Mercy Health Select, LLC: The IBM Explorys Platform integrates disparate data sources to help identify at-risk patients
Customer Company Size
Large Corporate
Region
- America
Country
- United States
Product
- IBM Explorys Platform
- IBM Explorys EPM: Measure
Tech Stack
- Data Integration
- Healthcare Analytics
Implementation Scale
- Enterprise-wide Deployment
Impact Metrics
- Customer Satisfaction
- Productivity Improvements
Technology Category
- Analytics & Modeling - Big Data Analytics
- Analytics & Modeling - Predictive Analytics
Applicable Industries
- Healthcare & Hospitals
Applicable Functions
- Quality Assurance
Use Cases
- Predictive Maintenance
Services
- Data Science Services
About The Customer
Based in Cincinnati, Ohio, and serving communities throughout Ohio and Kentucky, Mercy Health operates more than 450 health facilities, including 23 award-winning hospitals. Its services span all aspects of life, from maternity to senior care, and its net operating revenue in 2015 was USD 4.3 billion. Mercy Health Select, LLC, is an expanded network that supplements the organization’s 563 directly employed primary care providers (PCPs) with another 89 affiliated PCPs. In 2016, Mercy Health Select managed the care of nearly 150,000 patients in at-risk contracts.
The Challenge
Mercy Health Select, LLC, an accountable care organization (ACO) for the Medicare Shared Savings Program (MSSP), needed to improve the quality of care it provides by mining disparate data sources and identifying at-risk patients so that clinicians could intervene quickly. As an ACO, Mercy Health Select must demonstrate the ability to increase the quality of care while lowering costs. However, not all of the affiliated primary care providers (PCPs) in the Mercy Health Select network use the same electronic health record (EHR) platform, making it difficult to share information about at-risk patients among facilities. Insurance claims can bridge these gaps in data sharing, but facilities must submit and bill the claims before PCPs receive them— a process that can take as long as three months.
The Solution
Mercy Health Select chose the IBM Explorys Platform from IBM Watson Health to help it in its journey toward value-based patient care. Using the Explorys Platform, Mercy Health Select can quickly gather all the pertinent claims and clinical information about its patients. The IBM Explorys EPM: Measure application then uses analytics to identify and prioritize high-risk, high-cost patients rapidly. The Explorys platform integrates claims and clinical data and then uses sophisticated analytics to identify and prioritize at-risk patients. Employees across the organization can use this information to provide better, more targeted care and improve the overall quality of Mercy Health Select’s services.
Operational Impact
Quantitative Benefit
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