Putting Medical Data on Autopilot

When driving a car, we use data to direct our decisions. We need to know how fast we are going, how much gas we have in the tank, and whether the engine is operating properly. We get this information from the dashboard located above the steering wheel, so the driver can quickly check it at a glance while focusing on navigating the road.  

The vast amount of information the Internet generates has led to a data revolution over the last decade. This data is often summarized in dashboards similar to those we use when we are driving. Business dashboards, for example, enable executives to quickly look at Key Performance Indicators (KPIs) to get a snapshot of how their business is performing at any given time. Being able to quickly review KPIs is a very effective way for CEOs to measure the success of their businesses. It is even better when this reporting can be automatically generated in real time, enabling an executive to get a real time analysis of their company at any given moment in time.  

The Affordable Care Act seeks to change the way medical treatment is provided, by increasing the quality, availability, and affordability of private and public health insurance to over 44 million uninsured Americans. The law also aims to curb growth in healthcare spending in the United States.

Currently, doctors are paid by volume of treatments provided. The Affordable Care Act, strengthened by the “Doc Fix Bill” of 2015 has transformed the old volume payment system into one that rewards doctors for the quality of their care. A new Merit Based Incentive Payment System (MIPS) has now replaced the Medicare SGR reimbursement formula. Starting in 2017 Doctors will be given a grade from 0 to 100, which will determine the amount of their Medicare reimbursement. Doctors scoring below a 50 will be penalized for providing poor service, while doctors above the 50-point threshold will be rewarded for providing high quality service. 

In the medical world, KPIs are referred to as “measures.” Organizations develop and market these measures, most prominent of which are the NCQA HEDIS measures, which are currently used as the standard for measuring the performance of health insurance plans. The Center for Medicare and Medicaid Services is now looking to develop and implement Patient Centered Measures, which they will use to implement the MIPS program. Exactly how they will do this remains a challenge. 

The new focus is on clinical data and utilizing patient-recorded outcomes measuring devices (PROMS).  Unfortunately clinical data are not structured for analysis and PROMS such as iPhones and other digital devices cannot be relied upon for secure mass collection of such critical and complex data. This is where our Vector Mapping comes into play. Claims data are captured during the workflow, and with the new ICD-10 changes, this claims information intrinsically contains rich data, however these data are nominal and not easily manipulated for analysis. 

Our Vector Mapping will enable MIPS measures to be calculated in real time. This provides doctors with a dashboard to monitor their practice performance. The measures can be analyzed for individual patients, and reporting can be structured to enable doctors to focus on their sickest patients. Our vector mapping will bring the data revolution to the medical world, allowing physicians to generate patient centric dashboards that help them to properly steer their practices in the right direction, and most importantly provide quality care to their patients.