Adobe Digital Enterprise Apps Aid Creation of Health Insurance Exchanges

Adobe says its new Digital Enterprise Platform can enable the health care industry to create HIXs (health insurance exchanges), which are open Web-based marketplaces that allow people to shop for and buy health care plans.

Introduced June 20, the Digital Enterprise Platform is a modular, open-standards infrastructure for running applications using social networking, Web, mobile and print. It integrates HTML5, Adobe Air, Flash Player and Adobe Reader.

The PDF Reader is a key aspect of the Digital Enterprise Platform, according to Michael Jackson, head of health care solutions for Adobe. “Until you pay for those capabilities, you’re not aware of the power of Adobe Reader,” Jackson told eWEEK.

The Digital Enterprise Platform allows companies to customize which features of PDFs will be visible to consumers. The PDF reader allows insurance companies or government customers to customize welcome kits and incorporate digital signatures and brochures.

HIXs will be able to incorporate online chat with customer service representatives, access to EHRs (electronic health records), integration with Google Maps to locate doctors and also the ability to schedule appointments from within EOB (explanation of benefits) statements, Jackson said. Patients will also be able to dispute claims from within EOBs.

PPACA (the Patient Protection and Affordable Care Act) requires that all states set up HIXs by Jan. 1, 2014, to provide a marketplace for the public to purchase health care plans. The public won’t be required to buy their health plans through the exchanges, however. They can still purchase separately through carriers-that is, if they’re not covered by their employers.

“For any state that claims that they are unwilling or unable to establish their own exchange by 2014, then the federal government will implement an exchange on their behalf,” Jackson said.

Although the technology behind HIXs and having an open marketplace for people to purchase health plans may have bipartisan support, requiring people to purchase health plans does not. Twenty-two states are challenging the legislation that requires citizens to buy health insurance plans.

“It’s not a right that’s been ordained on the federal government to make people purchase things,” Patrick Howard, a principal at Deloitte Consulting, told eWEEK.

Still, this shouldn’t affect the potential for HIXs, according to Jackson. Rather than states, IT companies can market HIX platforms directly to the insurance carriers themselves. “Even if health reform gets tweaked in some way, I’m sure these exchanges will continue to exist in one form or another,” Jackson said.

Implementation is still in the early stages, according to Howard. “They haven’t gotten to what the design model is going to look like,” he said. “There’s a state looking at building everything custom; there’s another state looking at using the Oracle [Siebel] stack to build their solution.”

Other companies working on similar platforms include IBM and Microsoft, which rolled out an HIX infrastructure in February.

Five areas of the Digital Enterprise Platform enabling the creation of HIXs are Web Experience Management, Social Brand Engagement, Selection and Enrollment, Unified Workspace and Custom Communication.

Web Experience Management is a tool that allows companies to create and manage content across the Web, social media, mobile devices and email.

Social Brand Engagement provides integration with social media tools such as Facebook and Twitter, and the Selection and Enrollment interface includes sliders to help applicants make choices during the application process, such as selecting their income.

Meanwhile, Unified Workspace allows for built-in chat with customer-service agents, and Custom Communication incorporates further interactive communication among customers and exchange or insurance company personnel.

The Digital Enterprise Platform will be available in August 2011.

Along with the Digital Enterprise Platform, Adobe announced Flash Builder 4.5 and Flex 4.5 to allow developers to create applications for the iPhone, iPad and BlackBerry PlayBook.