Quality management starts with setting quantifiable goals. The MedGrail quality supports unlimited number of goals associated with its members. Gathering the quality information is managed through the workflow and individual reviewers fill the forms that may be either constructed from standard pieces (questions) or loaded from a pre-established templates.
Typical quality group consists of nurses and other medical professionals that may be visiting the patients either in hospital or their home. The software uses a workflow facilities to distribute the load and to manage timely follow-up. Distribution is aided by a graphic presentation of workload and by easy transition of individual members from one reviewer to another.
Gathering quality data as part of the care management is essential for efficiency and comprehensive coverage. The MedGrail system supports multiple workflows with to-do lists directing the users to activities that are most critical at the time. The workflow allows assignment of particular member / quality program combination to a specific reviewer.
Distribution of materials and notification of both members and providers is an important part of the quality cvare management. The MedGrail system supports generation of multiple exports that can be used for mass print of letters. The exports are in the spreadsheet friendly CVS format and contain both demographic data with addresses, but also content of the surveys.
Each measure followed by the quality program is recorded in a Quality Program. A member is associated with one or more quality programs (SNP follow-up, chronic disease follow-up, etc.) and the parameters of the quality relationship (date and type of enrollment in the quality program / measure, opt out, discharge, etc.) are maintained for clear disposition of each member and quality program.
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