Commentary: As the health care industry makes progress in the shift from volume to value, technology solutions that promote clinical excellence, improve patient satisfaction and reduce costs are more in demand than ever. Solutions that support these goals hold tremendous value not just for health plans and providers, but also for employers, who can especially gain from the use of advanced clinical decision-support (CDS) tools.
Early CDS tools focused on high-risk patients, assisting physicians in considering complex information and guidelines in deciding the best course of treatment for diseases such as diabetes and heart disease. CDS solutions today support high-value care across the health spectrum and monitor an individuals health status over time. As a result, no matter where employees are on the spectrum of health generally healthy, early at-risk or high-risk advanced CDS tools can enable employers to offer personalized wellness and health improvement interventions.
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Advanced CDS tools create a 360-degree view of the patient that extends beyond the walls of any single practice, aggregating data from claims, lab results, pharmacy records, electronic health records and more. Patient information is matched with evidence-based literature in CDS libraries, which are continuously updated by teams of clinical experts and weighted with sophisticated algorithms. Automated analysis provides real-time updates to the patients care plan to supply caregivers and patients with targeted decision-support for care.
By delivering unprecedented guidance regarding an individuals health, analyzed according to the most up-to-date, evidence-based practices, advanced CDS tools enable improvements across the entire population. Employees in good health can receive continuous monitoring and alerts that promote ongoing wellness and decrease risk factors for chronic disease, such as timely reminders regarding routine screenings and exams for preventive measures and healthy living. When these employees are prescribed medications, a CDS tool can promote adherence as well as guarding against adverse interactions with other medications that have been prescribed.
These tools can also be used to improve care delivery among employees with chronic conditions. For individuals with heart disease, for example, advanced CDS tools can help identify whether the most effective medication is being used, call attention to other conditions or medications that may affect health, monitor key biometric targets such as weight and blood pressure and identify personalized care plans to drive health improvement.
Also see: 10 health care trends to watch in 2015
When employees are more severely ill, advanced CDS tools can provide additional benefits, empowering case managers as well as care providers with highly informed support for value-based approaches. This can include making sure that patients are receiving evidenced-based care to avoid patient complications, along with measures that can reduce hospital visits while also focusing on behavior change to improve overall health.
Employees benefit from the fact that advanced CDS tools break health information free from the silos that have traditionally contained it, while also creating personalized care plans that are linked to dynamic coaching and self-service tools. Powered by analytics that cover the patients longitudinal record, care and maintenance are continuously informed by all aspects of health: medications prescribed and refilled, care delivered by multiple providers and the labs ordered by each, notifications around hospital stays and more.
As the primary providers of the nations health coverage, employers are uniquely positioned to put advanced CDS tools to use in programs that promote clinical excellence for a healthier employee base, improve employee satisfaction regarding health benefits, and reduce costs for the ultimate benefit of employers who shoulder the bulk of health care expenses.
Madhavi Vemireddy is the chief medical officer and head of product management for ActiveHealth Management, a vendor of population health management tools.
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