The emergence of “Managed Care” Services, the most common type of healthcare services provision in the U.S., is one the latest trend that recently appeared in Europe. The Managed Care Model was created in the U.S.A. out of the need for cost rationalisation and effective, high-quality healthcare services provision as well as integration of healthcare and insurance services. The existence of the same needs in Europe is expected to bring about the growth of this model in the European healthcare system.

According to the “Managed Care” model, healthcare services provision is implemented via a “one-stop” format, a network of healthcare services providers - organisations and professionals under the coordination of Health Management Organisations (HMOs).

An example of a model under this regime is the following: The beneficiary pays a standard premium to receive all health services from the HMO or its affiliates. In this way he or she is certain that he or she has access to services offered by a variety of medical experts, hospitals, laboratories, e.t.c. whereas his or her health plans are centrally coordinated by the HMO. In this way, he or she is certain that he or she has access to a wide range and high variety of healthcare services, centrally coordinated by the HMO, and thus, that the overall process of service provision will be smooth, organised and will require minimal cost and effort on his or her part.

In parallel, the healthcare service providers that participate in the Network under the HMO management, achieve increased turnover and competitiveness, optimization of their services and rationalization of their costs via the organized structure offered by the Network.

Health Networks, one of the most rapidly increasing types of healthcare service provider, come in several shapes and forms, depending on the organizations that comprise them. There are two broad types of Health Networks:

• "Homogeneous" Networks consist only of healthcare service providers engaged in the provision of:

In both of the above cases, the strategic alliance between healthcare service and, in the case of heterogeneous networks, insurance service providers, combines the expertise of different but complementary organizations or individuals, aiming at the better and faster service to beneficiaries.

In this sense, it leads to a synergistic effect whereby the strength of the Network is greatest than the sum of the strengths of its participant organizations or individuals. The reason for this is that:

• The market trend is that beneficiaries prefer to deal with one entity that integrates and provides all services than having to coordinate different organizations or individuals in the provision of healthcare services.

• The Networks have greatest momentum, combine more resources and thus, may create very high awareness among beneficiaries.

• Each Network member automatically provides services to beneficiaries of other organizations in the Network and thus, it expands its "customer" base.

For the above reasons, the future lies with networking between organizations either providing only healthcare services or offering both healthcare and insurance services.

Very often, the different types, working practices, even "cultures" of organizations participating in Health Networks hamper the smooth cooperation within the Network, create complex problems of exchanging data and may lead to excessive administrative overheads and work overload for personnel.

The above problems cannot be effectively solved by any medical software or any management information system software or even by any combination of the two. Even if they were, it would be very difficult to ensure that the system would have the necessary expandability for expansion to new services, more locations, and more beneficiaries. In all probability, the system would have to be replaced by a more sophisticated and automated one, in a very short time.

Thus, the system allows to the Network Managing Organization (NMO) as well as its partners to have it all: immediate availability of structured, exploitable data and optimized cooperation at minimized costs.

All data can be shared by all Network partners providing a guarantee for the smooth operation of the Network. For example:

• The system provides actual medical data at the site of expertise regardless of where this is located. By being directly connected to medical devices, the software can automatically integrate actual medical readings to the patient record, the Multimedia Health Record (MHR). This means that the attendant doctor as well as any other specialist doctor or expert on the Network can conduct diagnosis or telediagnosis, having at his or her disposal the whole patient record including real medical data.

• The system automatically integrates in the patient's record (MHR) all information pertinent to this patient's visits at different health professionals of the Network. Whether these are Care Actions (i.e. blood pressure measurements), sets of Care Actions and Services (Protocols i.e. complete Check-up) or Diagnosis and Telediagnosis (i.e. Doctor comments, Expert opinion), or even the cost of services provided at the visit, all these data are automatically integrated in the patient Multimedia Health Record in a structured way and thus they are fully exploitable for further analysis, correlations, e.t.c.

The system has advanced financial management capabilities allowing to each healthcare service provider - member of the network to automatically process patient charges, referrals and insurance claims whereas the NMO can do the same for a group or all of network members. In parallel, any insurance organizations in the health network, can receive all insurance clearances from all affiliated health organizations in a homogeneous manner, thus greatly reducing their operating expenses.

Optionally and via Smart Card Technology, the software can fully support the development of an Electronic "Health Card" that will encompass a portable MHR accessed via smart card readers and through the use of Personal Identification Number (PIN). The Electronic Health Card is much more than a simple Insurance Card: it contains all necessary information that can be immediately accessible in an emergency situation or in case that connection to the system is not possible, simplifies the access to the MHR at local sites, whenever necessary and psychologically "binds" the patient with the Network.

The application also has an advanced security system that guarantees both the patient's confidentiality as well as the access to / use of information only from authorized personnel. The security of the application is further enhanced by the option of a Health Card (Smart Card) as well as the capability for data encryption both in the storing and in the transfer of data in the Network.

In addition, the system can fully support and enhance network policy. The NMO system administrator can define himself or herself and in the way that suits network management and members best all system parameters, ranging from the definition of medical services, the codification of diagnosis up to the security mechanisms and rules of access to patient records by different people in the Network.

In parallel, scientific personnel in member organizations can define themselves ways of monitoring specific cases by defining specific monitoring profiles that correlate and compare a multitude of medical data, including actual readings.