Canada Health System Management | InSync

By: Intrahealth  09-12-2011

InSync Provides innovative tools for better management of health care provider communities and delivers a complete solution for health system management. Insync has been designed for Health Authorities, LHINS, HMO’s and Ministries of Health.

InSync provides real benefits to your healthcare organization or network:

  • health status information of defined populations
  • rapid and inexpensive implementation of a range of health and wellness programs
  • improved clinical quality assurance and governance
  • better management of your available resources
  • integration of hospitals with primary care for improved discharge planning
  • central patient registration and capitation calculations
  • population Electronic Medical Records are fed from the front office
  • provider systems, enabling population health, individual care plans and screening.

Intrahealth’s Insync application offers a series of capabilities covering the scope of management processes and data across the provider network.  Insync integrates the data from a series of independent healthcare providers to build a view of the system as a whole.  It also allows the hospital and any other facilities and providers to participate in a similar way.

A synchronisation module using XML technology is used to represent aspects of each health provider within the InSync database.  Flexible rules, reporting and capabilities then allow the health system manager to implement a range of management processes on top of this network.

Capabilities possible through inSync include:

  • Privacy and security – data can be assigned role level security and then roles assigned to users to identify what they can see
  • Master Patient Index – a series of data and processes intended to deliver a clean list of the patients being managed within the health area, whether enrolled or casual
  • Master Provider List – a record of all providers, locations and places of service, used to support other elements of the system
  • Primary Health Organisation structures – allows the operator to group provider organisations and providers into geographic, organisational and professional structures, including peer review groups
  • Contract Management – a bridge between the administrative and financial systems, identifies the providers, services, validity and locations of contracted services
  • Continuing Professional Education (CME/CNE) – tracks courses and activities completed by health care professionals, including printing completion certificates, in multiple categories
  • Geocoding and Geospatial analysis – allows all addresses to be identified to XY coordinates, including bulk updating where these are not known; includes geographic segmentation to compare and contrast external data series against what the health system understands to identify intervention opportunities
  • Disease and Risk Registers; shared reference mapping to avoid the need to recode
  • Disease Surveillance, Incidence and Prevalence – including defined sets of diseases, allows new cases or existing cases to be plotted on maps
  • Key Performance Indicators – allows users to define key metrics to measure performance of health providers and then compare and contrast to comparators (such as time series, review groups or targets). 
  • Focused Lists – generates specific worksheets and activities for health providers to allow the system to undertake back office administrative activities and then present priorities to the health providers (e.g. lists of 3yr non attending clients for confirmation)
  • Centralised Task management – allows the system to generate tasks lists for health providers, audit completion, check for overdue or incomplete tasks
  • Region wide care plan audits – checks for network system wide performance against established national goals and guidelines, including specific audit for the local area
  • Screening – undertake screening and call and recall activities
  • Clinical rules – set up and run a series of clinical rules and processes
  • Outcomes monitoring – define outcomes and analyse and report, possibly through the KPI system
  • Resource Utilisation

Insync can be extended with a customer relationship management (CRM), claims processing and financial management system.  The system has these capabilities:

  • The CRM is a module that enables divisions to manage their membership services and track their members
  • Implement health funding programs for collections of related services
  • Set up budgets and phases for each program, indicating whether or not the budget can be overspent
  • Define adjudication rules for each service within a program, so that the system can electronically adjudicate and report the adjudication to a financial system
  • Electronically receive and report explanation of benefit systems (EOB)
  • Multiple capitation calculators with variable rates, date ranges and periods
  • Integrated Contract management system as described above

The software suite includes a community based case management system that allows case managers to implement multiple cases, with specific case outcomes, ADT, services, tasks recalls, objectives and notes.  The system allows the following:

  • Implement case management
  • Track referrals and accept, hold, decline referrals, or make cases
  • Assign case care teams
  • Track Admission, Discharge, Transfers and movements
  • Undertake multiple diagnosis and service discharge coding
  • Provide case orientated views of the clinical system
  • Track case tasks and recalls
  • Review case actions and activities by activity type or by date
  • Pre-approve planned care against the case and then allow the claims processing system to undertake automatic adjudication based on specific, tailored care for the patient when combined with the claims processing system

Automatic identification of, and registration of high risk cases based on clinical rules when used with the claims processing system

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