A Veterans Health Administration office is leading efforts to implement an online care coordination tool intended to integrate data points for coordinating care of between 900 and 1,200 patients each, GovExec reported Dec. 23.
Lara Shane writes the VHA’s office of analytics and business intelligence aims to figure out which of its 6.5 million primary care patients have the highest risks of hospitalization or death.
Stephen Fihn, head of the office, led efforts to develop the care assessments needs score, the coordination tool that works to draw from 80 terabytes of patient data and other information.
“She’s got this list in front of her with patients who are at highest risk and she can go down it systematically now and say, ‘Oh I see Mr. So-and-So was in the hospital twice in the last month and he’s got a really high risk score and we’re not giving him any of these services. Maybe I will go talk with his primary care provider and figure out in our daily huddle which of his patients should be referred to one of these programs,’ ” Fihn told GovExec.