The Truven Health Blog

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By Truven Staff

What Data Is Needed to Run an At-Risk Organization?

Larry Yuhasz imageThe recent article, “Seven Changes the Affordable Care Act will Likely Encourage in the Medical System,” discusses several new approaches to healthcare that rely on effective management of new data sources and data streams. The ripple effects of the Affordable Care Act will take on many dimensions, ranging from the operational work flow of a health network, to the revenue cycle of those entities going at risk, to the relationship between patients and providers, to the way providers prioritize and spend their time with patients. Given this level of dramatic change, Truven Health Analytics is developing development partnerships with select customers to focus on the required flow of information that will be needed to run at at-risk organization, and the types of analytics and decision support various roles throughout a health network will need to have.

At the center of these activities is the fundamental requirement to establish a single patient record that accumulates knowledge of the patient through each and every encounter. Furthermore, the data collected needs to be organized and acted upon given specific temporal requirements. There is data used for an initial encounter, data for diagnosing, data for monitoring treatment effectiveness, and data for determining overall quality and effectiveness over time. Each requirement has specific conditions, and potentially, limitations, based upon how robust the single patient record is or is not. For example, encounters with new patients where no background information exists will be treated differently than encounters where there is a rich patient history of information. Likewise, encounters with healthy patients may provide the opportunity to collect new data insights into behavioral measures that can be used to keep them healthy, whereas patients with chronic conditions will likely require insights collected related to improving compliance to care guidelines.

In many respects, we may see a future where each encounter has both a patient care and an information care component with it. In fact, patient care and the required work flow is intimately connected to the information gleaned from diagnosis and the eligibility and payment and risk requirements the encounter triggers.

Larry Yuhasz
Director for Strategy and Business Development
3568

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