REAL-TIME

Data Diagnostics®

AT THE POINT OF CARE

An award-winning platform driving impact across the healthcare ecosystem.

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OVERVIEW

With the healthcare industry transitioning from volume- to value-based care, organizations need transaction-based tools that provide the necessary insights to make better decisions and improve care quality, utilization and financial performance. Inovalon’s solution provides patient-specific analytics with actionable insights that can be ordered on demand, anywhere, anytime, empowered by the following key components:

  • Large Datasets: Inovalon harnesses the power of its proprietary dataset informed by clinical data pertaining to more than 231 million patients and 34 billion medical events.
  • Real-Time Analytics: Inovalon’s industry-leading, cloud-based platform delivers real-time, patient-specific analytics providing actionable insights.
  • Seamless Integration: Inovalon’s modular platform seamlessly integrates with any EHR, provider portal, or other platform to complement and augment existing programs.
  • On-Demand Access: Authorized users, such as physicians, administrators, health services personnel and patients can order diagnostics on demand, as needed.
  • Flexible Interface: Inovalon’s platform provides a flexible integration channel to provide a multitude of end points. Structured data streams, such as HL7 and CCD, that can be adapted to the unique needs of organizations.

Benefits

  • Improved Clinical & Quality Outcomes: Achieve higher quality, leading to increased incentive benefits (e.g., the achievement of 4-Stars within Medicare Advantage results in up to $600 PMPY1 in financial benefit).
  • Better Financial Performance: Achieve improved financial performance through accurate documentation and improved risk score accuracy, providing up to $2,300 per closed HCC2 gap.

 

  • Increased Utilization Efficiencies: Prevent unnecessary/duplicative medical services, avoiding emergent care and reducing costs.
  • Improved Care Quality: Enable better care continuity, improved health outcomes and increased patient satisfaction.

 

How It Works

In today’s value-based healthcare landscape, providers and healthcare organizations require business intelligence and reporting visualization tools that enable data to be viewed, assembled and analyzed efficiently and expediently. Data Diagnostics® provides real-time analytics delivering actionable insight to drive improved quality of care, better risk score accuracy and informed decision-making.

Insights include:

  • Medical History
  • Member/Patient Demographics
  • Disease Progression & Comorbidity
  • Quality Measure Compliance & Eligibility
  • Inpatient & ER Records

 

  • Encounter & Procedural
  • Prescription
  • Imaging Insights, Laboratory & Pathology
  • Activities of Daily Living (ADL)
  • Cost

Inovalon’s analytics seamlessly integrate with any platform or system to provide patient-specific insights at the point of care in real time.

Inovalon also collaborates with Quest Diagnostics, MDLIVE, and many EHR vendors, to bring Data Diagnostics® to the point of care through additional distribution channels.

Quality-Related

Quality-Related

Quality-Related Data Diagnostics® allows clinicians to gain on-demand insight into patient's historical, current, or predicted clinical and quality status under models such as NCQA HEDIS®, Medicare Advantage 5-Star Quality bonus programs, managed Medicaid quality incentive programs such as New York's QARR program, the Affordable Care Act's commercial Quality Reporting System (QRS), and Accountable Care Organization (ACO) quality performance hurdles for shared savings, and a multitude of other quality performance programs that now are used to measure quality and dictate billions of dollars of annual incentive bonuses. The results of quality-related Data Diagnostics® informs clinicians on precise quality measure status and provides insight to facilitate improvements to quality measurements for the patient.

Historical Data-Related

Historical Data-Related

Historical Data-Related Data Diagnostics® allows clinicians to gain on-demand insight into historical disease progression, laboratory results, medication adherence, cardiac tests, vaccination histories, surgical procedures, and other factors, which can materially aid in the clinician's evaluation of the acutely ill and previously unknown patient, new patient intakes, specialty consultations, and other valuable patient assessments. The results of Historical Data-Related Data Diagnostics® can save significant amounts of encounter time, improve the targeted nature of exams, save lives when patients are unable to provide data accurately or are previously unknown to a physician or emergency department, and save costs by avoiding unnecessary duplicative evaluations or tests.

Risk Score-Related

Risk Score-Related

Risk Score-Related Data Diagnostics® allows clinicians to gain on-demand insight into historical risk score status, progression, diagnosis contributors and predicted future progression across all major risk score models, including Medicare Advantage, state-specific managed Medicaid, commercial Affordable Care Act, and Accountable Care Organization (ACO) models. The results of Risk Score-Related Data Diagnostics® provides insight to support the achievement of patient risk score accuracy, supporting accurate disease burden documentation of unaddressed or worsening conditions, and appropriate reimbursement accuracy.

Inovalon/Quest Relationship

Data Diagnostics® is transformative, bringing the benefits of big data, and real time speeds to the point of care - delivering valuable insights precisely when and where clinicians need them. Leveraging two of the world's largest datasets of clinical, claims, quality and laboratory data, including Quest's 20 billion clinical laboratory test results and Inovalon's clinical datasets of more than 231 million patients, with Inovalon's advanced analytical breadth and speed, Data Diagnostics® is seamlessly integrated within Quest's more than 200,000 Quest Care360® installations and more than 400 electronic health record (EHR) platforms, serving half of the physicians and hospitals in the United States. This solution enables clinicians to order and access high-value analytical reports within their existing clinical workflow, receiving results in seconds, a functionality that is integral to bringing the power of big data to the point of care in real time.

Waste Avoidance-Related

Waste Avoidance-Related

Waste Avoidance-Related Data Diagnostics® allows clinicians to gain on-demand insight into factors impacting care costs, such as medication prescription formulary alternatives, back imaging, head imaging, and acute care utilization. The results of Waste Avoidance-Related Data Diagnostics® provides insight into the how unnecessary duplication of tests can be avoided, less expensive formulary alternatives can be identified, and high-cost patient behaviors can be addressed.

Eligibility-Related

Eligibility-Related

Eligibility-Related Data Diagnostics® allows clinicians to gain on-demand insight into patient eligibility for payment and/or support programs related to care, support, rehabilitation and more. The results of Eligibility-Related Data Diagnostics® provides insight for clinicians, administrators and patients to determine payer eligibility (e.g. Medicaid eligibility status), state-specific program eligibility (e.g. NY DSRIP), and patient-specific support eligibility (e.g. a local Diabetes Support Program or Cystic Fibrosis Home Care Nurse Support Program).

Custom Data Diagnostics

Custom Data Diagnostics

Healthcare organizations participating with the Data Diagnostics® platform can request custom analytics to be developed for clinicians to order on demand; receiving responses back in real time directly within their existing clinical workflow. Examples would include analysis to provide insight into custom formulary optimization, custom quality and care measures, custom state-specific or organization-specific pay-for-performance (P4P) measurements, custom pre-approval or screening criteria, custom patient eligibility indicators for specific support programs such as diabetes support or asthma support programs, and many other examples.

Inovalon/MDLIVE Relationship