By Allan Maurer
ATLANTA—One way to lower health costs is for doctors to make sure patients follow evidence-based clinical guidelines, yet 55 percent of diabetes patients, for example, are not in compliance with those guidelines. By partnering with health plans and doctors to remedy that, MDdatacor can save the plans $1,000 a year for each diabetes patient alone.
It’s not just for diabetic care. Disease management of hypertension, asthma, and others all deliver a return on investment in evidence-based clinical guidelines, the company says.
MDdatacor’s patented CareInformatix technology automates the collection of patient clinical data from disparate sources such as electronic medical records, transcribed office notes, lab results and directly from treating doctors.
The patient data is combined with claims and pharmacy data from health plans into a searchable, HIPPA compliant database. The patient data is then analyzed against evidence-based guidelines so that health plans and doctors can access Web-based reports that identify patients not currently in compliance with evidence based clinical guidelines for blood pressure and cholesterol levels and other measures.
Doctors can then reach out to the patients proactively and improve the quality of their care.
MDdatacor has raised $20 million in equity backing over seven years and seeks about $4 million to expand its operations and infrastructure, says CEO and President Tim Roche.
Currently, the company is working with health plans—who pay for the service—in Iowa, South Dakota, North Dakota, and Nebraska. “We’ll be looking at doing this in the Southeast as well,” says Roche.
Roche says the company can deploy its solution throughout a state quickly because the technology is a Web-based, scalable platform. “The doctor doesn’t need hardware or software, just Web access,” says Roche.
“It’s really about putting disease management and control in the hands of the doctors, where it should be,” he adds. “Studies have been done that show that by allocating more resources to primary care doctors, the quality of care increases. If a patient spends more time with the doctor, care improves. We have to start compensating them for spending more time with these patients.”
One of the difficulties of bringing about changes such as these, Roche notes, is that the major of U.S. doctors practice in groups of five or less. “They’re essentially small businesses without the resources to innovate. Only about 20 percent even have electronic medical records. We provide this data at no cost to the physicians, sponsored by the health plans.”
That means that practices, small or large, have access to the company’s decision support tools, and they trust the data, because it comes from their own records, not insurance plan claims data alone.
The company focuses its marketing on health insurers, specifically the 44 regional Blue Cross Blue Shield health plans. The health plans themselves promote the MDdatacor network, giving doctors incentives to join. MDdatacor’s revenue is directly related to the number of doctors in each network.
The company estimates its potential market at $2 billion.
Thus far it has received patient medical records from more than 7,000 doctors, collecting data on more than 7 million patients. The data is subject to HIPPA guidelines for guarding its security and privacy.
“We all need to work together to solve the healthcare problem,” says Roche, “and information is a big component. I think we’re making a significant difference.”
On the Web: www.mddatacor.com
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