Johns Hopkins Medicine Consulting for WellPoint/RHI
Wed, 3 Feb 2010
Wellpoint/Resolution Health provides personal health care guidance, using sophisticated data analytics to identify opportunities to improve the quality, safety and cost effectiveness of health care delivered to particular individuals. The company sends messages to individuals and their physicians to alert them to these opportunities. Using “clinical rules” — computer algorithms that compare the care an individual has been receiving with authoritative evidence-based best clinical practices — the firm performs a Personal Health Scan™ of information provided by insurers, labs, physicians, other care managers and patients themselves. They then analyze these data regarding an individual’s age, gender, diagnoses, prescription drugs, tests, procedures, lab test results and various health risk factors — including family history, lifestyle and smoking.
Johns Hopkins experts in more than 20 clinical departments review, refine and expand upon the set of “clinical rules” and help the firm identify situations in which the cost of care could be reduced through elimination of services that may be less effective or no more beneficial than less expensive alternatives. Johns Hopkins’ experts are also expected to broaden the number of medical conditions and situations addressed by these clinical rules and therefore increase the utilization of the Personal Health Scan™.