Risk Model Analyzer

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Product Overview

Risk Model Analyzer is aimed at clinical directors and operational directors. The application helps users visualize underlying risk models that calculate risk for a patient at a particular point in time. The risk models currently contained within the application include the Health and Human Services derivation of the HCC model (HHS-HCC), Charlson/Deyo, and APRDRG severity of illness. Risk models can be evaluated from a population or patient standpoint as well as comparatively to determine how high risk patients in one model correlate with high risk patients in another model.

Features

  • 3 ‘Out of the Box’ Risk Models
  • Architectural framework that accommodates implementing additional risk models
  • Drill-down Data Visualization
  • Comparison across multiple risk models
  • Ability to view population risk and patient risk over time

Benefits

Benefits Include:

  • Get a broad overview of risk models
  • Explore average risk scores for specific conditions
  • View population risk over time
  • Become familiar with various risk models
  • Dive deep into population and patient risk
  • View patient risk variables over time
  • View patient coverage within each risk model

Measures

Population

  • Mean score for population by risk model or specific conditions
  • Patient coverage of score components. Ex. What portion of the total risk score is contributed by age or condition
  • Average population risk over time

Risk Models

  • Average score by model for each risk level
  • Average total risk score and patient count for each risk model component
  • Comparative risk scores by risk model

Patients

  • Patient risk over time
  • Historical conditions contributing to a patient risk score
  • Historical log of conditions contributing to a score

See Sample Screenshots of Risk Model Analyzer

Data Sources

  • EMR (required)
  • Professional Billing (Optional)
  • Claims (Optional)

Risk Model Analyzer: A Deeper View

Background

In a healthcare system looking for potential areas of improvement such as lowering cost per case, it is important to have a method for determining cases that could merit a higher cost. The risk models contained within the application assign a risk score for a patient at a particular point in time and categorize that patient into one of five risk levels. These levels can be used as a way to view similar patients grouped within each risk level. The Risk Model Analyzer provides a window to explore the current risk models with the intent that risk can be evaluated in other advanced applications and process improvement initiatives. The underlying framework allows other risk models to be added by associating a score to a patient relative to a point in time. The current risk models are based heavily off of diagnosis codes from the previous encounters for the patient and identify comorbid conditions within the Charlson/Deyo model and Hierarchical Condition Categories in the HHS-HCC model.

What types of problems does Risk Model Analyzer address?

Many organizations need a methodical approach in evaluating patient risk as a means to improve the quality of care for that patient and evaluate risk for a specified population. Populations can be defined in a variety of ways such as a primary care physician’s panel of patients, patient registries, geographical area, or the physical location of a clinic or hospital. Once populations are defined, individual patient risk within the population can be explored. This application will provide a view of risk for a broad population displaying capabilities for future smaller, more targeted outcome improvement projects.

Anticipated Improvements

In many or most cases these will be a focused, shorten version of the benefits above.

Success Measures

Opportunity Identification:

  • Identify risk within the population and specific patients