Integrated Quality Care Monitoring System
CareSentry 5x is an integrated real-time quality care monitoring system designed to help identify and monitor patients that are at risk or have been diagnosed for specific conditions based on evaluation of their EMR data against a set of risk profile data points and monitoring criteria entered into CareSentry Manager. CareSentry Probe runs as a small toolbar above the EMR main title bar on the workstation and displays alerts and /or status information to EMR users during the encounter regarding the patient's profile status as the visit progresses.
Patients that may be at risk but not diagnosed with conditions defined in CareSentry are screened during their visit. If they satisfy the risk parameters defined in CareSentry for one or more profiles, an alert is displayed to the provider prompting them to evaluate the patient further. Once a patient is added to a profile watch list, the patient is monitored on subsequent visits to insure that required data in the EMR is documented and scheduled labs or procedures that are due have been ordered. Patients may be associated with multiple profile watch lists in which case they will be monitored on all criteria from all profiles. Additional capabilities include the addition of insurance specific parameters and required documentation based on the visit level insurance. These additional monitored parameters are appended to the profile to insure accurate and complete data collection for Pay-for-Performance (P4P) monitoring. The insurance profile parameter association occurs at the encounter so if the patient's insurance changes, parameters defined for the new carrier are automatically added on their next visit and parameters from their previous carrirer are removed.
CareSentry provides three levels of functionality to help standardize and manage your patient’s care. Identification of patients that are at risk for specific disease profiles or qualify for inclusion in specific care plans, alerting providers during an encounter that specified care guidelines have not been met or scheduled procedure/labs are due and prompting providers to complete required information during an encounter for better documentation and to insure compliance with P4P data collection guidelines. Patients matching inclusion criteria for a profile are added to the profile’s watch list. Parameters for monitoring patients in the watch list can include required field data entry in EMR templates, required scheduled procedures/labs with number and interval for each, target values for lab results so that out-of-range results prompt an alert notifying the provider. Profile inclusion evaluations occur during the encounter so that patients matching the profile are identified while in the clinic. Monitoring of patients already in a profile watch list would usually occur toward the end of the encounter to notify the provider of missing information or out of range lab results. The primary focus of CareSentry is to help the organization maintain a consistent level of care across all">providers. With the advent of pay-for-performance reporting by Medicare and an increasing number of insurance carriers, the data collection monitoring provided by CareSentry will help insure that the required information is collected consistently so that reimbursements are not negatively affected because of missing information.Qualification Criteria:
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Diagnosis codes - inclusion/exclusion criteria, wildcard characters (i.e. 250*) for range checks.
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Medications - inclusion/exclusion lists, easily search and select from the entire medication list.
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EMR template field criteria – Text, date, numeric and decimal values. Range checks for number and date fields and exact and partial matches for text fields. The ability to designate a minimum number of data points for evaluation as well as a maximum timeframe for the values (i.e. 3 BPs within the last 90 days).
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Parameter groups can be defined as inclusion/exclusion and configured to evaluate multiple fields as a single parameter.
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Preliminary database scans which include demographic, diagnosis and medication parameters from a defined profile can be used to identify patients that match that profile for inclusion into the profile watch list.
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No limit on the number of parameters a profile can have
Patient/Encounter Management:
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Profile watch lists can be configured to monitor almost any field in the EMR to insure that the appropriate information is collected during the encounter alerting the provider of incomplete documentation and to insure that the PQRI reporting offered by NextGen remains consistent.
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Scheduled procedures/labs can be set up to alert the provider when a scheduled event is due and require that the event be performed during the encounter.
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Lab results can be monitored so the provider is notified when lab results fall outside of target values.
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Standardization of care across your organization for patients included in profile watch lists so that providers with varying levels of experience for different disease management plans conform to a consistent baseline for documentation and patient evaluation.
If you need additional information or would like to schedule an online demonstration, please contact us via the contact information on the Contacting Simbiote page and we will be in contact with you as soon as possible.
