Rover Transitions

Introducing BHA’s Rover-Transitions.

When it comes to Stars and HEDIS®, health plans can’t always assume the network is addressing every gap in care.  Sometimes you need your own staff to work the phone to get the job done.  You can try to run a campaign from spreadsheets, or you can try to adapt an overly complex care management system that doesn’t really solve the right problem.  But if you want to maximize results with minimal effort, the best solution is a system that is designed specifically for the campaign you’re running.  That’s what BHA Rover is all about.

Hospital discharges can be confusing for the patient.  Medicare and Medicaid know this and have put a special emphasis on reducing 30-day readmission and measuring the coordination between providers, especially:

• Communication of admissions and discharge plans

• The ability to track patient engagement with their PCP

• The patient’s medication usage when they leave the hospital

Rover-Transitions is an application developed by Baltimore Health Analytics (BHA) to mirror the NCQA® Transition of Care HEDIS® measure. It aids in tracking of patient data around an inpatient hospital transition to home. with an emphasis on decreasing patient readmission by facilitating communication between the hospital and the patients primary care physician. We have created a simple workflow to display data for tracking patient prescriptions and changes; admission/discharge dates and discharge summaries. The application also tracks the engagement of the member with their PCP and whether a reconciliation of the pre-hospitalization medications and the changes made during the hospital stay.

Highlights of Rover

• Enables user to track patient transitions from inpatient care to home

• Allows user to verify that patient has had a clinician review/reconcile their medications

• Easily creates documentation of:
           o Phone calls
           o Follow up visits
           o Notes in the chart

• Easily view:
          o Patient admission and discharge date:
          o Detailed information about the patient
          o Doctor information/PCP:

• Displays data to allow user to easily contact patient or patient family
• Stores all findings and data
• Prioritizes “must complete soon” members

Rover can take its input from an existing prospective HEDIS® engine, or it can construct is discharge prospect list directly from your claims and auth data warehouse.

Rover is a part of our BHA Suite and complements the other applications that we offer, including Pisces and Ocular.

Pisces is a chase tracking tool that consists of the Call Queue, Additional Chase Management, and the Provider Consolidation.

• The Call Queue is the main hub for tracking contact with providers, contact information, call logging and history, faxes, chases, and received/scanned charts.
• Provider consolidation allows merging of multiple provider-ids into a common grouping.
• Pisces Additional Chase Management is a ‘One-Stop-Shop’ to track activity related to multiple chases outside of the current Call Queue.

Ocular is our OCR tool that allows the user to upload charts and convert them to a digital format to easily find “hit” documentation.

• The Member List displays files loaded in the application specific to an individual, including which gaps the member currently has across the Star HEDIS measures.
• The Abstraction Queue section is where charts are abstracted/validated for having HEDIS MRR hits for the current HEDIS reporting year. It also lists all of the scanned charts that have potential matches in them to the gaps the member has.