Clinical Content

Click4Care provides the ultimate flexibility and depth when it comes to aligning
with your medical policy. Today, our highly configurable care management platform
allows our customers to leverage their own clinical content, under development are
Click4Care developed content through our Care Management Pathways™. We also provide
out of the box integration to InterQual and Milliman clinical criteria.
Imbedded within Click4Care is a full suite of content authoring and workflow management
tools, allowing our customers to define, copy/edit, and update assessments, including
business rules that align program-specific materials, interventions, talking points
and correspondence to the appropriate health and wellness, case, or disease management
activity.
Click4Care includes Integrated Workflows for all care management activities. Our
unique Work Board, a virtual “Mission Control” where all CM, DM and UM notices,
alerts and overdue items are highlighted, provides the most important aspects of
your workload quickly and easily to the user’s attention. Additionally, a supplemental
Supervisor Dependent View (SDV) is available through the User Interface, allowing
care managers and supervisors a quick view into their care team’s progress.
Health and Wellness is included within the Click4Care 360° Member Record and integrated
with Case Management, Disease Management, and Utilization Management to continually
keep all Member data refreshed. Our comprehensive, integrated care management capabilities
are uniquely designed to provide best-in-class workflow configuration and care plan
functionality, designed by our product management team made up of experienced clinicians.
The result for our customers is a positive effect on MLR while also fully automating
the administration of wellness programs that not only save on members’ claim costs,
but also promote healthy behaviors.
Within our Health Risk Assessments, the Click4Care Member Record can consume external
HRA’s or a HRA can be configured utilizing Click4Care's full suite of content authoring
and workflow management tools, including risk stratification tools. Additionally
Click4Care can support the calculation and tracking of Incentive Based Benefits.
For those who prefer vendor provided and supported clinical content, Click4Care’s
content is extensively researched and incorporates evidenced based guidelines as
well as nationally accepted guidelines from organizations such as the CMSA, DMAA,
NCQA, URAC, National Guidelines Clearinghouse, and other specialty organizations.
Click4Care's clinical team continually reviews these guidelines to keep our
clinical content current. Our programs are imbedded within Click4Care’s intuitive
automated workflow engine which proactively identifies Care Opportunities, Gaps
in Care, and potential areas of need regarding evidenced based care. Click4Care’s
programs identify and automated guidance to associate stratified and individual
based goals, care management interventions, and patient and provider actions. To
measure the effectiveness of a program’s impact to a member’s care, Click4Care reports
when opportunities are identified, the length of the process, process status, and
process outcome.
While measuring a program’s impact, Click4Care also reports on the barriers to the
overall patient's wellbeing and specifically to meeting their goals.
Click4Care Clinical Pathways™ will promote organized and efficient member
care thus improving outcomes tied to the interventions and actions. The multidisciplinary
management approach to development of the Care Management Pathway’s ™ provides comprehensive
care management support for the member. Click4Care Clinical Pathways coupled with
our workflow engine allows for an early identified, consistent approach; enriched
reporting of care management outcomes; and positive effect on the overall health
and wellness of the member. Our current list of committed disease conditions is
below, additional development will align with customer requests.
Oncology Suite
- Lung Cancer
- Breast Cancer
- Prostate Cancer
Disease Management Suite
- COPD
- CAD
- HF
- Asthma
- Diabetes
- Kidney Disease
Case Management Suites
- Complex
- Low Back Pain
- Hip and Knees
- Hypertension
- High Risk Pregnancy
- Healthy Pregnancy
- Wellness
- Healthy Behaviors Assessment (only)
- Weight Management
- Exercise Management
- Tobacco Cessation
Behavioral Health