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 Affinity Health System Performs Proactive Clinical Care Management Using the Data Repository Company Overview Comprised of three acute care hospitals and 23 clinics throughout the community, Affinity Health System is one of the top 100 integrated healthcare networks in the nation. Business Challenge Affinity Health System endeavors to improve the quality of patient care by analyzing clinical information across the healthcare continuum, quantifying specific indicators, and effectuating proactive actions based on these findings. In particular, the chronic diseases of diabetes and coronary heart disease were initially targeted for clinical data analysis. Solution The MEDITECH Data Repository (DR) at Affinity Health System contains a remarkable abundance of patient clinical information including data gathered in doctor office visits, outpatient clinics, as well as hospital stays. This wealth of clinical data spanning years of healthcare activity provided the foundation on which reporting initiatives to improve the quality of care could be developed. Affinity Health System developed specifications comprised of a series of criteria that were used to categorize a patient as having a chronic ailment of diabetes or coronary arterial disease. Criteria included factors such as the number of office visits over a recent period, patient age, results from laboratory tests and other exams, medication prescriptions, diagnosis codes, and CPT codes. Acmeware developed corresponding data extracts using SQL Server Stored Procedures containing Transact-SQL code that extracted and filtered data from the DR. Data identified for reporting included patient demographic information, lab and exam results, most recent and next scheduled office visit dates, provider and provider group, and insurance plan. Patient's clinical results were further analyzed in an endeavor to categorize how well the specific chronic disease was being managed by the patient and by Affinity Health System's healthcare network providers. Clinical factors in the extract were "scored" for patients resulting in a quantification of quality and success of care measures. Patient's score results were then aggregated and stratified by different groupings including provider, provider group, and insurance plan. Business Object's Crystal Reports® was used to render the study results in tabular, cross-tab, and graphic output. These reports allowed Affinity Health System to assess how provider, provider group, and insurance plans compared with their counterparts on patient population management success for diabetes and coronary arterial diseases. Furthermore, Affinity Health System worked with Acmeware to leverage information obtained in this project and implement proactive measures intended to improve chronic care management. Evaluating patient scores and comparing their results to standards for diabetics and coronary arterial disease patients (with regards to frequency of care, test result values, and other factors), we were able to create personalized care guidelines. Mail-merge technology using phrases and sentence structure derived according to the data was used to develop personalized letters containing important care guidelines, suggestions, and reminders. These letters are scheduled to be mailed on a regular basis. The success of this mailing program has been measured by improvement in score stratifications over the course of this project. Conclusion The wealth of data in the Data Repository can assist you in gathering information across the wide spectrum of healthcare issues, from keeping an eye on financial performance to helping patients be more proactive in their own care. Affinity has tapped into that data to successfully track and improve patient care. Acmeware is committed to assisting Affinity in developing new DR-based reports as well as the ongoing management and support of the DR application. |
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