Informatics

The Informatics Committee is charged with developing and implementing the effective and efficient healthcare informatics to support the mission of the RDN. The informatics strategy will focus on structure and processes. The strategy will include the customers, financial, clinical, and operational functions of the organization. The committee's role is to challenge traditional methods of communication and analysis thtat promote innovation. Informatics is premised upon privacy, security and confidentiality.

In addition to the continued development of outcome measures, the informatics committee is currently creating a business and strategic plan for informatics development that will allow information to reach our members and customers in the most expedient manner. A web site is being developed that will ultimately allow physicians to access their own data.

The WMRDN has focused much attention and resources to the development of their infrastructure. Two major endeavors that have been undertaken are the development of an Oracle data warehouse and the partnership with Integrail, a physician profiling software vendor.

The partnership with Integrail began in 2001 and the RDN has worked with Intrgrail to develop corporate goals, which include medical management, quality improvement, and the development of quality guidelines. Thsi tool was purchased as an add-on to the warehouse and includes episode groupings or ETGs and diagnosis based risk adjustment groupings or DCGs.

The Magellan Risk Tracker module will allow for profiling to be done on providers, patients, and employer groups, specifically for the examination of and risk adjustment for patient populations using DCGs. It will allow the PHO and RDN to analyze the current costs associated with our patient mix and use regression analysis to predict future expenses.

The Magellan Episode Pathfinder will use the ETG methodology to compare provider practice patters which will allow for the assessment of the use of clinical guidelines, review the impact of pharmacy utilization on total episode of care, and has the ability to drill down to individual performance on procedure or drug level.

In addition to the Integrail partnership, the RDN has purchased and developed an Oracle database through which specific clinical and finacial reporting can be conducted.

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