One on One With Robert Mau, Vice President, eBusiness, Medical Mutual of Ohio

Medical Mutual's online strategy is as much about user-friendly information access as it is about effective online transaction capabilities, as exemplified by the health insurer's iHealth personal health record.

I&T:What's Medical Mutual of Ohio's online strategy?

Mau: Our Web strategy is to provide our constituents with more than just the ability to pay bills or perform enrollments online. We want to display information efficiently and intuitively so that it is easy for casual or infrequent users to access.

I&T:What are you doing to improve ease of use?

Mau: We've made major changes to the employer registration process to really spruce up the look and feel of the portal, and we've changed the back-end data architecture to improve performance. We've also redesigned our individual health insurance sales Web site. We added quoting-engine enhancements and lead-tracking capabilities so our sales team can follow up on leads generated by someone requesting a quote who completes the optional contact information.

I&T:Is the company standardizing its portals on one technology platform?

Mau: The strategic platform for our portals is the Microsoft [Redmond, Wash.] .NET framework. We're looking at migrating our portals over to a Microsoft SharePoint Server 2007 environment.

I&T:Are you using document imaging as part of your online strategy?

Mau: Our primary focus has been enrollment transactions, online billing and providing access to benefit books. But some of our transactions do integrate with our document imaging solution. We are also taking a close look at different member and broker portal platforms and will implement paperless explanations of benefits.

I&T:What's the background on the iHealth personal health record initiative?

Mau: The iHealth personal health record is a really interesting solution. When we started on this journey, we were looking for a new e-business marketplace offering. We were prepared to spend a little money and experiment to get to best of class in the online environment.

At the same time we were looking at expanding our e-business capabilities, we started researching personal health records-based solutions and came across Medem Inc. [San Francisco]. We liked that the Medem solution allows doctors to engage all of their patients -- not just the patients for a particular insurer, such as Medical Mutual.

I&T:What are iHealth's major components?

Mau: IHealth replaces the clipboard still used by many doctors during that first office visit. As a new patient, typically you're asked to fill out a personal health record by answering a barrage of questions about your medical history while you're sitting in the waiting room. You need to remember all the medications you are taking and what surgeries you've had. With iHealth, the doctor can offer the patient the option of filling out an online personal health record in the comfort of his or her own home. You don't have to try to remember the dosage of a medication you are taking -- you can walk over to your medicine cabinet and look it up.

I&T:What's the adoption rate?

Mau: The average personal health record adoption rate is about 1 percent if the insurer requests that the patient fill it out. But if the doctor asks the patient to fill out the online form, the adoption rate is 30 to 40 percent. That makes sense: Who are you most likely to listen to -- your doctor or your insurance company?

I&T:What else does iHealth include?

Mau: The core of iHealth is the personal health record, but Medem offers other services that support collaboration among the member, the doctor and the health insurance company. For example, secure messaging enables the patient to electronically contact the doctor and allows the doctor to send an electronic prescription to the patient. Doctors also receive a personalized Web site they can use to promote different wellness offerings.

I&T:Can you provide an example of the efficiencies gained using the iHealth personal health record?

Mau: Let's say an insurance company denies a patient's claim for an MRI because the patient did not get the appropriate precertifications. In most cases, the patient would need to contact the doctor, the health insurer or both. With iHealth, the patient can send an electronic message to the doctor or insurer at 10:30 at night or whenever it's most convenient. The member doesn't have to make a call during business hours. The doctor is saved the time on the phone with the patient, and providers can process claims faster and get paid more quickly.

I&T:How does iHealth differ from other insurers' personal health records?

Mau: Their solutions only work for their own members. Most doctors see patients from a variety of insurers and are less likely to implement a solution that changes their practice and behaviors to meet the requirements of only one insurance company. Our solution engages the doctor for their entire practice. We believe that is a key differentiator from other vendor offerings; a number of solutions from other health insurers only help the doctor create personal health records for their own members.

Another key differentiator of the iHealth offering is that patients keep their personal health records for life. If a member leaves Medical Mutual, that comprehensive information goes with him or her. This is a great advantage since most people aren't in control of choosing their health insurer; their employer chooses the insurers with which they can participate. Do you want to go through the hassle of setting up a personal health record if there's a chance your employer will change health insurers next year? Probably not.

I&T:How are you promoting iHealth to physicians?

Mau: We are very actively promoting iHealth. Our provider contracting group loves this solution. IT is focused on making this work and is helping us reach the medical practices most likely to use iHealth. We'll train our provider contracting representatives on iHealth, provide marketing materials, promote it during doctor visits and we'll do some mailings. We'll also offer seminars for CME [Continuing Medical Education] credits, which appeal to doctors.

I&T:Are you promoting iHealth to members?

Mau: We're promoting iHealth on our Web site and are putting stuffers in our explanation-of-benefits mailers. We're also promoting it to our sales force so they can talk to employer groups. As an incentive for employees to use the site, we're offering a health risk assessment. Employees complete a long questionnaire about personal and health habits, and iHealth ranks them compared to their peers and provides them with an action list of things to do to improve their health.

Some companies pay their employees to take the health risk assessment. They do get a much higher adoption rate. We then ask those employees to go one step further and fill out a personal health record that we integrate into their overall health and wellness report. This improves patient safety and is a nice benefit for members.