Targeting Chronic Illness Together

Looking for gaps in care sounds good as a concept, but Aspen Advisors’ Dan Coate warns that is easier said than done. “We know a diabetic patient should have an A1c test every three months and it is easy enough to identify a population of diabetics and urge an intervention. But that is probably the easiest, most clear-cut example,” he says. Defining other gaps in care is not so easy. “I would say to health system CIOs you have to be careful with the definitions. I would push back to clinician teams that they must make sure the scenarios are defined in enough detail. You can say you want to look for high-risk members, but high risk of what? High medical costs? Low-quality treatment? Not being treated with evidence-based protocols? Before you send in five business intelligence guys to start drilling into the data, be sure you have your definitions and goals clear.”