MDdatacor Care Center software
Donald Skinner, MD, of the McFarland Clinic in Ames, Iowa, uses MDdatacor’s Care Center software to locate clinical patient data and identify opportunities for optimal care. (A new product just released from MDdatacor called MDinsight shares patient information with the patient as well as the physician.)
The software consists of a database that aggregates structured data such as electronic medical records, labs, and immunization registries as well as unstructured data, such as transcribed notes in Word documents, free-form text in EMR progress notes, and any electronic text-based file. The software collects data from PDF files, continuity of care records, in the XML (the eXtensible Markup Language) format, from HL7 feeds, and Excel sheets.
With this data, Skinner identifies patients in disease control situations who need to keep appointments to keep their disease under control: “When you do population management— managing the health care of a large population of patients rather than individuals— it is very difficult to keep track of all these people. There are people you think are coming in who you have not seen for a while, or there are people who have fallen off the map. With the disease registry, if they are in this particular insurance company’s database [Wellmark], we can find them using MDdatacor and take some intervention to try to get them into the office to provide the care they need, both in terms of disease management and preventive care,” says Skinner.
MDdatacor screens the data it collects based on the insurer’s clinical guidelines (NCQA guidelines in this case) to determine whether the patient’s treatment falls outside processes and outcomes for the particular disease.
If a lab test suggests a particular path for treatment, for example, and the patient has not been in for follow up to receive that care, an opportunity for care would surface in a Web based report at the product Web portal. The software also helps to ensure that practitioners do not duplicate the tests and do not compound the costs of care.
Since MDdatacor was introduced to Skinner and the McFarland Clinic (during a Wellmark Blue Cross Blue Shield of Iowa Collaboration on Quality Primary Care Initiative), the physicians have used the product to support childhood immunizations up to age two and patients with asthma, as well as diabetes and hypertension. “We also use it to keep track of our cancer surveillance, the number of patients having pap smears, mammograms, and colon scopes,” Skinner says.
“MDdatacor is really an indispensable part of chronic disease management. I think it would be extremely difficult to [manage] that in a paper environment,” says Skinner.
Goals and objectives
The objective is to bring the quality of care up while bringing costs down. “Our personal experience is that at first your healthcare costs go up,” says Skinner. The hope is that over time, by avoiding major complications, the product will make up for those initial costs.
But, the results are significant. Patients benefit from both process improvements and outcome improvements thanks to MDdatacor. A process improvement for diabetics might be an increase in the number of people who get an A1c for their diabetes. An outcome improvement for people with hypertension might be an increase in the number of people who get their blood pressure under control.
“There is a substantial improvement— probably a 25- to 40- percent improvement—in the number of patients who get their A1c. We are beginning our fourth year of the project [using MDdatacor] and so that data is based on our baseline before starting this project,” says Skinner.
“We have seen improvement in the 15- to 20- percent range in achieving our overall goals for patients,” Skinner adds. Examples of these goals include getting patients to make behavior changes, eat less, exercise more, and eliminate salt in their diets.