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Intelligent Physicians Association (IPA)

A Clinical Integration Solution Designed Specifically for IPAs, MCOs and MSOs by experts from these organizations

Introduction

The objectives for the Pay for Performance (P4P) incentives and incentives developed by health plans are focused on driving the cost of providing care down and to keep the quality of care at the highest level possible. Reducing the number of brand drugs prescribed, patient's health maintenance for patients with chronic diseases (COPD, HBP, Diabetics, etc.), hospital days, emergency room visits and the patient satisfaction levels are a few of the indicators being measured today.

SuiteMed's Clinical Integration Solution creates a tool to allow IPAs, MCOs, and Medical Groups to access data from disparate systems and transforms it to useful information. SuiteMed combines:

  • Laboratory Results
  • Pharmacy Scripts
  • Claims Data
  • Radiology

Information about the Patients, Providers, and practice patterns can be compiled and drilled down to identify ways to take the corrective actions to meet the goals of the organization.

Examples of queries:

Identify the top 50 Brand Prescriptions that have an equivalent generic or therapeutic equivalent drug.

  • Identify the top script writers
  • Identify patients taking the medication

Identify patients with chronic conditions:

  • Identify if the prescription has not been filled for a period of time

Identify patients that are passed due for their annual procedures such as PAPs, PSA, mammograms etc.

In each of the examples above, SuiteMed can generate a "communications link" to request the patients or providers to take a recommended course of action.

Communications Link include: Automated Telephone Messaging Services, outbound call services by SuiteMed HIPAA certified employees, E-Mail, and Text Messaging services.

Brand versus generic prescription incentives:

  • Addresses the "points of failure" during the workflow process
  • Creates a knowledge database and reports.
  • Delivers proprietary software (GenRXTM) to assist in generic prescription generation at the POS.
  • Provides a Messaging Service to proactively contact the RX eligibility service organization.
  • Delivers a Messaging Service for patients, describing the benefits of the program.
  • Provides a Healthcare Portal to increase the communications between: Patients – Providers - Pharmacies.

SuiteMed's Intelligent Medical Software (IMS), Version 2007, Release 1/1/07, has received CCHIT Product Certification.

Quality Indicators (Incentives relative to preventative medicine and health maintenance)

  • Tracks and helps increase adolescent immunization.
  • Includes reminders for screening procedures (PAP, PSA, Breast exams, etc.)
  • Provides Care Plans for multiple diseases, eg:
    • Asthma
    • Diabetes
    • HBP
    • Cardiovascular Conditions
  • Mental Health Follow-up

Patient satisfaction surveys conducted via:

  • Healthcare Portal
  • Kiosk
  • Paper-based
  • Telephony Technology
  • Integration of Information
  • Parsing of data for the IPA patients
  • Eligibility
  • Real-time update to the IPA knowledge base
  • Sharing of pertinent patient information between practices
  • Secured, uniformed data; no user intervention

SuiteMed's Intelligent Physicians Association (IPA) is designed to meet the unique requirements of the IPAs and MCOs and can be delivered on a pay for performance schedule. Please call us for more information about Intelligent Physicians Association and other SuiteMed products.

SuiteMed's Suite of Intelligent Products

  • Intelligent Pharmacy Software (IPS)
  • Intelligent Medical Software (IMS)
  • Intelligent Facility Software (IFS)
  • Intelligent Dental Software (IDS)
  • Intelligent Radiology Management Software (IRMS)
  • Intelligent Physicians Association (IPA)