Improving quality of care and reducing costs is the most important goal facing healthcare payers and providers today. Considering that a significant portion of the population suffers from chronic conditions, effective disease management has become an important objective for payers. Payers also realize the importance of prevention and have undertaken several wellness management initiatives such as obesity disease management. Whether it is for medical management, disease management, or wellness management, payers need health care management software that is member-centric and enables collaboration between various stakeholders.
One way Healthcare Payers and Care Management Organizations can improve the effectiveness of disease management projects is to leverage insights gained from medical predictive modeling. Medical predictive modeling solutions provide potential clinical outcome indicators for a patient base on his/her profile. For this to be possible, the health care management software should be able to facilitate interoperability among the disparate systems to assemble all relevant patient data including claims, labs, diagnostics, drug data into a single patient health record that can be analyzed over time and in comparison to the population and rules to identify high risk members.
These insights can be used to engage member at the appropriate level i.e enroll member in a wellness management program or a obesity management program if member has indicated an interest in knowing more in those areas. Effective disease management is possible if it is managed as an outcome based management. Outcomes can be clinical outcomes or non-clinical outcomes (e.g clearly identify the member is not interested and therefore do not engage member/send material on weight management), but should be measurable. Adopting best practice disease management is possible only if practices are trackable, measurable and reportable.
ZeOmega's Jiva is a health care management software allows Healthcare Payers and Care Management Organizations in improving the effectiveness of disease management, wellness management and medical management by providing a seamless web-based workflow system that can be used to configure business rules and workflows. Activities, clinical outcomes and other non-clinical measures pertaining to disease management and wellness management initiatives can be tracked at a granular level and is reportable. Further rules can be setup to automate actions based on insights gained from such measurements resulting in improvements.Our health care management software solutions provide collaborative health management capabilities through electronic health records, point of care tools, decision support, care analytics, and configurable workflows for care management.
Our health care management software solutions provide collaborative health management capabilities through electronic health records, point of care tools, decision support, care analytics, and configurable workflows for care management.
Contact ZeOmega to learn more about our utilization management software and medical decision support available through Jiva.