Strong Technology Platform Key to Successful Outcomes

Health Enhancement Newsletter
February 2005

Now that more employers are turning to disease management as a solution to healthcare costs, the process for measuring credible outcomes has fallen under the ever-widening spotlight of public scrutiny.

Suddenly, articles in major national newspapers and magazines are discussing the issue, whether the topic is highlighting cost savings attained by companies that have already implemented programs, addressing how the best outcomes are achieved or discussing whether disease management outcomes can be trusted at all.

During a recent media conference call announcing Matria’s outlook for 2005, CEO Pete Petit predicted that 2005 will become “the year of disease management informatics” for the industry.
“By that,” Petit explained, “I simply mean there will be more emphasis on outcomes, the key information that’s being produced through these programs, and there will be more emphasis on peer-reviewed scientific publications of these outcomes, and review by credible independent sources.”

Petit stressed that disease management is a massive data management process. “It’s huge. It’s massive, and I don’t know that everyone has fully comprehended just how massive an issue it is,” he said.

Strong Informatics Team Essential

Informatics is the scientific process of measuring healthcare interventions. Matria's Informatics Department measures medical costs, pharmacy costs, length of hospital stays, use of emergency room facilities and numerous physiologic and psychosocial parameters that serve as markers of clinical status, quality of life and functional status and recidivism.

Dr. Marty Olson, Corporate Vice President of Informatics at Matria, says that without a state-of-the-art integrated information infrastructure, it would be very difficult to build a comprehensive patient data management system an absolute necessity for achieving maximum health outcomes that result in optimal financial outcomes.

Whether a disease management program produces valid, measurable results depends upon whether the program has a strong data warehouse and information system capable of storing the most accurate and up-to-date clinical information, according to Olson. An integrated database produces the best health outcomes and cost savings and then uses outcomes data to improve or modify disease management operations, procedures and care plans, he explains.

“Matria’s technology and informatics departments have been laying that foundation since we started our disease management program,” Olson says, referring to Matria’s TRAXTM technology platform. TRAX drives the disease management process by gathering the data from multiple sources, analyzing the data and using the information to adjust and enhance care plans and the overall program, thus facilitating continual improvements and better outcomes.

Matria’s TRAX system integrates information from claims data, pharmacy prescriptions, lab results, emergency room visits and hospitalization information. Clinicians access a patient profile containing this information as they interact with patients, allowing them to provide more informed medical counseling and guidance.

Instant access to all relevant, timely and recent medical information allows Matria’s healthcare professionals to make informed decisions regarding an individual’s healthcare needs, from an analysis of claims, lab and prescription data to identification of risk levels to the calculation of quantifiable, measurable outcomes by the informatics team. They calculate the following four levels of performance indicators or outcomes from data gathered during the disease management process:

• Operational Performance Indicators measure operations of the disease management program, such has how long it takes for a nurse to answer and patient abandonment rates.
• Clinical Performance Indicators measure how well Matria is managing patients to comply with national clinical standards for their specific diseases, such as blood glucose testing for people with diabetes and use of rescue inhalers for people with asthma.
• Utilization Performance Indicators measure frequency of utilization of healthcare services, such as hospitalizations and emergency room visits, which is an indicator of the cost savings.
• Financial Performance Indicators show cost savings from the program.
  

Matria Committed To Technology

Also integral to the disease management program is the company’s Enterprise Data Warehouse, which stores all of the data gathered from multiple sources, including claims and pharmacy information, lab results, emergency room visits and hospitalizations. TRAX pulls the data from the CDS Warehouse to build a comprehensive record of the patient case, which allows Matria’s clinicians to access and analyze all of a patient’s clinical data when working with a patient.

During the media conference, Petit said that Matria is continuing to invest in strategic planning, mentioning the recent addition of Richard Hassett, M.D., to Matria’s top leadership. Hassett, who has been involved with disease management since its formative years, will work closely with Olson to study how to use information from the outcomes measurement process to continue improving the company and overall healthcare processes. And Olson’s Informatics Department recently relocated to a much larger section of Matria’s headquarters to make room for major staff additions to the informatics and technology departments.

“Medical informatics has become a crucial ingredient for producing disease management outcomes because it is essentially the application of the scientific method to the evaluation of healthcare interventions and outcomes,” Olson says. “Informatics is necessary to measure interventions, develop methods and principles which allow such interventions to be designed and evaluate the impact of these interventions on individuals and disease populations. But we also use our findings to improve our existing interventions.

“Our TRAX system is both a collection and a delivery piece,” Olson continues. “When we apply that information to the business, it becomes knowledge. That knowledge allows us to make improvements to the business, which then creates more data, and then the cycle starts all over again. It collects data and uses and generates new data from the old data, which answers questions that then become information.

“All of this is driven by technology and human capital. There is no way we could achieve our outcomes without our advanced technology, which we have been developing and modifying for years. When it comes to data management, we have to keep up with new developments or we fall behind. That is why Matria is so willing to continue investing heavily in our technology system, so that we can always provide the most reliable, credible outcomes for our clients.”