Get Your Health Record, a web and mobile Android and Apple app developed by Health Endeavors and approved by Medicare in April 2018, syncs four years of Medicare enrollee health history using Fast Healthcare Interoperability Resources (FHIR) EOB resources. After the data syncs, data-driven intelligence calculates the consumer’s health score.
Health scores are a standard risk stratification process for value-based programs and payers. The higher the score the sicker, and usually the more costly, the patient will become if their conditions are not managed appropriately.
The goal of the health score is to encourage Medicare enrollees to review their health information and verify their diagnoses are correct. For the most part diagnoses drive the health score and many enrollees are unaware of or not managing conditions that have been coded as associated to them in their claims data. Removing inaccurate diagnoses will improve the individual health score.
After synching their data, the consumer’s health score is populated along with their health history for the past four years (weekly updates) and data-driven intelligence then populates the consumer’s care gaps (such as labs, exams) to send text alerts to the consumer or their delegate when due to complete. The combination of data sync, health score and text alerts for care gaps is intended to bring actionable data to the point of care.
Medicare enrollees may also share their data with Part D drug plans, Medicare supplement plans, life insurance agents, pharmacies, second opinion providers, emergency departments, urgent cares, primary care providers, specialists, ACOs, PACE programs or surgery pre-certification programs that are using the Health Endeavors’ Application Program Interface (API) for various purposes such as picking a Part D drug plan or retrieving a consumer’s health history when a patient presents to the emergency room or for surgery.
For providers in value-based programs, the data is shared by the consumer, analyzed and put in an actionable format at the point of care. Items such as benchmarks, health score, quality measure status, gaps in care are presented to the provider team at the point of care, to the consumer in the app and via text alerts.
In Spring 2019, Health Endeavors will begin offering the health score, text alerts and data-sharing to non-Medicare payers to distribute to their enrollees.
“We need to get actionable data to both the consumer and provider team to be successful in value-based care programs,” says Kris Gates, CEO, Health Endeavors.Text Alerts (Graphic: Business Wire)