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September 2006 • Volume 11 Number 9
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Member Profile: HealthMeans Inc.
This month, Smart Card Talk spoke with Frank Avignone, Vice President of Business Development, Healthmeans. A healthcare practitioner, Mr. Avignone effectively combines his knowledge of healthcare and his practical experience in the delivery of healthcare services to bring proven leadership, vision and business development expertise. Prior to joining HealthMeans, Mr. Avignone held executive positions with HealthBlocks Corp., Emergisoft Corporation and KPMG Peat Marwick. Mr. Avignone’s professional background in the information technologies field includes technical support, development, management consulting, marketing and sales. Mr. Avignone directs the HealthMeans strategic initiatives to further build the Company’s healthcare offerings and refine the technology business model. In addition, Mr. Avignone is a licensed healthcare professional, has over 15 years experience in various aspects of healthcare delivery, and chairs the Smart Card Alliance Healthcare Council. 1. What are Healthmeans' business strategy and product offerings? What role does smart card technology play in supporting Healthmeans' business? The core business strategy of HealthMeans Inc. (HMI) is to provide smart cards and smart card ready applications as the centerpiece of an information community assembled as a distributed network of connected physician offices, hospitals and clinics with patients for the purpose of building a unified health information community. The key contributors of a health information community are the chief stakeholders involved in the provision of care, the recipient of that care, and the payor supporting that care. By building information bridges between payors, providers and patients, the company has begun to realize the goal of interoperability between disparate information sources and all three stakeholders. HealthMeans, Inc. offers a range of products and services to achieve this connectivity, with the smart card serving as the nucleus. This approach to this complex market supports the rapid, accurate and HIPAA-compliant transportation of a patient’s medical and demographic information and links to legacy information systems throughout any healthcare system or community. HealthMeans, Inc. leverages the patented eNvision smart card application framework to connect smart cards with medical record information to patients, existing systems, and devices through software. Integrated across a web services platform, eNvision provides the ability to quickly deploy, manage, and use connected, security-enhanced solutions with eNvision smart card services. This solution enables healthcare delivery networks to integrate their current systems more rapidly and in a more agile manner, as well as to help provide access to critical health record information anytime, anywhere, on any device. The eNvision smart card application system includes an easy-to-use framework consisting several basic modules: (1) Personal Demographic Information, (2) Rapid Registration, (3) AHIMA Health Summary and Illness Index, (4) Insurance and Demographic Verification, (5) Scanning and Imaging, and (6) HL7 Integration/Web Services or ODBC application integration, in addition to a set of add-on modules to support the non-base applications. The eNvision Private Patient Portal is secure, customizable, and patient-specific. Using IDs and passwords, or their eNvision smart cards, patients can log onto the health systems already existing health information system/web portal infrastructure. Once logged in, patients can view and build their own personal health records with adjunct functions including viewing lab results and other tests, medication lists and prescriptions, allergy lists, insurance coverage, personal information, and next of kin data. Patients can also read facility-driven content that might include complete condition-specific questionnaires and assessment tools, and follow links to customized, trusted information about their conditions. The eNvision smart card-driven pre-registration solution facilitates safe, fast and efficient care across multiple health system venues. The eNvision pre-admission system goes beyond just automating the physician ordering process or registering a patient. By embedding all pre-registration and orders information in one easy-to-use solution, physician offices can enter information into the eNvision orders application and write that same information on the smart card. eNvision kiosk check-in streamlines the process of checking patients in for hospital services such as lab tests, X-ray studies, or therapy as well as in the physician office for normal appointments. All administrative and clinical data required for that visit is transferred via the smart card both to the registration system and to the clinical systems involved for that specific visit. When patients check in, they are placed on an automated queue in the areas where that patient will be visiting. 2. What trends do you see developing in the healthcare market that Healthmeans hopes to capitalize on and that impact the use of smart cards in healthcare applications? In today's health care system in the United States, the combination of the need to reduce medical errors and improve safety has shifted the focus away from the traditional approach of managing health care costs to managing health information through the use of technology. The 1990s encouraged a national move toward managed care in an effort to reduce rising health care costs. T he main driver of this approach was the health insurance industry. The last several years have seen a different approach to this problem. Efforts have been made across the United States to improve patient safety and quality of care through technology-based solutions that provide patient information at the point of service. The past 30 years in the healthcare information technology market has sustained the trend toward fragmentation through the vast array of proprietary, non-integrated health information systems used by healthcare providers, integrated delivery networks, and health plans. For every segment there are multiple technologies on many computing platforms, many of which are incompatible in the same hardware and network operating system environments. Although the free market that created this situation has been extraordinary for the entrepreneur and given rise to many technology advances, the lack of standards has foiled any opportunity for many standards to take hold and provide for interoperability. There is enough rhetoric and solid evidence to substantiate the facts that access to a patient’s clinical record can avoid disastrous clinical mistakes and that authenticated patient identification and administrative data access avoids costs, saves money and delivers a proven hard dollar return on investment any CFO will understand. The only remaining question is how we get to that point. Health information technology (HIT) can transform health care delivery, bringing information where it is needed. This has to be done without substantial government regulation or industry disruption. The appropriate transformation will give the U.S. marketplace better, safer, patient-focused care that is more cost effective, less wasteful, appropriate, and, most importantly, obtainable. The changes that will accompany the full use of information technology that leverages our already existing infrastructure in the U.S. health care industry will pose challenges to long-standing notions and practices. My supposition is simply that action must occur now to realize the benefits of already existing technology and build for the future HIT. This must be a supported and sustained effort unlike the Y2K-like misfortunes of the past and must to adhere to already existing standards while setting the stage for cooperative efforts to create new standards where they are needed. Because we are realizing the shift away from managed care as a driver for change to managed information as its replacement, approaching the issues of information availability and interoperability will position the National Health Information Infrastructure (NHII) effort for success. Since most of the roughly 6,000 hospitals and 750,000 physicians in the U.S. have made technology commitments and investments, it will not be feasible to have a block of four or five vendors supply all of the applications to healthcare as has been suggested in the one vendor/one solution framework. On the other hand, the best of breed approach does not work for the industry and healthcare cannot continue down the path of information fragmentation. As patient care becomes more advanced, it becomes more difficult to stay current with all the new procedures and to expect any practitioner to provide safe, timely, quality care while looking for medical records, x-rays, lab results or orders and referral information. Smart cards provide a high-tech, soft-touch solution that involves the patient, physician and health system. It supports privacy, security and dependable access to information in almost any environment. By deploying smart cards as the keystone to interoperability, the U.S. HIT market can continue down the path to interoperability and the realization of the NHII at a much more rapid pace. It also leverages a decentralized approach that keeps closely-guarded healthcare information where it belongs -- with the practitioner or institution responsible for that patient's care. By deploying smart cards based on already existing standards, 40 years of HIT infrastructure and expense can be leveraged and not replaced, augmented and abandoned. Smart cards will be the incremental success in the march toward the National Health Information Infrastructure. 3. How do you see your involvement in the Alliance and Healthcare Council helping Healthmeans become successful? In your role as Chair of the Smart Card Alliance Healthcare Council, what do you see are primary goals for the Council for the next year? The most difficult matter for me to discuss would be to focus on me as the Chair. I believe the focus should be on the Smart Card Alliance as an organization and all of its members as the contributors to the cause we have taken up. Since I took the position as Co-Chair of the Healthcare Council almost two years ago, my focus has been on building the council and increasing awareness of smart cards in the healthcare marketplace. Simply put, I see the mission and vision of the Council as one of becoming the evangelist of smart cards in healthcare, while supporting other standards bodies in this market in order to bring realistic, practical and sustainable smart card solutions in support of safer, cost-effective and patient-centric healthcare. The chairmanship of the Council has brought attention to my day job at HealthMeans Inc.; however I have made a conscious effort to support the Council and not to emphasize my company but to promote the Alliance and the Council activities. For me it is simple. There is a large market for smart cards in healthcare in the U.S. It would be better for the industry to participate in Alliance efforts that will promote interoperability in the market based on smart cards and provide opportunities for the many integrators such as HMI to participate. By approaching my position with the Alliance in this manner, my fervent belief is there will be enough business for everyone if we work cooperatively inside and outside of the Council. I have attempted during my tenure to push for work product such as white papers and public speaking engagements that would continue to advance the Alliance to the forefront of the health information management market here in the U.S. My goals for this year have not changed drastically as I look toward the publication of our next white paper. I do think that the council needs to become more involved, vocal and informed in organizations such as the ASTM (American Society for Testing and Materials), HL7 (Health Level Seven), MoHCA (Mobile Healthcare Alliance), and other healthcare standards bodies. If we are to truly educate this market on the real potential of smart cards and their ability to be part of the interoperability solution, we as an organization must start now instead of ten years from now. The past focus by health systems on cost cutting has helped many healthcare organizations survive their immediate financial struggles; however, this approach ultimately has had a more negative impact and forced a reduction in services, closure of needed clinics and hospitals, and a consolidation of markets that functioned better in an environment of competition. Only those health systems that pursue constant innovation can ensure long-term success. Smart cards are the innovation that will provide the platform for future interoperability in healthcare and the Smart Card Alliance will be the organization to educate and evangelize this for the healthcare market.
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