always been to improve collaboration among patients, physicians and health plans by placing valuable, actionable health data into the appropriate hands at the point of care," Deborah Gage, MEDecision President and CEO said. "Our technologies power the BCBSIL/Pronger Smith EHR by gathering data from multiple sources through a health information exchange, transforming it into valuable clinical information through analytics and delivering it quickly and efficiently to improve patient care."

David G. Seaman, Chief Executive Officer of Pronger Smith Medical Care states, "the refinement and fusion of information between providers is the first of many steps that our health care system must deliver if we are to be successful partners in improving the quality of our healthcare delivery system – we owe this to our patients and to our nation. We appreciate Blue Cross Blue Shield's willingness to step up and provide the leadership necessary to make this a reality."

About Blue Cross and Blue Shield of Illinois
With nearly 7 million members, BCBSIL, a division of Health Care Service Corporation, a Mutual Legal Reserve Company, is the largest health insurance company in Illinois. Started in 1936, BCBSIL is committed to promoting the health and wellness of its members and its communities through accessible, cost-effective, quality health care. BCBSIL is an independent licensee of the Blue Cross and Blue Shield Association.  BCBSIL contracts with health care service providers throughout Illinois to provide health care services to members enrolled in its health benefit products and is not directly engaged in the provision of health care services.  Pronger Smith Medical Care and MEDecision are independent third parties that are contracted with BCBSIL.

About Pronger Smith Medical Care
Pronger Smith's mission is to provide high quality, cost efficient health care services to a large, diverse population serving Chicago's south side and southwest suburban residents in a safe, quality driven environment that communicates sensitivity and is responsive to changing patient needs.

About MEDecision
MEDecision's contribution to the healthcare industry is a powerful platform that delivers meaningful data to inform the most important healthcare transaction: patient care. We start with a philosophy that patients, providers and payers are all driving towards better health outcomes and that this common interest dictates the need for collaborative working environments. Then, we apply 23 years of experience, $85+ million in research and development and the strongest clinical knowledge to deliver the MEDecision collaborative health management platform, which includes Nexalign®, a health decision support service that applies analytics to information gathered from multiple sources to foster better business and clinical decisions on a patient's behalf, Alineo®, a health management platform for delivering outcome-driven case, disease, utilization and behavioral health management, and InFrame™, a set of tools to facilitate the health and performance management processes for physicians and accountable care organizations. For more information, visit

SOURCE Blue Cross Blue Shield of Illinois