The information you need, when you need it, to support your healthcare decisions

Transcription

1 The information you need, when you need it, to support your healthcare decisions

2 2 Quest Diagnostics extensive patient interaction uniquely affords us the opportunity to gather large-scale health data and extract meaningful insights 1/3 50% Quest Diagnostics provides laboratory testing and reporting for 1 in 3 Americans each year with a testing menu of over 3,500 tests for a broad range of conditions. By serving approximately half of all physicians in the U.S., who treat more than 150 million patients, Quest has amassed the largest clinical laboratory data repository available. Leveraging this rich collection of data, we offer you a suite of data analytics solutions designed to deliver important insights and illuminate answers to better guide your decisions towards more efficient test utilization and population health management. Data Diagnostics

3 3 Why test utilization management? The Lab Utilization Insights solution Healthcare stakeholders understand the critical need for data analytics to guide appropriate testing decisions. Why test utilization management? The Lab Utilization Insights solution Data Diagnostics

4 4 Appropriate test utilization is a growing challenge... Why test utilization management? The Lab Utilization Insights solution 1/3 Laboratory testing is healthcare s single-highest volume activity. One-third of tests performed each year in the U.S. 1 are unnecessary, while roughly the same number of needed tests are not being ordered 2. As a result, the average hospital loses $1.7 million annually to unnecessary testing, 3 and much more when inadequate testing leads to conditions requiring costly imaging, surgeries, and hospital stays....providing an opportunity for improvement. Do the right test... on the right patient...at the right time With laboratory tests guiding more than 70% of all medical decisions, improvements in appropriate test selection in compliance with evidence-based guidelines have the power to radically improve patient outcomes and reduce healthcare costs. 1 A COLA White Paper: Federal Government Questions Quality in Waived Testing. The Hard Facts and What Can Laboratories Do Now? 2 Ming Zhi, Eric L, et. al. The Landscape of Inappropriate Laboratory Testing: A 15-Year Meta-Analysis. PLOS One. November Institute of Medicine Report. Best Care at Lower Cost: The Path to Continuously Learning Healthcare in America. September Data Diagnostics

5 5 Why test utilization management? The Lab Utilization Insights solution Lab Utilization Insights Performance insights in action Quest data analytics solutions are designed to provide the insight you need, when you need it, in a way that delivers actionable information. Tools that are easy to use and informative, backed by Quest s deep medical expertise, can illuminate trends, identify areas of high performance or in need of change, and ultimately support your organization in its aim for continuous quality improvement. Utilization Details and Utilization Spend reports Spectrum Analysis Data Diagnostics

6 6 Why test utilization management? The Lab Utilization Insights solution Utilization Details and Utilization Spend reports Spectrum Analysis Utilization Details & Spend Access on-demand utilization reports With Utilization Details and Utilization Spend reports, you have anytime access to self-service, customizable reports to analyze utilization patterns and costs. As a webbased portal, Lab Utilization Insights makes it fast and easy to identify improvement opportunities, promote clinically-appropriate test selection, and track ongoing metrics to monitor progress for more uniform and cost-efficient care. Note: Report customization allows date range changes and addition of CPT Codes and Billing Amounts Ability to export to PDF or Excel Click image for larger view Utilization Details Tab Utilization Spend Tab Test count by specified time period available Total utilization spend per test and average spend per test available Rolling 12-month summary of test performed available Bill code included

7 7 Spectrum Analysis Leverage our medical expertise Why test utilization management? The Lab Utilization Insights solution Utilization Details and Utilization Spend reports With Spectrum Analysis, you can electronically request a medical consultation to review the analysis of your testing patterns and compare against utilization benchmarks by time, gender, age and geographic site. Our expert Medical Directors prepare and present their findings and recommendations to your team and help you set a course of action. Click each image for larger view Spectrum Analysis Utilization is color-coded by the ordering physician Large contiguous color blocks indicate dominant orderers of a particular test Ability to drill down on particular doctors to identify potential test ordering inefficiencies Patients age and sex distribution by test Test results from low to abnormal Key demographic information for who is getting specific tests. View number of abnormal tests to determine the diagnostic yield.

8 8 Why Data Diagnostics? The Data Diagnostics solution Point-of-care data analytics provide real-time decision support Quest Diagnostics and Innovalon have partnered to offer the Cloud-based health analytics platform to cull comprehensive patient healthcare information on demand and at point of care. Data Diagnostics is a suite of hundreds of patient-specific data queries that: Delivers valuable insights precisely when and where clinicians need them Offers instant, on-demand access to real-time patient information Provides seamless in-workflow integration, with more than 400 supported EHR systems Draws from two of the world s largest datasets of clinical, claims, quality and laboratory data for expert decision support Why Data Diagnostics? The Data Diagnostics solution Data Diagnostics

9 9 The benefits of Data Diagnostics Why? The solution The full picture of patient medical history. aggregates patient medical history details to provide a comprehensive picture of the patient s health status. Reduce unnecessary costs and improve financial performance. Real-time insight into patient health data can guide decisions for more efficient and cost-effective care and improve reporting accuracy to maximize reimbursements. Uncover critical insights to improve care quality. Receive point-of-care insights on gaps in quality performance to guide prioritization of activities and improve quality of care. Receive guidance on directing more efficient patient care. Insights reveal previouslyperformed care activities and procedures to avoid unnecessary duplication, while providing guidance on formulary coverage to limit patient costs.

10 10 Insights that drive excellent care coordination Why? The solution Clinicians can select from hundreds of queries that can aid in all aspects of diagnosis, treatment, and utilization management, as well as quality-measure achievement and reporting. Quality Historical Risk-score Waste avoidance Eligibility

11 11 Quality-related Data Diagnostics reports Why? The solution Quality These reports enable clinicians to guide improvements in quality measures with insights into a patient s historical, current, or predicted clinical and quality status, so that clinicians are more informed on how to direct patient care according to targeted benchmarks. Click image for larger view Historical Risk-score Waste avoidance Eligibility Summary of quality-measure standards that are applicable for a specific patient Real-time clinical and quality outcome measures to enable proactive quality improvements

12 12 Historical data-related Data Diagnostics reports Why? The solution Quality A comprehensive medical history, including diagnoses, prescribed medications, laboratory results, and surgical procedures, is needed to take the proper action for patients, but gathering this information is a persistent challenge. The limited integration of EHRs, long query times, and even paper records can slow clinicians down. Gain insight into your patient s health history at the point of care to: Historical Improve efficiency and satisfaction of patient visits and increase overall productivity Risk-score Reduce duplicative evaluations or tests Waste avoidance Click image for larger view Eligibility Comprehensive medical history with insights in key areas Detailed content helps direct appropriate care and reduce unnecessary costs

13 13 Risk-score-related Data Diagnostics reports Why? The solution Quality Physicians within your network can view a patient s health data through all major risk-score models in order to improve risk-score modeling, disease burden documentation and reimbursement accuracy. Click image for larger view Historical Risk-score Waste avoidance Eligibility Relevant risk-score model (e.g., HCC, CRG, CDPS, etc.) for a specific patient Clinicians gain a more accurate understanding of historical, current, and predictive disease burden and risk scores for a specific patient

14 14 Waste avoidance-related Data Diagnostics reports Why? The solution Improper tests and procedures and non-formulary medications are unlikely to be reimbursed by your patient s health plan although it is difficult to know that at the time of ordering. Provide clinicians with insight into key factors impacting care costs: Quality Test duplication Historical Medication formulary alternatives Risk-score Waste avoidance Imaging utilization Eligibility High-cost patient behaviors Hospital admissions Click image for larger view The ability to identify medication formulary alternatives is one way clinicians can recognize unnecessary costs

15 15 Eligibility-related Data Diagnostics reports Why? The solution Quality Apply real-time point-of-care program eligibility insight to accelerate the engagement of patients and ensure enrollment in the right programs, while avoiding duplicative or unnecessary program costs and patient confusion. Click image for larger view Historical Risk-score Waste avoidance Eligibility Care-management resources available for a patient, including federal, state, and healthcare organization-specific programs

16 16 Why population health management? The Population Lab Insights Keeping patients healthy requires enhancing your capacity to assess patient needs and proactively engage individuals in adherence to care plans. Today, successful health systems monitor the health status of their patient populations, identify gaps in care, and ensure uniform treatment. Why population health management? The Population Lab Insights Data Diagnostics

17 17 Improve population health Why population health management? The Population Lab Insights With the passage of the Affordable Care Act (ACA) and the subsequent move toward value-based payment arrangements, it is a financial imperative to better understand the health status of the patient populations you serve. Laboratory testing provides pivotal information pertaining to medication adherence, renal function, cardiac output and other key indicators of health among patients with pervasive chronic conditions. Carefully collected, interpreted and reported results offer insight into the health status of your patient population and your current practice patterns, so you can identify gaps in test utilization and ensure uniform treatment guided by evidence-based practice.

18 18 Why population health management? The Population Lab Insights Population Lab Insights Quest s Population Lab Insights is modular, providing disease- or conditionspecific guidance for common laboratory test-intensive medical conditions. Quest can help you understand your patient s clinical risk profile and set population health goals. Then, to stay the course, track laboratory outcomes and identify patients whose care plan deviates from laboratory best practices. Track your performance Know your population Identify gaps in care Track laboratory outcomes Data Diagnostics

19 19 Track your performance Why population health management? The Population Lab Insights Measure your compliance with evidence-based guidelines and benchmark your practice or system against your peers in the extensive national Quest Diagnostics database using our clinical performance scorecards. Evaluate practice variations across individual doctors, sites, and departments to target specific test ordering behaviors for focused provider education and to reduce the variability in the quality of healthcare services provided. Track your performance Know your population Click image for larger view Track performance trends quarter over quarter to benchmark and identify improvements Identify gaps in care Track laboratory outcomes Target key performance areas tied to quality metrics and reimbursement Performance ranking shows how you stack up individually vs the nation Compare performance vs national average, as well as fellow office physicians

20 20 Know your population Why population health management? The Population Lab Insights Track your performance Proactively apply our lab-based algorithms to identify patients with medical conditions that reflect high clinical risk. Use this information to refine or pre-populate your disease registries to optimize the care you are providing. Click image for larger view Know your population Lab-based algorithms identify patients with medical conditions that reflect high clinical risk (e.g., denominator populations) Identify gaps in care Track laboratory outcomes Use this list to prioritize at-risk patients and ensure that care efforts are directed at those in greatest need

21 21 Identify gaps in care Why population health management? The Population Lab Insights Track your performance Employ the Quest analytics engine to mine your current utilization data for timely identification of specific medical services required per evidence-based guidelines. Proactively generate a schedule of when patients should have their next health service performed to avoid gaps in care before your bottom line is impacted. Click image for larger view Know your population Identify gaps in care Highlighted areas alert you to overdue tests and potential problems Track laboratory outcomes Create a list of patients to contact to ensure timeliness of critical tests and improvements in preventative care

22 22 Track laboratory outcomes Why population health management? The Population Lab Insights Track your performance Know your population Tracking laboratory outcomes at a population level allows you to measure the success of your efforts to optimize test utilization and impact your patients clinical risk. Note: Given the timeliness of lab data, these reports allow for real-time management of target populations (vs claims data), empowering organizations to better manage population health. Click image for larger view Identify gaps in care Performance criteria are established by the American Diabetes Association, per evidenced-based guidelines Track laboratory outcomes Track laboratory outcomes, including changes in the clinical risk profile measured by distributions of laboratory test results

23 23 At Quest Diagnostics, we work every day to provide insight that can empower you to make confident decisions for the health of your patients and your business Leverage our data resources to inspire accountable, sustainable, and effective test utilization and population health management. Get the answers with less effort. With powerful automation and customization capabilities, you save time navigating to and interpreting the information you need for critical decision-making. Access expert enhanced analytics. Utilizing the industry s largest clinical data repository of laboratory test results, our expansive test menu, and deep clinical and informatics expertise, Quest is uniquely positioned to deliver much more than just data we provide insight to inspire well-informed action. Allow data to drive better healthcare decisions. Our test utilization and population health management solutions are driven by the valuable data needed to better equip your organization with the knowledge and tools to make more informed healthcare decisions for superior patient outcomes. Data Diagnostics

24 Lead with data-driven strategies. Empower your decision-making with Quest Diagnostics data analytics. Gain visibility into test utilization patterns, population norms, and improvement opportunities. Visit QuestForHealthSystems.com or contact your Quest Diagnostics sales representative today. Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics Quest Diagnostics Incorporated. All right reserved. MI4849 1/2016 Data Diagnostics

25 25 Why test utilization management? The Lab Utilization Insights solution Utilization Details and Utilization Spend reports Spectrum Analysis Data Diagnostics Why Data Diagnostics? Why population health management? The Population Lab Insights Track your performance Know your population Identify gaps in care Track laboratory outcomes The Data Diagnostics solution Quality Historical Risk-score Waste avoidance Eligibility Data Diagnostics