CareQuotient

CareQuotient™ is a Data Management and Analytics platform that furnishes Providers and Payers quick insights into key performance data about the business and health profile of their patient/member population, and lets them drill down into the clinical, claims, financial and administrative data when they need deeper insights. This is a product that every care provider and healthcare business administrator needs to manage and monitor quality of care delivered, enhance efficiency and improve overall business performance.CareQuotient™ – Key Product Modules

  • CareQuotient™ Export Import (CQ-EXIM) – Data Extraction Mechanism
  • CareQuotient™ Care Data Repository (CQ-CDR) – Clinical and Claims Data Model
  • CareQuotient™ Performance Intelligence Engine (CQ-PIE) – Pre-built Analytics and Reporting
  • CareQuotient™ Portal (CQ-Portal) – Intelligence & Knowledge Sharing.
  • CareQuotient™ CareNavigator – Virtual Health Record to offer 360 degree view of patient/member
  • CareQuotient™ Ad-hoc Query Tool (CQ-AQT) – Intuitive, web-based Query and Analysis tool for business, reducing Time-to-Insight and dependence on IT
  • CareQuotient™ Risk Profiler – Population risk stratification, episode of care analyses, and identification of potentially preventable events

CareQuotient™ Analytics Solution explained:

PluralSoft’s CareQuotient™ delivers a four-pronged approach that empowers our customers to address their stated goals and objectives for the Analytics Solution that optimizes efficiency of resources and enhances effectiveness of care. This allows for adoption of a community-based, value-driven model of care delivery, which also enables the organization to decrease risk and utilization while preserving quality and reducing cost:

Data Extraction – CQ-EXIM (CareQuotient™ Export-Import) is a multi-tiered data extraction, transfer, and acquisition application that can extract data from healthcare interoperability standards prescribed formats (such as HL7, CCD, X12, NCPDP, etc) as well as natively access any remote healthcare information system source to extract required data and securely transfer that data to a central data warehouse.

Information Modeling – CQ-CDR (CareQuotient™ Care Data Repository) is a data quality verified, healthcare vocabulary standards-compliant, Member/Patient-centric data model that amalgamates healthcare data from payers, providers, laboratories, pharmacies, diagnostic imaging facilities, drug databases, and external data sources. CQ-CDR supports data models for source data profiling-validation-quality enhancement, normalized representation of data and metadata, and multi-dimensional analytical structures. It forms a robust data foundation and refinery for information analyses.

Intelligence Formulation – CQ-PIE (CareQuotient™ Performance Intelligence Engine) is a robust Patient/Member-centric healthcare performance intelligence infrastructure that comes with hundreds of clinical quality, utilization, cost, operational and financial performance measures or indicators. These span across the clinical, claims, operational and financial data in CQ-CDR. These measures are industry standard metrics developed by various quality standards development bodies such as NCQA, NQF, CMS, AHRQ, USPSTF, AHA, AMA, AHIP and many more. Consequently, CareQuotient™ comes pre-built with quality measures for CMS Meaningful Use Stage 1 and Stage 2 for both Eligible Professionals and Eligible hospitals, CMS Physician Quality Reporting System (PQRS), CMS Accountable Care Organization (ACO), CMS STARS, NCQA HEDIS, HRSA Unified Data System (UDS), Patient Centered Medical Home (PCMH) reporting, Dental Quality Alliance (DQA), and Medicaid Redesign initiatives such as Delivery System Reform Incentive Payment (DSRIP), to name a few. To support clinical quality improvement, CQ-PIE provides robust registry management capabilities with risk stratification for chronic diseases, acute care and preventative care medical conditions. These drive clinical decision support, which in turn identifies gaps in care, creates lists for patient outreach, and enables care/case coordination functions. Operational and Financial performance indicators provide insights into access-to-care, cost of care, utilization management, and revenue management.

Foundation for Action – CQ-Portal (CareQuotient™ Portal) makes CQ-PIE created analytics as well as CQ-CDR data ubiquitously available to all authorized users based on role-based access control configured at the data presentation and visualization level. Information can be visualized as dashboards, scorecards and tabular lists. Pre-built dashboards are available for typical quality, cost, utilization, and revenue metrics, Patient-centric Care Gaps Scorecards and Provider Performance Scorecards can be custom configured in minutes. CQ-Portal provides a Virtual Health Record to visualize a longitudinal, 360 degree view of a Patient’s/Member’s health record aggregated across clinical and claims data domains integrated from multiple sources within CQ-CDR. Further, CQ-Portal has an Ad-hoc Query capability for quick data exploration, analysis and reporting by non-technical end-users.

In Summary, CareQuotient™ users are able to harness the power of advanced analytics to readily:

  • Gather Data
  • Place Information on Common Ground
  • Execute Pre-Defined or Ad-Hoc Analysis
  • Identify Strengths and Weaknesses
  • Form Decision Support Models
  • Assure Readiness for Quality-Based Reimbursement
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CareQuotient™ ONC Certification Information

Disclaimer:

This EHR Module is 2014 Edition compliant and has been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services.

Certified EHR Vendor and Product Information
Vendor / Developer Name PluralSoft Inc
Certified EHR Name CareQuotient™
Certified EHR Version Q3201401.01.01
InfoGard Certification # IG-3385-14-0082
Certification Criteria §  170.314(c)(1) Clinical Quality Measures – Capture and Export

§  170.314(c)(2) Clinical Quality Measures – Import and Calculate

§  170.314(c)(3) Clinical Quality Measures – Electronic Submission

§  170.314(d)(1) Authentication, Access Control, and Authorization

§  170.314(d)(5) Automatic Log-Off

§  170.314(g)(4) Quality Management System

Clinical Quality Measures CMS2, CMS22, CMS50, CMS68, CMS69, CMS74, CMS75, CMS90, CMS117, CMS122, CMS123, CMS124, CMS125, CMS126, CMS127, CMS129, CMS130, CMS131, CMS132, CMS133, CMS134, CMS136, CMS138, CMS139, CMS141, CMS142, CMS146, CMS147, CMS148, CMS153, CMS154, CMS155, CMS156, CMS157, CMS163, CMS164, CMS165, CMS166, CMS167, CMS182
Additional Software Required Microsoft Windows Server 2008 or later, SQL Server 2008 or later, .NET Framework V4.0 or later
 Transparency and Disclosures
  1. Fees: Besides applicable licensing or subscription fees, customers will be required to pay implementation fees; and may optionally subscribe to additional Pluralsoft services to enhance the use of CareQuotient™ offered functionality.
  2. Limitations: Accuracy and completeness of measure output is limited by the accuracy and completeness of EHR data supplied. PluralSoft offers optional services to enhance the accuracy and completeness of measure data.

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