How decision support can help derive value from wellness exams

Application enables insertion of findings into EHRs and otherwise supports needed tests, says David Conejo.


Wellness exams, typically an increasingly common annual event for most patients, can be automated to expedite the process and make the resulting findings more useful.

That’s the experience of a small New Mexico health system, which is moving to an automated system to get more value out of the health-preserving initiative.

In most wellness exams, a physician goes through a checklist that includes an eye exam, family history, vaccinations, smoking status, body mass index and any history of depression or diabetes, among other checkpoints. Often, the checklist is manual but increasingly it is done electronically, with the updated checklist moving information to the electronic health record, where it is more likely to be acted upon.

Rehobath McKinley Christian Healthcare Services in Gallup, N.M., recently went live with the ProVizion AWV decision support software of Zoeticx that captures data and then assesses the data to find insights that the physician should be aware of but may not be. Rehobath McKinley includes a 60-bed inpatient substance abuse hospital and a 70-bed acute care hospital, along with three clinics.

For example, a patient may have diabetes, and that could suggest that heart disease also could be an issue and should be checked. Or data could indicate that an obese patient may be at risk to develop asthma.



Such data checks improve patient health and outcomes while also improving RMCHS’ bottom line, says David Conejo, CEO. The organization’s EHR vendor collects a handful of data types that can be used to assess care, but ProVizion gives the physician a complete list of insurance and age-recommended care appropriate for the patient, such as an eye exam, artery checks and extremity exams to make sure the lower body has good circulation. “Instead of ordering three tests, we may order eight,” Conejo adds.

Also See: Industry group issues its clinical decision support guidelines

Zoeticx also gives the hospital lists of uninsured patients eligible for insurance so the patients can be targeted, enrolled and treated, says Thanh Tran, CEO at Zoeticx. The company further supplies lists of patients eligible for an annual visit and has data that can give information on the potential of a patient to contract a specific disease, such as tuberculosis.

“If a patient has diabetes they might also have heart disease and that we can check for—there’s hundreds of variables that can be checked,” Conejo says. “ProVision uploads all insurance-recommended treatments for patients of a certain age, which insurers like because they are paying for wellness checks rather than dialysis. We make money because we’re now capturing all approved revenue from Medicare, Medicaid and private insurers.”

In addition to launching the ProVizion software, Rehobath McKinley Christian Healthcare Services also is embarking on another major health information technology initiative.

The organization is retrofitting a bus and going on the road to better serve residents living on a reservation who currently face a 160-mile round trip just to get an X-ray or lab work done. The bus will have X-ray and ultrasound equipment along with a lab, as well as a telemedicine system to enable hospital-based physicians to remotely assist clinicians in the bus when necessary.

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