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GWI-Health
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GWI-DM
GWI-Hedis
GWI-DM
GWI-DM is a system of coordinated, interactive healthcare interventions and communications that support collaboration between patients, providers and medical management staff, where patient self care efforts are significant. GWI-DM is proactive and target members from authorizations management, HRQ, lab/radiology (HL7) even before claims are submitted.

Benefits:
  • Early intervention improves quality and lowers health care costs to build the foundation for better payer and patient outcomes.
  • Evidence-based best practice guidelines.
  • Patient participation to prevent disease based exacerbations and complications.
  • Intelligent, suggestive patient scheduler that synchronizes with disease/case manager’s and provider’s schedules.
Disease Management Components:
  • Automated population identification based on clinical, financial and predictive indicators.
  • Descriptors, benchmarks, key tests, nutritional goals
  • 24/7 access to most up to date patient education to understand, monitor and modify disease and co-morbid conditions.
  • Clinical and financial outcome measurements.
  • Executive reporting and feed back to include clinical and financial effectiveness of disease/case managers, medical directors, providers for program evaluation and management.
Robust, End-to-End Functionality in a Secure and Versatile Environment
  • Automatically identify members with chronic conditions based on clinical and financial markers.
  • Highly individualized patient management with chronological record of every encounter/contact.
  • Patient access to disease log for recording home monitored values.
  • Manage diseases to include ICD9-D/ICD9-P codes, parameters and parameter values according to age and sex
  • Configure and administer rules to identify status for current patient condition (acute / normal status).
  • Define and monitor multiple-level alerts for patients, providers, disease/case managers, medical directors.
  • Segregate system claims based on single or multiple filters
  • Manage letter content and delivery mechanisms
  • Define and administer appointment schedule intervals
  • View configurable chart templates
  • Manage educational material and links to relevant sites
  • Supervise member's medical diary
  • Track provider ratings by utilization dollars and quality performance
  • Suggest providers based on disease
  • Rate providers based on referrals and quality of care
  • Rate members compared to plan averages on common conditions.
  • Display performance index for all providers and networks.
  • Deliver comprehensive utilization reports that track every dollar
  • Provide metrics on program usage and rewards for providers and patients - pay for performance.


 

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