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12 July 2022
Blog

Cost & Utilization Explorer: Seeing, Understanding, Acting

eClinicalWorks

ChrisPopHealthSeries7_CostUtilizationExplorer blog

Unlock the power of Medicare claims data at your practice

The most fundamental difference between modern and medieval medicine isn’t found in the fancy equipment, powerful medications, or lifesaving skills of physicians, nurses, and EMTs. All those things help, but the most critical difference is the ability to see.

Centuries ago, physicians could not easily see inside the human body to detect changes caused by disease. They could not detect — or even imagine — the microscopic germs often responsible for illness. Relying largely upon exterior observations, they often missed life-threatening conditions that are today routinely detected and successfully treated.

Modern healthcare has another powerful way of seeing that was completely unknown to our ancestors — the insights that can be gained from data. And it is precisely here that tools such as the Cost & Utilization Explorer module from eClinicalWorks can be such powerful tools for promoting wellness.

Why holistic care includes ‘data vision’

Cost & Utilization Explorer may sound complex, but the idea is simple: By providing easy access to patients’ Medicare claims data, the module empowers providers to fill in information that might be missing from a given patient’s record, omitted from a questionnaire or survey, or forgotten by the patient during their discussion with a doctor or nurse.

With younger, generally healthy patients, the physician’s job is relatively straightforward. It involves a physical examination, a brief discussion, occasional bloodwork, and perhaps a few recommendations for staying fit. Doctors still look carefully for anything that may be amiss, but there is usually very little to see.

But patients 65 and older — most of those eligible for Medicare — tend to have one or more chronic medical conditions. They have much longer and more complex health histories. And many simply do not recall — at least not fully and accurately — every detail of past health encounters.

For such patients, Cost & Utilization Explorer can add a kind of “data vision” to the professional skill and experience the physician possesses.

Improving outcomes and lowering costs

With vision comes understanding, and with understanding there are additional opportunities to improve health outcomes and control costs. Cost & Utilization Explorer can be of value to practices of any size or specialty, providing the insights necessary to meet the challenges of outcome-based and value-based care.

Providers can see their patients’ well-visit histories, which vaccines they have received and when, the date of their last colonoscopy, mammogram, or other screening test, any allergies, and even whether the patient may be at risk for opioid misuse.
With access to this wealth of Medicare claims data, a practice’s quality analysts can analyze patients — individually or as groups — to determine the most common reasons they are seeking care at the emergency room and when and how such visits might be reduced or prevented.

For more information or to schedule a demo, contact pophealthsales@eclinicalworks.com

Next month, our Population Health blog series looks at our solution for Chronic Care Management, a program from the Centers for Medicare & Medicaid Services to help medical providers achieve and maintain the best possible overall health outcomes for their patients with multiple chronic conditions.