What is W3 DRS? W3 DRS is an information driven software solution designed to help managed care organizations control costs and improve the quality of care they deliver. W3 DRS is a robust and flexible analytic tool that allows healthcare organizations to analyze their valuable data to make financial and clinical management decisions faster and more accurately. How is W3 DRS built? W3 DRS is constructed from your organization's own raw data - claims, enrollment, provider files and pharmacy data. Our team of healthcare informatics experts - each with years of experience managing healthcare administrative data - work with your team to determine the specifications of your custom version of W3 DRS. Once we gather the data, it is scrubbed, transformed and loaded into an Oracle database. Next, a series of multidimensional "cubes" are built to allow your users to filter and analyze your data across all the relevant dimensions and measures. To enhance your data usefulness, W3Health adds clinical analytic intelligence, including ETGs, DCGs, Evidence-based Medicine metrics and HEDIS Effectiveness of Care measures. What tools were used to develop W3 DRS? W3Health uses PowerPlay for the Web by Cognos to develop the reporting component of W3 DRS. The database is a combination of Cognos multi-dimensional cubes and an Oracle database, so you can "drill down" to detailed service data. What is W3 DRS Network Management and how can it help my organization? Network Management delivers a robust set of capabilities to help you to measure costs and utilization trends across your network of physicians; create severity adjusted profiles of your providers; identify and track high impact members; and perform other customized analyses to track out-of-network leakage and prescription drug usage. What is W3 DRS Clinical Management and what can it do for my organization? Clinical Management is the latest enhancement to W3 DRS. This module contains critical functionality that enables your organization to predict resource use among your patient population; track physician performance against Evidence-based Medicine metrics; and assess quality of care with HEDIS Effectiveness of Care measures. What are Episode Treatment Groups? W3 DRS utilizes Symmetry Health Data Systems' Episode Treatment Groups (ETG). Symmetry's patented ETG grouper is a patient illness classification system and episode building software product that captures all clinically relevant services and prescriptions provided during a patient's treatment. ETGs group services together based on data from inpatient, outpatient and pharmacy claims and can be used to perform risk-adjusted performance comparisons among physicians. What are Diagnostic Cost Groups? W3 DRS includes Diagnostic Cost Groups (DCGs) from DxCG. DCGs are population-based models that assess the health status of a population and predict cost and resource use. DCGs enable organizations to analyze the current risk of a population, as well as predict future risk of that same population. With DCGs, healthcare organizations can adjust current levels of resource use by identifying groups with high impact medical problems and predicting costs by disease state and individual patient. What is Evidence-Based Medicine? Evidence-based medicine is the process of mining the reams of data available to physicians - clinical trials results, outcomes studies, direct patient data, etc. - to understand fully the risks and benefits of various chronic and acute conditions. The results of this effort are "best practices" - based solely on the best medical evidence available from the most current research into the clinical management of patient care - that can help guide patient treatment decisions. How is Evidence-based Medicine used in W3 DRS? The Clinical Management capabilities of W3 DRS include specific reports for key clinical conditions. Your organization's medical directors, clinical staff, and individual PCPs and specialists can view summary reports for each condition, compare the key metrics across a variety of dimensions and measures, and collaborate on techniques to improve patient outcomes. To support the evidence-based metrics for each condition, W3Health provides background information about the conditions addressed, key reference information and a summary of the rationale underlying each metric, all organized in a simple, easy to read format. What are HEDIS Effectiveness of Care measures? HEDIS Effectiveness of Care is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans. The performance measures in HEDIS are related to many significant public health issues such as adequate immunization, cancer, heart disease, smoking, asthma and diabetes, and can be used to compare quality levels among physician groups, or against norms. HEDIS is sponsored, supported and maintained by NCQA. How are HEDIS Effectiveness of Care measures used in W3 DRS? HEDIS clinical quality measures are included as part of the Clinical Management module of W3 DRS. The HEDIS measures included in W3 DRS identify populations of patients and determine whether those populations received treatment for various clinical conditions. HEDIS Effectiveness of Care measures provide an excellent way for healthcare organizations to track quality metrics and report the results to customers and physicians. Using HEDIS measures as part of W3 DRS helps your team align clinical practice patterns with nationally recognized best practices — resulting in a healthier, less costly member base.