The use of an integrated clinical laboratory and pharmacy diabetes database to provide physician performance feedback in an IPA-model HMO.

ABSTRACT

The ability to link pharmacy claims and clinical laboratory result databases in a managed care setting holds great promise as an outcomes management tool. The authors have created a powerful disease management capability that generates dynamic, disease-specific reports containing actionable, provider-patient-level laboratory and pharmacy information. This system is used to send reports to primary care physicians in an independent practice association (IPA)-model managed care setting to improve the care of patients with diabetes mellitus. This systematic feedback methodology can augment physician decision-making behavior, promote compliance with national guidelines, and measure improvement in plan-level, population-based outcomes over time.