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 HEDIS, providing reporting of clinical care, and effective adoption of EMRs (electronic medical records). 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 key reports needed to improve performance. While many associations have begun to implement custom solutions using standard 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 offers a packaged, affordable, and supported solution including both products and services based upon the Report Central server and report library for Physician Associations to implement and deploy a data warehouse focused on their unique needs.

Key components include:

Infrastructure

• Data Trust repository schema and processing systems
• Report Central quality datamart
• Report Central report server
• Report Central 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 Report Central report library includes the following key capabilities for physician associations:
• Best practice workflows for executing outbound campaigns to improve performance
• Multiple role based reporting levels and views (patient, provider, medical director, administrator, payer)
• Integrated 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
• ETL development/coding
• Establishment of logic to define panels/denominators
• Report customization and deployment
• Data quality audit
• 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 best practice based reporting library allows for best practices to be shared and development effort to be minimized.

Key Benefits for Physician Associations

• Improve performance on key HEDIS/P4P and publicly reported measures

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

• Execute outreach programs to providers and patients

• Maintain superior results on public reporting measures like PQRI

• Reduce the latency in information from payer data sets

• Integrate data across areas

• Establish objective based physician quality incentive programs