Cerner Corp. has integrated the Patient-focused Episodes Software of 3M into its HealtheIntent population health management platform to give providers tools to better manage entire episodes of care that patients receive from inpatient and ambulatory facilities.
Cerner bought the 3M software to further enhance its support for helping clients succeed with value-based care, accountable care organizations and the overall push by insurers toward accountability for value, says Bharat Sutariya, vice president and chief medical officer at Cerner. Insurers, he adds, increasingly are comparing treatments at an episode level.
3M’s software includes more than 500 different types of episodes of care with the goal of helping providers better understand the cost and quality of care, including outcomes.
There are two types of episodes, according to 3M. An event-based episode includes all services within a user-defined time window surrounding a trigger event, such as a hospitalization, significant outpatient procedure or outpatient medical visits. A cohort episode includes services provided to patients who share a common condition, disease or characteristic within a user-defined period, such as a pregnancy.
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3M algorithms and software integrated into HealtheIntent deliver pertinent data on a patient’s status, or the status of a panel of patients, to a doctor through the electronic health record workflow, Sutariya says.
This data, normalized to account for factors such as patient acuity, multiple conditions and chronic disease, helps a physician or administrator assess variances in care, costs, resource use, outcomes, and overall quality, enabling apples-to-apples comparison of physician performance. The software defines an episode of care based on encounters and claims associated with a patient during a specified period, but data from other sources, such as medical devices, also can be analyzed.
Cerner wants physicians to proactively know how they are performing regularly, not find out later how they performed with a patient panel a year ago, with data on that performance just coming out now from Medicare or other payers, Sutariya adds.
Consequently, the software gives answers to two critical questions: What is your performance overall? What is the reduction of cost, and improvement in quality and outcomes?
“In order to reduce costs, you need to know where the variances are,” Sutariya says.
Further, the software gives intelligence to providers to have a discussion with payers when they question performance, he notes. “From the individual clinician to groups, to health systems and ACOs, they all need an increasingly smarter methodology to compare performance.”
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