What Data-Driven Tools Do Physicians Really Need to Improve Quality of Care?

June 26, 2015 Inovalon

Ask providers what keeps them up at night, and many will say it’s a patient needing care and not getting it. But ensuring that every patient who needs care receives it— regardless of how busy the provider is and how difficult the patient is to reach—is no easy feat.

Consider the steps involved with providing precisely the right care for the right patient, in the right place, at exactly the right time. We can assume that providers manage their practices differently. Even if you had full-time staff focused exclusively on this task, a few patients would inevitably fall through the cracks.

For most providers, it’s virtually impossible to achieve this, using manual systems. A sophisticated data-driven technology platform offering the components below can be an essential tool that helps providers and health plans improve care quality:

  1. Displays provider encounters, administrative claims, medication prescriptions and other data to create a comprehensive 360° profile for each patient that providers can easily access from anywhere and use for better insight into their patient’s health status.
  2. Uses advanced analytics to examine those profiles and identify care gaps.
  3. Allows providers access to past patient documentation and creates regulatory-compliant documentation during the assessment.
  4. Allows for various roles and workflows to be created, such that clinical staff can enter patient data and providers have an opportunity to review and verify the information before signing the final document.
  5. Completely protects all patient data from unauthorized access, 100% of the time.

This type of integrated platform would enable health plans and providers to easily identify which members are in need of an encounter, so they can reach out to patients to facilitate this process. Providers would receive a scheduling list showing which patients should be seen, with information on the specific gap(s) that should be addressed for each patient.

Advanced patient-specific analytics can also identify gaps in care for patients who are already being seen on a regular basis. For example, a diabetic patient with frequent visits to monitor glucose levels might have other health issues that are overlooked in the midst of medication adjustments and ongoing check-ups. A data-driven platform like the one described above could flag the fact that patient is at risk for another condition, such as heart disease.

Providers and health plans that leverage data-driven tools can benefit from the following:

  • Improved care quality
  • Greater patient satisfaction
  • Enhanced provider-patient relationships
  • More timely preventive care
  • Improved documentation for risk adjustment accuracy

In other words, sophisticated cloud-based technology providing analytically-driven access to comprehensive patient data is a key tool for driving improvements in healthcare.

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