Blues’ Big Database

CSC is helping the Blue Cross Blue Shield Association build a healthcare/health insurance informatics resource drawing on data from 79 million individuals.

Leveraging its nationwide network of participating plans, Chicago-based Blue Cross Blue Shield Association (BCBSA) is creating Blue Health Intelligence (BHI), a massive HIPAA-compliant database that will serve as a resource to employers, health plan members, healthcare providers and researchers. The database will include claims, enrollment, provider and laboratory data that can be processed to yield actionable information for healthcare decision making, according to BCBSA president and CEO Scott P. Serota. "Eventually, BHI will provide consumers with the information they need to make informed healthcare decisions and will heighten collaboration with providers," he says.

Dwarfing previous attempts at health insurance databases -- such as the Care Focused Purchasing initiative embarked upon by Aetna, United Health Group, Mercer and others -- BHI contains claims data without personal identifiers from 79 million plan members, drawn from 20 of BCBSA's 38 associated plans. The initiative is being managed by BCBSA's Business Informatics division and draws heavily upon the IT organizations of the participating plans.

BCBSA's main vendor partner will be El Segundo, Calif.-based CSC, which signed a two-year, $21.5 million contract with the Association. CSC will be assisted by Towson, Md.-based ViPS, which will provide data modeling software, and Seattle-based Milliman, which will contribute data validation services. BHI has been piloted at three BCBS plans and is scheduled to be fully operational in 2007.

"The initial deliverable will be sets of benchmarks for employers to use to determine how best to manage their employees' benefit options," explains Shirley Lady, executive director, business informatics, BHI, BCBSA. "For example, if an employer has a high incidence of a particular disease in a particular location, he or she can provide a specific improvement program to that location."

Among the drivers motivating participating Blues plans to commit resources to BHI is the opportunity to have access to a wider set of data, according to David Kirshenbaum, VP, enterprise information management, Indianapolis-based WellPoint (total assets of $41.8 billion). "We've seen a huge demand increase for healthcare informatics," he comments. "While we are also responding internally [within WellPoint], BHI was an opportunity to get an even broader geographic base."

The greatest burden on participating plans is the actual transfer of data, according to Kirshenbaum. "The data that each of the plans sends is going through an extremely rigorous certification process," he relates. "The biggest work for all the plans is extracting the data, getting it into the right shape and getting it to pass through all the certifications to make sure that it's rock-solid."

Kirshenbaum says he sees BHI as indicative of broader trends to standardize healthcare-related data. "With BHI, we're really starting to see the beginnings of real data standards, at least for the Blue plans," he says.

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio