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Customer Experience and Design

Diagnostics Markers in Information Systems to Enhance Quality

Provider and payer organizations will be in a position to utilize their information systems in comprehensive organizational health, ranging from patient management to revenue cycling, but will also be able to delineate diagnostics markers to bridge population health with healthcare delivery systems. The most apparent ramification of this is the cross over between actual claims diagnostics and procedural coding with public health data collected that trends disease specific rates. Two main layers are treatment modalities and mortality rates by disease per organization across defined geographic regions. The augmentation of information systems will enable a parallel mapping of real time disease management and treatment by claims processing with population-based measurements of prevalence and incidence.

The short and long term implications include, but are not limited to, addressing the variances of disease specific rates across regions. This can then be refined by patient demographics, provider access, and insurance coverage to determine pivotal points in patient management in preventing chronic or acute management. As a result, with effective markers based on diagnostic and procedural codes organizations will establish milestones in patient care from initial visit through short and long term recovery. Captured claims can be the intermediate point between treatment initiation with the provider and thorough process management. Code markers will entail periodic assessment of viability within the current payer and provider organization, and will continue with modification of healthcare delivery systems operations focused on patient population demographics and disease manifestation. Diagnostic and procedural markers can therefore serve as preventive measures in effective patient management.

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