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QualOptima Overview

QualOptima v2.0 – Robust Technology Tools for Enterprise Management

q_iconThe evolving technology of QualOptima v2.0 is available for product demonstrations at selected reference sites. Version 2.0 technology primarily adds the big data analytics technology for more robust deliverables across customer segments with the Qualytx common data platform crossing traditional enterprise boundaries. This full product version further provides data capture, integration, aggregation and analytics tools to more fully empower physicians and patients as consumers in engaged personalized and individualized care and wellness.

QualOptima v1.0 – Initial Versions Focused on FPPE-OPPE

dB.2014The initial versions of the QualOptima clinical intelligence system focus on the traditional core competence of Q, to measure clinical performance and patient outcomes integrated with peer review tools for single case drill-down functionality.

Versions of QualOptima v1.0 provide technology for each of the three (3) requirements of Joint Commission Standards for Focused & Ongoing Professional Practice Evaluation (FPPE-OPPE) and all three (3) integrated into a single application:

  • Version 1.3 – Qperformance & Qreview
  • Version 1.2 – Qtriggers
  • Version 1.5 – Qproctoring
  • Version 1.7 – complete modules into single FPPE-OPPE application

Joint Commission FPPE-OPPE Requirements

The Joint Commission Standards for Focused and Ongoing Professional Practice Evaluation (FPPE-OPPE) require measuring clinical performance and outcomes for every “practitioner” in the organization. Compliance with these Standards is vital to receiving and maintaining “accreditation” to received federal reimbursement for care. There are three (3) specific tools required to be used for FPPE-OPPE compliance:

  • Clinical performance measurement in the ACGME framework for each practitioner and for each clinical privilege granted at reviewed at least twice per year
  • Triggers indicating the need for performance monitoring from single incidents or evidence of a clinical practice trend, coordinated with performance criteria
  • Proctoring to evaluate current clinical competence to grant new privileges to practitioners

Crossing Functional Boundaries of Quality/Risk/Credentialing

The QualOptima clinical intelligence data platform is designed to span and engage operational functions across the boundaries of quality and risk management, medical staff coordinators, and the organized Medical Staff. These functions have tended to act almost independently in the past, with software in their respective operational silos. However, with FPPE-OPPE Standards, the Medical Staff Coordinator does not have the expertise and tools to evaluate clinical quality and competence evaluation, and their software products are designed to collect documents into a database. What were clinical indicators of suboptimal care for peer review are now triggers, and quality management and risk management functions must now be shared and coordinated from the different perspectives. And proctoring is a function that falls to the Medical Staff Coordinators but necessarily performed by quality management with significant risk management implications.

QualOptima Common Data Platform with Remote Data Entry

QualOptima creates a common database from existing data collected electronically for each of these three (3) required functions. Peer review, which has been the traditional tool of quality management, remains anticipated by the FPPE-OPPE Standards but as a tool and not a regulated standard. QualOptima integrates the processes of measuring clinical performance from aggregated data with Q’s analytics for pattern and trend evaluation while integrating peer review for single case drill-down to assess perceptions from aggregate data and root causes for solutions. As anticipated by the Joint Commission FPPE-OPPE Standards, QualOptima functionality permits remote peer review, both to facilitate local reviews and external peer review.