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March 28, 2013 /PRNewswire/ -- TRICAST today announced the debut of its new
Gaps in Care Analysis product, a set of analytic tools that enable any organization to gauge the effectiveness and performance of its wellness and preventive medicine programs.
What Are Gaps in Care?
Gaps in Care, sometimes referred to as Gaps in Coverage, are found by identifying the discrepancies between recommended best practice medical care, and the medical care that is actually provided to a patient. The gaps generally result from obstacles that prevent patients from implementing a physician's recommendations.
"TRICAST's Gaps in Care approach focuses on the key diseases linked to both high-cost medical programs and complex medical conditions. The value of the TRICAST analysis lies in our ability to proactively identify members who are receiving less than optimal treatment and then direct them to more active care management, or medical therapy management programs," says TRICAST President
Greg Rucinski, R.Ph.
The Data Holds the Answers
TRICAST begins a Gaps in Care analysis by examining medical, pharmacy, and episodes of care data. After it ingests the data and uses its proprietary software tools to analyze these crucial components, TRICAST identifies and portrays diagnoses, procedure codes, and pharmaceutical treatments.
Disease State Profiles
Armed with this information, TRICAST can profile disease states and their associated costs by comparing the "best practice" treatment of a disease state to actual patterns of treatment. The reports that result define the gaps in care for these disease states:
Coronary Artery Disease
Chronic Obstructive Pulmonary Disease with Asthma
Each disease state is profiled for total costs, as well as members identified with gaps in each one of those treatment modalities. Members having 10 or more gaps in each disease will be portrayed in the reporting system. TRICAST also defines and compares treatment gap patients with average costs per disease state to patients with no gaps in therapy to determine if the gap patients are increasing medical costs on a long-term basis.