Program Provides Insurers Real-Time Access to Electronic Health Records

Software and technology services provider SunGard Financial Systems, a unit of SunGard Data Systems Inc., has launched a health information exchange communication product that aims to help health payers identify and mitigate fraud, waste and abuse in health insurance claims.

Health information exchanges allow health care professionals and patients to access and share a patient’s medical information electronically.

SunGard’s iWorks tool links a health information exchange with a health plan’s databases and processing systems, allowing health plans to access and analyze a patient’s electronic health records in real time, rather than after a claim is processed, Wayne, Pennsylvania-based SunGard said Wednesday in a statement.

The tool also enables health plans to receive alerts on patient care activity, manage and analyze data, and coordinate workflow with care managers, SunGard said.

In the statement, SunGard said the tool could help reduce the length of a patient’s stay, duplicative procedures, readmissions, fraud and abuse, thereby lowering costs and improving the quality of health care.

“The demand for electronic health information systems is growing along with nationwide efforts to improve the quality, safety and efficiency of health care delivery,” J.P. James, president of SunGard’s insurance business, said in the statement. “SunGard’s health information exchange connectivity solution can play an important role in a health plan’s overall cost containment and customer service strategies, which will become more crucial as the number of individuals enrolling in health plans continues to grow.”

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