综合诊所：借助 IBM Watson Health 提高医疗保险年度健康访问合规性
公司规模
Large Corporate
地区
- America
国家
- United States
产品
- IBM Watson Health Population Health Management
- IBM Phytel Outreach
- IBM Phytel Remind
- IBM Phytel Insight
- IBM Phytel Coordinate
技术栈
- IBM Watson Health Cloud platform
实施规模
- Enterprise-wide Deployment
影响指标
- Revenue Growth
- Customer Satisfaction
- Employee Satisfaction
- Productivity Improvements
技术
- 分析与建模 - 实时分析
适用行业
- 医疗保健和医院
适用功能
- 商业运营
用例
- 远程病人监护
- 监管合规监控
服务
- 系统集成
- 培训
关于客户
该综合诊所是一家由医生拥有和经营的多专业诊所，在大西雅图地区有 15 家分店。它是华盛顿州第一家 Medicare 共享储蓄计划 (MSSP) 参与者。该综合诊所认识到，为了优化 Medicare 计划下的临床和财务绩效，它需要一种促进遵守 Medicare 年度健康访问要求的方法。该综合诊所向其现有合作伙伴 IBM Watson Health 寻求帮助，以提高这一关键领域的合规性。
挑战
综合诊所是一家多专业诊所，在大西雅图地区拥有 15 个分部，在促进遵守 Medicare 年度健康访问要求方面面临挑战。综合诊所的许多提供者对年度健康访问的资格、协议和福利了解不多，因此无法向患者传达其价值。这导致大量符合条件的患者没有前来参加年度健康访问，而对于那些前来就诊的患者，预约的无接触性质引起了混乱和不满，因为许多人期望更多的是年度体检。该组织面临的另一个挑战是，一些接受年度健康访问的患者患病或身体虚弱，带他们来接受评估并不合适。
解决方案
综合诊所需要直观的工具来帮助自动化和增强符合条件的患者选择、外展和数据分析，以提高效率和参与度，并缩小护理差距。因此，该组织寻求一种解决方案，能够根据年龄和资格快速准确地识别患者，有效地吸引患者让他们参加年度健康访问，并有效利用年度健康访问数据和临床接触来识别护理差距并更好地协调服务交付。在对其流程进行“精益”分析后，综合诊所认识到它可以使用现有的 IBM Watson Health 人口健康管理工具，包括 IBM Phytel Outreach、IBM Phytel Remind、IBM Phytel Insight 和 IBM Phytel Coordinate，来实施几项关键改进。
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