Located in Savannah, Memorial Health operates one of the most active managed–health organizations in the Southeast. Memorial Health provides managed health care services to approximately thirty client companies with more than 55 thousand people while also operating a tertiary–care teaching hospital. And when decisions are made on matters of patient care, medical director Dr. Richard Lachiver is there to see that they're made in an accurate and timely manner. "When doctors have a patient on whom they want to perform a procedure," he explains, "they tell us about the case and the circumstances, and we make a judgment on whether the procedure is permissible under the client's coverage plan. We also have a disease management program, a new concept under which patients with chronic complaints — diabetes, asthma, and the like — are helped to get managed treatment that's both effective and efficient."
Information moves through Dr. Lachiver's department in constant streams – case histories, diagnoses, documentation of claims — but his staff never loses sight of the fact that there are real people on the ends of each stream. So it's one of Dr. Lachiver's priorities to ensure that claims are processed as quickly and accurately as possible. "We'd been leasing proprietary claims management software, a cost running between $100,000 and $150,000 a year," he recalls, "but we had to generate claims management letters by hand, typing the information into the system and then printing out the letters. There were stacks and stacks of paper."
I had been using FileMaker Pro personally for years and we were using the software elsewhere in the organization for scheduling patients and other functions. I just kept adding functions to it — and ended up with the system we have now. You name it — we can do it on FileMaker Pro.
It was an inefficient system from the company's perspective — and delays in approval for claims meant delays in care for patients. But about a year and a half ago, Dr. Lachiver began to experiment with FileMaker Pro. "I had been using FileMaker Pro personally for years," he says, "and we were using the software elsewhere in the organization for scheduling patients and other functions. I just kept adding functions to it — and ended up with the system we have now. You name it — we can do it on FileMaker Pro."