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Effective population health management (PHM) is critical as healthcare becomes more customer-centric and providers assume financial risk with value-based contracts. Emerging outcome-based payment models require clear metrics and accurate population health risk assessments.
With WellSERV PHM, your organization has the tools needed to address chronic and preventive care needs. Available on-premise or in the cloud, WellSERV helps you improve physician performance, understand health risks and minimize expensive interventions.
To improve care coordination, population health and individual patient outcomes organizations need to integrate and harmonize data being shared across the continuum of care and examine it at both patient and population levels. With WellSERV, providers access an event-based data model consistent with the HL7 Four-tiered patient registry. It unifies transactional data from multiple sources, including electronic health records (EHRs) and helps users analyze information such as care gaps and clinical markers.
WellSERV includes a rule authoring tool for building a library of custom cohorts used to identify patient groups that can drive ROI and outcomes. It leverages all elements in the patient registry data model, triages risk by incorporating outputs from various predictive models and runs on a periodic schedule to add new members. Providers and command centers receive near real-time clinical alerts based on data in motion such as hospital ADT messages and HL7 lab results.
The prepackaged risk stratification model built into WellSERV offers a proven clinical classification system for predicting member risk and service-level risk scores. Besides calculating the probability of hospitalization, the model enables health organizations to understand how patient characteristics vary across providers. It also supports risk‑adjusted pay-for-performance, improves disease management program effectiveness and provides data for risk-adjusted premiums.
WellSERV ships with an extensive set of pre-built business apps that address clinical, predictive analytics, data management and value based healthcare requirements. These apps are highly modular and scalable and leverage a KPI library of over 500 measures including HEDIS®, PQA and Cost & Utilization.
Excel based querying of OLAP database enables organizations to gain better data transparency and decision support with the flexibility to create ad hoc reports and examine data from various aspects. It also reduces dependency on IT and turnaround time for report creation.
Population health management is critical as healthcare becomes more customer-centric and providers assume financial risk with value-based contracts. With WellSERV, your organization has the necessary tools to improve physician performance, understand population health risks and minimize interventions.