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DiagnosisOne CDS Empowers a Leading Insurer to Address Care Gaps, Reduce Costs and Improve Outcomes for Patients

June 29, 2011

We recently posted a case study to our website that highlights how our smartPath Clinical Decision Support (CDS) and Analytics Platform helped a leading northeast-based health plan and insurer to study the ability of CDS to impact patient care.

With more than three million members and a large group practice with over 500 physicians, the health plan wanted to improve patient health and safety while reducing costs by analyzing lab enriched claims data to identify and alert care providers to patients with significant gaps in care, including those at high risk for cancer.

Our analytics team conducted a two-phase study to prove the efficacy of DiagnosisOne’s clinical decision support solution in improving patient safety and reducing costs. This study covered over 77,000 patients in a period of 18 months and consisted of a retrospective study followed by a prospective study.

We understand that, for health plans and insurers, containing costs while improving the quality of care is a never-ending battle, so we were very pleased with this study’s results.  The study verified that DiagnosisOne’s search engine of clinical algorithms can be effectively and accurately applied to a clinical and claims database to identify cases with quality concerns, including care gaps.

DiagnosisOne alerts were found to be 100-percent accurate, and more than half, 55-percent pointed to quality concerns that were significant enough to require care provider intervention. Based on addressing gaps in care, there was a cost reduction of between $400 and $800 per patient, per year for claims paid. 

To learn more about the phase one and phase two studies and the cancer surveillance results, view a copy of the case study here.

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