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QualOptima v2.0

QualOptima Clinical Intelligence System Version 2.0

Connectivity & Analytics Platform

q_iconQualOptima is an intelligent clinical data and knowledge solutions system to improve clinical, operational and financial outcomes. QualOptima is different from other analytics software products because it captures existing clinical data rather than relying on claims and administrative databases. As a clinical intelligence system, QualOptima is the strategic technology platform layer that sits on top of the electronic medical record to unify all disparate databases pulling data from multiple sources making it available for the myriad of purposes essential to the enterprise. This intelligent second-generation database is then available as the analytics platform – the complete solution for business intelligence and enterprise management. QualOptima’s common data platform for connectivity and analytics is available retrospectively or in real-time for all purposes in the complex healthcare enterprise, crossing functional boundaries of users who have previously been confined to silos of data. The QualOptima system empowers users across the organization – for healthcare providers, payers, patients, employers, and insurance companies.

Q’s QualOptima Solution

Quture (“Q”) makes the best software in the world better, integrating its vast evidence-based clinical content, metrics and algorithms into the technology of the QualOptima software. The QualOptima data interface engine strategically captures, integrates and aggregates clinical data from disparate databases on this common data platform. Only an estimated 15% of the valuable clinical data in these databases is structured, with the extremely valuable text data in discharge summaries, history & physical examinations, operative reports, and radiology and pathology reports. QualOptima implements a powerful combination of machine reading with learning tools to also derive and integrate unstructured narrative text data into the aggregated second-generation Qualytx database. Q’s competitive advantage is seamless connectivity across existing application databases from its range of proven technologies into QualOptima’s unified “single stack” architecture.

The new generation Qualytx database technology provides multiple modes of data access, so data is instantly available using object access, high-performance, and powerful multidimensional access. QualOptima technology then provides user-customized data display of data, converting data to knowledge to actionable wisdom.

Strategic Path to Big Data and Value-Driven Care

This powerful, highly-scalable common data platform is available to all users in the healthcare enterprise for strategic analytics based upon the QualOptima intelligent system:

  • Personal risk and fitness factors
  • Aligned with evidence-based performance metrics using clinical data (not only billing codes) from disparate EMR and vendor application databases
  • With Q’s embedded clinical content, metrics and analytics
  • Envisioned to be available for transition from evidence-based processes and metrics to experience-based content
  • Displayed visually not only as one-moment-in-time snapshots but in graphic data displays across months and quarters

Q’s customers are engaged in a value-driven data plan to transform their enterprises with a combination of strategic data analytics and “big data”. Analyzing large quantities of data (high volume) with data variety at high velocity is called “big data,” with the three (3) characteristic “3 V’s” of volume, variety, and velocity. The QualOptima common data platform is a large collection of disparate data sets (inevitably from disparate vendor databases integrated with the electronic medical record database) that are analyzed for learning and pattern recognition resulting in actionable wisdom.
The path to value-based care from healthcare data science and transformation with digital health begins by learning from integrating existing clinical data with administrative data for actionable knowledge from strategic analytics to transform outcomes. Optimal patient management and quality must be demonstrated by outcomes correlated with resource use and cost. The quality-value relationship is the fabric of QualOptima.

QualOptima for Quality & Risk Management and Credentialing

Benefits of adoption of the QualOptima Connectivity & Analytics System begin with improving quality and patient safety by exceeding the compliance requirements of the Joint Commission for Focused & Ongoing Professional Practice Evaluation. QualOptima v1.7 is fundamental to implementing clinical performance and outcomes measurement with credentialing focused on optimal clinical processes.

QualOptima v1 tools are designed to comply with the essential requirements of performance and outcomes measurement, triggers to identify potentially suboptimal outcomes and clinical processes, and to proctor clinical practitioners to assure current clinical competence. The initial product is designed to exceed the myriad of requirements for:

  • Compliance with the strategic imperatives to improve clinical outcomes and implement the requirements of the Joint Commission for Focused and Ongoing Professional Practice Evaluation (FPPE-OPPE)
  • Compliance with strategic imperatives to transition to new payment systems driven by value and penalizing suboptimal outcomes while incorporating the potential of meaningful use of electronic medical records and new provider entities consistent with these imperatives.

Transforming Quality & Risk Management with Health Data Science Analytics

QualOptima v1 is intended as the transformative technology to transition from antiquated quality, risk and credentialing systems to the opportunities from new data science with strategic analytics and big data. QualOptima v2 is the common data platform crossing the traditional boundaries and silos of quality, risk and credentialing for the new frontier of healthcare quality science. Machine reading with learning changes how we will identify not only case examples of sub-optimal outcomes, even with a sophisticated system of electronic triggers as in v1.2, but identifying rates of complications and electronically assessing root causes. For example, the article by Dr. Laurent Glance and his associates demonstrated that identified “low-performing” hospitals were nearly 5 times more likely to experience a major complication (20.93%) than women undergoing C-sections at identified “high-performing” hospitals (complication rate 4.37%). On August 4, 2014, the American Congress of Obstetricians & Gynecologists jointly announced with the American Society of Anesthesiologists that this study of such remarkable variability among hospitals for maternal complications identifies the need for their Maternal Quality Improvement Program, a joint effort to develop a national obstetrics outcomes registry.

QualOptima not only identifies rates of complications, such as post-partum hemorrhage, but implements the technology to identify the root causes of such sub-optimal outcomes. Q empowers our customers with the new health data science tools that will change operational processes, then transforming clinical process with actionable insight. And in the new environment of transparency, hospital brand equity will drive income, as well as proven optimal outcomes for value-based purchasing. Q’s QualOptima and QualVal’s consultation services bundled with Q inside anticipates the coming disruptive impact of consumer-driven health care.

QualOptima Technology Solution

QualOptima is the large data platform integrating the total array of available disparate data with the technology to implement both strategic data analytics using defined data fields for analysis of relationships with big data to improve outcomes while reducing costs through optimal clinical processes. As a series of articles in a recent Health Affairs journal discuss, when a patient has an adverse event for example, which of the many dimensions of data are important – and which can be ignored. By capturing, integrating, aggregating and analyzing exponentially growing sources of data, clinical processes of care will be continuously improved by learning organizations.

The Strategic Analytics and Big Data Science of QualOptima

The prospective clinical quality and patient safety science of Q is embedded in the clinical content and structure of QualOptima. Patient-specific risk factors are analyzed in the perspective of clinical performance based on optimal clinical processes and monitored with short, intermediate and long-term outcomes, not “risk adjusted”. Predictive modeling improves both patient management and outcomes. Real-time patient management similar to air traffic control technologies integrate the clinical and administrative functions of healthcare providers. The QualOptima clinical intelligence provides both individual clinicians and organizational groups to continuously analyze patient data using clinical variables to learn from experiential data in contrast to evidence-based clinical processes.

QualOptima is the ultimate clinical intelligence system to rapidly and seamlessly incorporate knowledge produced from the science of data analytics, no longer passively clinging to antiquated processes and maintaining status quo. Competitive advantage and income are the strategic imperatives at stake.

Software technology has relied upon systems that look for specific defined indicators of potentially suboptimal care, whether called “clinical indicators” in peer review processes or now “triggers” in FPPE-OPPE standards. This is similar to the typical scientific method of establishing a hypothesis and then collecting data to prove or disprove that hypothesis. Big data provides the technology to learn from large data sets rapidly from a variety of data. Machine learning with advanced analytics finds causal relationships to identify classes of adverse outcomes and events such as prediction and signal detection. New big data methods can turbocharge powers of observation in healthcare. In the same way the microscope enhanced eyesight, sophisticated mathematical and computational approaches can augment what can be “seen” and understood from massive amounts of data.

Data-driven technology to illuminate suboptimal outcomes and patient safety concerns from diagnostic and treatment modalities, drugs and medical devices will first be identified and then analyzed for root causes. The new data science will not only identify suboptimal outcomes but will scrutinize optimal outcomes to transfer clinical knowledge to improve outcomes in other processes of the enterprise.

Bad Outcomes | No Outcomes | No Income

QualOptima v2.0 focuses analytics using electronic data collection from a variety of existing data sources to achieve optimal clinical, operational and financial outcomes. The new frontier of assessing outcomes in an ever increasingly transparent healthcare environment causes this strategic imperative to be the focus of our customers.

QualOptima for Learning Organizations Using Big Data and Clinical Variables

The urgent challenge confronting medicine, health care, insurance and health/wellness is to adopt methods and technologies to become true learning organizations. QualOptima is designed to meet this challenge and remarkable opportunity to promote health care as an information science and to strengthen the foundations of continuous quality improvement through a learning health care system. Advocated since 2007 by the Institute of Medicine (IOM), such a system is defined as one “designed to generate and apply the best evidence for the collaborative healthcare choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care.”

True learning healthcare organizations, systems, and clinicians will rapidly learn through data generated by individuals in clinical care and daily life. Learning organizations will transform through data-driven processes for operational changes through; optimal operational outcomes will then drive transformation through optimal clinical processes focused on optimal clinical and financial outcomes. Rapidly growing transparency initiatives, and the coming disruptive impact of consumer-driven health care are just two of the reasons our customers need to become learning organizations. Q inside with QualOptima v2.0 is the complete solution to take competitive advantage of marketing on outcomes.

Brand Equity with QualOptima

Just because a hospital, health system, insurer or medical device manufacturer, as examples, is well known, or even well regarded for a particular service line or product, doesn’t mean it has the brand equity to influence decisions in those critical consumer choice moments where factors like co-insurance or narrow networks or product perception loom large. Consumers will not continue to rely upon simple convenience if the hospital is identified as a low-performing organization with high rates of complications.

Our customers in all segments must define the product they are trying to build and to market around that brand. They must consider in highly competitive markets whether “being all things to all people” is their strategy or narrowing their focus and specializing is their branding plan. Our hospital customers, for example, have immediate access to their patient’s most recent and longitudinal outcomes, individualized with risk factors. When a patient presents for care, they know they are immediately known in all critical dimensions, with clear branding loyalty strategic initiatives available. QualOptima’s predictive modeling further enhances branding with consumer-driven outcomes and more engaged patients.