POPULATION HEALTH CARE TRANSITION

摘要

Methods, systems, computer storage media, and graphical user interfaces for population health management are disclosed. The population health management system may allow for cross-continuum tracking and subsequent interactions with transactional systems, providers, and/or patients. The population health management system may include utilizing clinically relevant algorithms to populate registries to enable healthcare providers to better facilitate care for a population of patients. The population health management system may consolidate and provide comprehensive condition-specific and/or patient situation specific information that is accessible and updatable across venues. The population health management system may create cross venue antibiograms based on medications information and susceptibility results which can be filtered for selected demographics. The population health management system may be utilized to provide multiple medication options including dosing, generic alternatives, cost, availability, and susceptibility information. Inappropriate trends may be flagged and monitored and medication stewards may be alerted or notified to intervene.

主权项

1. One or more computer storage media storing computer-executable instructions that, when executed by one or more computing devices, cause the one or more computing devices to perform a method that facilitates designing and utilizing population health programs
receiving, at a population health server, healthcare data from disparate sources; identifying a population of patients based on a set of criteria selected by a user; stratifying the population of patients, via the population health server, based the set of criteria and on one or more algorithms to create one or more groups of patients, wherein at least one group of the one or more groups of patients comprises a plurality of patients having at least one substantially similar attribute; and utilizing the population health server to create at least one transition registry comprising transition care information for at least a portion of the one or more groups of patients; and upon receiving a selection of a patient from the transition registry, providing transition care information to a clinician device associated with a clinician making the selection.