Assessing patients with software

The Washington PostFebruary 9, 2014 

HEALTH-DATA31

Keith Dunleavy, chief executive of Inovalon, says that ePASS is meant to guide – not replace – health-care providers by suggesting questions relevant to each patient.

JEFFREY MACMILLAN — VIA THE WASHINGTON POST

The next time a patient walks into a Walgreens clinic, the clinician may not be the only one assessing patients.

Soon, hundreds of Walgreens clinics will be equipped with new software that guides health care providers through checkups – requiring them to ask certain questions or request particular lab tests depending on the patient’s history. The software, called ePASS, was developed by Inovalon, a Bowie, Md.-based health IT firm with about 3,000 employees worldwide.

Inovalon’s analytics churn through data from more than 100 million patients and uses predictive algorithms to suggest health conditions they might have. Last month, Inovalon and Walgreens announced that clinicians may use ePASS to assess any patient whose records Walgreens has on file, expanding the number of patients Inovalon reaches. Previously, only patients whose health-plan providers had granted Inovalon access to their files would be assessed using ePASS.

Inovalon is one of many businesses managing and analyzing the large volumes of data stored in electronic health-record systems to predict problems; others include Reston, Va.-based Altruista Health, which identifies high-risk patients for health insurance companies; Vitera, a Tampa, Fla.-based firm whose analytic software tracks tests and referrals; and New York-based start-up AllazoHealth, which focuses on whether patients are taking their medication.

Before partnering with Inovalon in September, Walgreens did not use any predictive software to help clinicians question patients, said Heather Helle, divisional vice president of Walgreens clinics.

Walgreens has been gradually setting the system up in clinics across the United States, beginning with Philadelphia.

“Being able to have the power of advanced analytics at the point of care, and being able to combine that with immunization and lab resources we have” means clinicians have “as much information up front as possible when a patient checks in for assessment and is taken into the back room,” Helle said.

Upon arriving at a Walgreens clinic, patients sign in at a computer kiosk, and their names are fed into a list on a clinician’s computer in an examination room. During the checkup, the software tailors questions to the patient’s history from health records, and to conditions the patient is likely to have, based on Inovalon’s assessment of millions of other patients.

The system also takes into account patients’ behavior – whether they are likely to get regular checkups and tests or if they avoid them, for instance – so clinicians can make a note to follow up if necessary.

As an example, the software might suggest that a clinician discuss ways to improve kidney function with a 70-year-old diabetic so the patient does not develop blindness, but that discussion might be optional for a healthy 25-year-old with a cold who gets regular checkups.

EPASS ultimately is meant to guide – not replace – health care providers by suggesting questions relevant to individual patients, Inovalon chief executive Keith Dunleavy said. “If you had days to spend with this person and access to all their past care, you could deliver a similar” service.

At the end of the checkup, ePASS compiles a SOAP note – a “subjective, objective assessment and plan,” or a quick summary of the checkup and treatment – which is then transferred back into the patient’s electronic health records.

The predictive system can sometimes be stymied by gaps in health records, Dunleavy said. If a patient’s primary-care provider has not recorded the results of a lab test, for instance, ePASS notifies the provider that certain data points are missing.

The more patients who come to Walgreens, the more data Inovalon’s software collects, gradually improving the algorithm’s predictive capability, Dunleavy said.

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