As a leading provider of shared care records, our CareCentric software collects and integrates data across the whole health and care system.
This rich community-wide data is available via our cloud-based Population Health analytics platform to help segment, stratify, analyse pathways and identify gaps in care.
Our Population Health solutions can also help to plan and prioritise where investment should be made, as well as evaluate the impact of interventions.
By embedding Population Health analytics directly into the CareCentric integrated care record and myCareCentric Personal Health Record and Care Apps, both care professionals and patients can use the insight for decision support.
Use case - Diabetes diagnosis
We have collaboratively designed a dashboard which uses the shared care record to identify patients whose latest HbA1c and/or blood glucose results indicate that they may have diabetes, pre-diabetes or are at emerging risk but are not coded as being on the QOF diabetic register. This has obvious benefits in terms of supporting early intervention and prevention.
This dashboard will be part of a suite of dashboards which identify coding quality/possible missed diagnosis, including hypertensive patients with high BMI/blood pressure and also COPD exacerbation admissions without a primary care diagnosis.
Being development partners with Graphnet and using their population analytics platform has really enabled us to build the supporting analytics that enable our move towards developing a mature population health Intelligence system.
Mark Sellman – CIO Frimley Health and Care ICS & Connected Care