Carewise, Inc. Links with ThinkMed for Data Mining
ACTION ITEMS

CareWise, Inc., a Seattle-based demand and disease management provider, has signed an agreement with ThinkMed, a provider of clinical logic, data mining and decision support software.

CareWise, Inc. will use ThinkMed Expert to target patients for its care management interventions and to assist in measuring the effectiveness of these interventions for its clients. As a targeting tool, ThinkMed Expert enables systematic patient identification, stratification and analysis utilizing claims data to support patient-centric population health management.

"Our industry faces the challenge of finding more effective methods to improve ROI by reaching individuals who are or soon will be costly utilizers of medical care," said Craig S. Russell, CareWise, Inc.'s vice president of marketing, products and sales. "CareWise has expanded beyond triage, shared-decision counseling and chronic disease management to more effectively serve a broader population through health needs assessment and targeted member communications. Our collaboration with ThinkMed allows us to further target our services by identifying patients who will benefit most from our many initiatives."

ThinkMed will assist CareWise, Inc. in centralizing patient claims and demographic data into a proprietary patient-centric relational database. ThinkMed Expert will be used to mine the data, with ThinkMed's rule-based clinical logic serving as a filter to define specific and actionable patient groups according to CareWise's needs.

"CareWise, Inc. continues to make great strides in its evolution as a highly progressive care management organization," said Drew Palin, MD, ThinkMed's founder, chairman and CEO. "Not only will CareWise's clients benefit from a more systematic and proactive approach, so too will the patients they serve. We are extremely pleased to collaborate with an organization that exemplifies true leadership in developing such a quality-driven, cost-effective health care delivery model."

CareWise, Inc. will use ThinkMed Expert to identify and target patient groups for enrollment into its demand and disease management programs, which include CareWise, a comprehensive decision counseling service featuring a 24-hour nurse phoneline, and CareSupport, a targeted outbound, stage-based counseling program for people with chronic conditions.

Russell cited the following examples of ThinkMed's application: "Asthmatics using a bronchodilator could be identified and scheduled for outbound nurse calls for further assessment or education," he said. "Patients using steroid inhalers could be identified for our asthma disease management program. And chronic over- and under-utilizers of medical care could be directed to specific interventions to assist them in accessing more appropriate levels of care."

In addition, ThinkMed Expert will identify specific subsets of patients for CareWise's targeted educational mailings and for administration of CareWise's Health Needs Questionnaire (HNQ), a tool that predicts future health care utilization.

CareWise, Inc. is a national provider of health care decision support services that lower the cost of medical care while improving plan members' health and satisfaction with their health plan. Clients include United Airlines, HMO Blue/Blue Cross Blue Shield of New Jersey, the American Postal Worker's Union Health Plan and Capital District Physicians' Health Plan, Inc. PhyCor, Inc. has announced its intention to acquire CareWise, Inc. with closing scheduled for July 1998 ( http://www.carewiseinc.com ).

ThinkMed offers physician-developed logic that is comprised of thousands of unique database queries (rules) which search claims, demographic and other data to identify, profile and monitor patients who are at risk for clinical deterioration, financial escalation and/or increased utilization. On average, ThinkMed's logic identifies high-risk/high-cost patients when as little as 10% to 30% of total expected costs are incurred. This provides a window of opportunity for implementing proactive and targeted management interventions. ThinkMed's clients include WellMark (BlueCross BlueShield of Iowa), Oxford Health Plans, BlueCross California and American Medical Securities ( http://www.thinkmed.com ).