EXPERT HUMAN INTELLIGENCE
Goodbye, Doctor Referrals.
We’ve Got a Better Way.
Guided by our Clinical Advisory Board of world-class physicians, we are pioneering the
process of defining doctor quality at the condition level.
A MEDICAL DIAGNOSIS CAN BE SCARY
Recently diagnosed? Now what?
When someone is facing a diagnosis that threatens their quality of life, it may feel overwhelming and confusing. They want the assurance that their physician has proven expertise with your condition and accepts their insurance. And, they aren’t sure exactly where to start.
QualityCare ConnectSM gives them much more than the names of physicians. We add value, a personal touch, by ensuring the optimal patient-physician match leveraging evidence-based data science and the expertise of our experienced healthcare team and world-renowned Clinical Advisory Board.
CLINICAL INSIGHT WITH A HUMAN TOUCH
We know which doctor to see.
No matter the diagnosis, we know the best way to find a good doctor for our members. We leverage our clinical human navigators’ expertise in selecting and matching physician profiles. Having identified the optimal area of expertise for each condition, we find physicians who are leaders in their fields.
Whether its for a routine checkup, initial specialist referral, or getting a second opinion, our Care Navigation team provides the heartbeat to our business and personalized advocacy whenever patients need it.
“Getting the right patient to the right doctor the first time is a critical aspect of healthcare today.”
Head of Spinal Surgery, Department of Neurosurgery, Cleveland Clinic
Member of ArmadaHealth’s Clinical Advisory Board
IMPROVING HEALTHCARE OUTCOMES
How exactly do we define quality?
Defining quality in healthcare is no easy task. Fortunately, we have a team of physician experts on our side, and they help us determine the right clinical focus areas for each condition. They also identify our target metrics and help us ask the hard questions, like:
How many procedures performed per year are acceptable for us to recommend a surgeon for pancreatic cancer?
What is an acceptable complication rate for hip replacement procedures?
What kind of specialist should we recommend for gestational diabetes?
To answer these questions, we start with evidence-based clinical outcomes to define healthcare quality. Next, we leverage large volumes of data to determine qualifications and highlight relevant experience.
We can narrow the field of physicians to identify the ones of highest quality with the help of :
- Published evidence-based guidelines
- Internal and external subject matter experts
- Our Clinical Advisory Board
Together, we define and maintain definitions of healthcare quality at the primary, specialty, subspecialty and condition level, which we then translate into ontologies and algorithms on our data science platform.
PEOPLE CAN’T FIND THE RIGHT DOCTOR ON THEIR OWN
Why Health Plan Directories Are Not Enough
Suzanne Clough, MD, Chief Medical Officer for ArmadaHealth, explains why health plan directories aren’t enough to help people find the right doctor, and what we could do to fix it.
CLINICAL ADVISORY BOARD
See how Navigation-as-a-Service improves your member experience and enables you to drive down costs.