Physician Associations and Primary Care

Physicians associations and small primary care practices are under increasing pressure from payers and regulators to provide and document higher quality and lower cost care. This means becoming accountable for quality measures included in Health Effectiveness Data and Information Set (HEDIS), providing reporting of clinical care, and effective adoption of Electronic Medical Records (EMRs). Data is becoming more available with the adoption of EMR, electronic scheduling and billing systems, and the exchange of claims data from payers and laboratory providers.

Turning this information into actionable reports requires a repository that can merge information effectively between these systems and generate the reports needed to improve performance. While many associations have begun to implement custom solutions using standard Business Intelligence (BI) tools they are costly to maintain and specialized IT resources are rarely available to focus on creating an effective set of tools to use.

Recombinant By Deloitte offers a packaged, affordable, and supported solution including both products and services based upon the Selectrus Performance Analytics Suite and report library for Physician Associations to implement and deploy a data warehouse focused on their individual needs.

Components include:

Infrastructure

• Data Trust repository schema and processing systems
• Selectrus Analytic Datamart
• Selectrus report server
• Selectrus report library
• Patient list manager response tracking application
• Physician quality incentives administration portal
• Data integration adapters
   
  • Claims files from payers
  • EMR applications (patients, medications, problems, )
• Scheduling and billing systems

 
The Selectrus report library includes the following capabilities for physician associations:

• Leading practice workflows for executing outbound campaigns to improve performance
• Multiple role based reporting levels and views (patient, provider, medical director, administrator, payer)
• Integrated Health Insurance Portability and Accountability Act (HIPAA) privacy security on patient information

Pre-built reports in the growing library include:

• Chronic disease management
• Diabetes
• Coronary artery disease (CAD)
• Hypertension
• Asthma

Prevention

• Well child visits
• Mammograms
• Pap Smears
• Colonoscopies
• Adult immunizations
• Pediatric immunizations

Board/hospital reporting

• Patient flow
• EMR adoption
• Physician utilization
• Publicly reported quality and safety measures

Services

• Data warehouse planning and project management
• Extract, Transform and Load (ETL) development/coding
• Establishment of logic to define panels/denominators
• Report customization and deployment
• Data quality review
• Support and maintenance of installed solutions

Reporting applications support a number of groups including institutional wide reporting, management reports, and outreach to providers and patients for quality improvement projects.

The Selectrus reporting library allows for leading practices to be shared and development effort to be reduced.

Potential Benefits for Physician Associations

• Improve performance on HEDIS/Pay for Performance (P4P) and publicly reported measures

• Improve care for chronic diseases for diabetes, CAD, and asthma

• Execute outreach programs to providers and patients

• Maintain high quality results on public reporting measures like Physician Quality and Reporting System (PQRS)

• Reduce the latency in information from payer data sets

• Integrate data across areas

• Establish objective based physician quality incentive programs