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Pegasystems Earns First Milliman Care Guidelines Software Integration Certification

SEATTLE, Aug. 25 /PRNewswire/ -- The Pegasystems Care Management Framework (CMF) is the first application certified as fully integrated with Milliman Care Guidelines's interactive CareWebQI((R)) clinical guideline software under a new Integration Certification program. CMF, a patient-centric business process management solution designed to improve the entire care management continuum, proved its optimum clinical workflow and usability with CareWebQI through a rigorous validation process.

The evidence-based Milliman Care Guidelines((R)) are presented in several software solutions with feature-rich interfaces that enable third-party vendors to integrate Care Guidelines products into their software applications, primarily with CareWebQI software. These integrations leverage Care Guidelines clinical content and help healthcare payors and providers to improve the quality of clinical outcomes. The integration certification program, developed by the Milliman Care Guidelines Strategic Alliances team, supports seamless integrations and ensures product quality and client satisfaction.

An Integration Certification Committee of clinical and technical experts evaluates and assesses the clinical workflow and technical specifications of integration-candidate programs. The new Integration Certification Program Guide and validation report template are available at:

"The integration of Milliman Care Guidelines's clinical content through Pegasystems' rules-based CMF solution ensures optimization of care management processes," said Elizabeth Hart, Senior Director, Healthcare Solutions for Pegasystems. "By intelligently automating the processes around clinical content, organizations can use the latest technology to improve member health while also driving efficiencies in the cost of service, which is a win-win proposition for any healthcare organization."

"Our certification program is critical to a long-term strategy of tightly integrating the Care Guidelines content and interactive software with industry-leading workflow tools from our Strategic Alliance Partners," said Lynn Nemiccolo, Milliman Care Guidelines Vice President of Business Product Development.

The program specifically examines a Strategic Alliance Partner's integration with CareWebQI for workflow and usability in areas such as data-element exchanges, episode summary launch, search capabilities and viewing read-only clinical criteria. Integration Certification requirements will be updated as enhancements are added to CareWebQI software.

About Pegasystems' Care Management Framework (CMF)

Built on Pegasystems' SmartBPM platform, CMF is a patient-centric business process management solution that automates creation and ongoing improvement of personalized care management programs. By unifying disease management, case management, and utilization management across the healthcare enterprise, CMF gives care professionals the ability to provide whole-person care and to collaborate with the entire patient network in real time. CMF can reduce overall care management complexity, cut utilization costs, and reduce care-management program development costs by 40 to 60 percent. Pegasystems' healthcare solutions are used by major healthcare organizations including five of the top six US health plans and more than 50 percent of the Blues network, representing over 100 million covered lives. To find out more about Pegasystems' healthcare offerings visit

About Pegasystems

Pegasystems, the leader in Business Process Management, provides software to drive revenue growth, productivity and agility for the world's most sophisticated organizations. Customers use its award-winning SmartBPM((R)) suite to improve customer service, reach new markets and boost operational effectiveness.

The company's patented SmartBPM technology makes enterprise applications easy to build and change by directly capturing business objectives and eliminating manual programming. SmartBPM unifies business rules and processes into composite applications that leverage existing systems -- empowering businesspeople and IT staff to Build for Change((R)), deliver value quickly and outperform their competitors. Pegasystems' suite is complemented by best-practice frameworks designed for leaders in financial services, insurance, healthcare, government, life sciences, communications, manufacturing and other industries.

Headquartered in Cambridge, MA, Pegasystems has offices in North America, Europe and Asia. Visit

About Milliman Care Guidelines

Milliman Care Guidelines LLC, A Milliman Company, is located in Seattle, and independently develops and produces evidence-based clinical guidelines and software used by more than 1,600 clients, including 900 hospitals, and seven of the country's eight largest health plans. Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced, full-time team of clinicians and is used to support the care management of nearly two-thirds of US health plan members. For more information, visit

About Milliman

Milliman Care Guidelines is a wholly owned subsidiary of Milliman, Inc., which is among the world's largest independent actuarial and consulting firms. Founded in Seattle in 1947 as Milliman & Robertson, the company now has 49 offices in key locations worldwide. Milliman employs more than 2,100 people, with a professional staff of more than 1,100 qualified consultants and actuaries, including specialists ranging from clinicians to economists. The firm has consulting practices in healthcare, employee benefits, property and casualty insurance, life insurance and financial services. Milliman serves the full spectrum of business, financial, government, union, education and non-profit organizations. For more information, visit

SOURCE Milliman Care Guidelines
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