SCORE CARDS

• US 20150100336A1
• Filed: 08/07/2014
• Published: 04/09/2015
• Est. Priority Date: 10/08/2012
• Status: Active Grant

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Inventors: FORD, MAUNTELL RENEE, KRIZEK, KEVIN JOHN, O'BRIEN, PATRICK JAMES
• Granted Patent: US 10,621,534 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/06393 Score-carding, benchmarking or key performance indicator [KPI] analysis
• CPC Class Codes: G06Q 10/06395 Quality analysis or management
• CPC Class Codes: G06Q 30/0201 Market modelling; Market analysis; Collecting market data
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Methods, systems, and computer-readable media are provided for building a score plan for a healthcare organization, its providers, its payers, and/or its patients and presenting the results of the score plan on one or more score card user interfaces. Score cards graphically display an entity'"'"'s progress towards meeting quality measure objectives. The score cards provide information on percentage completion of one or more quality measure objectives by the entity and/or quality measure objectives that may be difficult for the entity to achieve.

Claims

1. One or more computer-readable media having computer-executable instructions embodied thereon that, when executed, perform a method of calculating a first opportunity index for a first quality measure having a target parameter, wherein the first opportunity index is useable to identify if the first quality measure offers a particular provider a significant opportunity to improve the provider'"'"'s performance incentive score, the method comprising:

calculating the first opportunity index for the first quality measure based on;

(A) a weight of the first quality measure;

(B) a number of patients in a scoring group for the first quality measure that have not met the first quality measure'"'"'s target parameter;

(C) a measure of the effectiveness of the provider in meeting the first quality measure; and

(D) a ratio of the number of patients in the scoring group for the first quality measure that have not met the first quality measure'"'"'s target parameter to a number of patients in the scoring group that do not have documented results relating to the first quality measure.

2. The media of claim 1 further comprising:

calculating a second opportunity index for a second quality measure; and

ranking the first and second opportunity indexes based on a numerical value of the respective indexes.

3. The media of claim 1, wherein the provider comprises at least one of a clinician, a clinician group, or a healthcare facility.

4. The media of claim 1, wherein the weight of the first quality measure is customized by a healthcare organization for the provider.

5. The media of claim 1, wherein the first quality measure is specified in a contract between the provider and a payer.

6. The media of claim 1, wherein the first quality measure comprises at least one of the following:

keeping readmission rates below a certain level, keeping costs of care low, or meeting standards-of-care for a disease condition.

7. The media of claim 1, wherein the scoring group for the first quality measure comprises a minimum number of patients needed in order for the first quality measure to count towards the provider'"'"'s performance incentive score.

8. The media of claim 1, wherein the target parameter is specified by a healthcare organization.

9. The media of claim 2, wherein a higher ranking of the first opportunity index of the first quality measure means a greater opportunity for the first quality measure to increase the provider'"'"'s performance incentive score.

10. The media of claim 2, wherein the first opportunity index of the first quality measure is directly proportional to the effectiveness of the provider in meeting the first quality measure, m, and inversely proportional to the number of patients, n, in the scoring group for the first quality measure that have not met the first quality measure'"'"'s target parameter.

11. The media of claim 1, wherein the first quality measure has a tiered scoring, and wherein the first opportunity index for the first quality measure is calculated based on the tiered scoring.

12. One or more computer-readable media having computer-executable instructions embodied thereon that, when executed, perform a method of calculating an opportunity index for a quality measure having a target parameter, wherein the opportunity index is useable to identify if the quality measure offers a particular provider a significant opportunity to improve the provider'"'"'s performance incentive score, the method comprising:

determining the opportunity index for the quality measure according to the following formula;

13. The media of claim 13, wherein when the weight, w, of the quality measure is above a predetermined threshold, the quality measure has a greater impact on the provider'"'"'s incentive score as compared to when the weight, w, of the quality measure is below the predetermined threshold.

14. The media of claim 13, wherein when the number of patients, n, in a scoring group for the quality measure that have not met the quality measure'"'"'s target parameter is below a predetermined threshold, the quality measure has a greater impact on the provider'"'"'s incentive score as compared to when the number of patients, n, in a scoring group for the quality measure that have not met the quality measure'"'"'s target parameter is above the predetermined threshold.

15. The media of claim 13, wherein when the effectiveness of the provider in meeting the quality measure, m, is above a predetermined threshold, the quality measure has a greater impact on the provider'"'"'s incentive score as compared to when the effectiveness of the provider in meeting the quality measure, m, is below the predetermined threshold.

16. The media of claim 13, wherein when the number of patients in the scoring group for the quality measure that have not met the quality measure'"'"'s target parameter is above a predetermined threshold, the quality measure has a lower impact on the provider'"'"'s incentive score as compared to when the number of patients in the scoring group for the quality measure that have not met the quality measure'"'"'s target parameter is below the predetermined threshold due to an increase in need to change the behavior of the provider'"'"'s patients in order to achieve success.

17. A computerized method carried out by a computer having at least one server and at least one processor for performing a method of calculating opportunity indexes for a set of quality measures, each quality measure having a respective target parameter, wherein the opportunity indexes are useable to identify if a particular quality measure in the set of quality measures offers a particular provider an opportunity to improve the provider'"'"'s performance incentive score, the method comprising:

determining, using the at least one processor, an opportunity index for each quality measure within the set of quality measures based on;

A) a weight of the each quality measure;

B) a number of patients in a scoring group for the each quality measure that have not met the each quality measure'"'"'s respective target parameter;

C) a measure of the effectiveness of the provider in meeting the each quality measure; and

D) a ratio of the number of patients in the scoring group for the each quality measure that have not met the each quality measure'"'"'s respective target parameter to a number of patients in the scoring group that do not have documented results relating to the each quality measure; and

ranking the different opportunity indexes for the set of quality measures according to their respective opportunity index value, wherein a higher ranking indicates a higher opportunity for the respective quality measure to increase the provider'"'"'s performance incentive score.

18. The method of claim 18, wherein at least one quality measure of the set of quality measures has a tiered score.

19. The method of claim 19, wherein multiple opportunity indexes are determined for the at least one quality measure that has the tiered score and an average is taken of the multiple opportunity indexes to generate an average opportunity index for the at least one quality measure.