TomorRx Software

  MD-info helps manage timely interventions to optimize care and cost for Clinical Pathway Automation.


The MD-info Pathway Database contains a customized series of procedures frequently used by the service provider.  Each diagnosis points to a series of procedures and medications; their schedule and resource demands, and a list of appropriate outcome indicators. In all cases, the pathway database maintains information about the acceptable range of values for indicators and intervention time frames.

Visual feedback

When you try to move an appointment, MDinfo displays visual clues to prevent errors and omissions. To change the date of an appointment, simply drag it to the new column.
 
If this action places the patient outside the pathway, a variance alert will pop up to warn the operator of pending variance creation. Similarly, failure to deal with a scheduled intervention causes an alert if the delay generates a time variance.

After patient encounter, one click generates any claims and automatically submits them to the appropriate carrier(s) for reimbursement. For capitated plans, only encounter transactions are generated.

Pathway Components:

• List of Procedures and Medications.
• Timeline for interventions.
• Index of problems with outcome criteria.
• Critical path with multidisciplinary staff interventions.
• Variance record.

The pathway automation begins when a Primary Care Provider determines that treatment is needed.  With a preliminary diagnosis in hand, a request for authorization (referral) is transmitted over the internet to the patient’s HMO or Insurance Carrier. (Some Providers have direct referral privileges to bypass this process.)

Operate MD-info at the Primary Care Provider’s office so that one click checks the member's plan enrollment database to determine eligibility for services in the clinical pathway; then submits the referral request over the internet. In addition, the Referring Provider may call the carrier or FAX a hard copy request. The IPA or HMO validates eligibility and directs the referral to a contracted provider.  When processed automatically, the referral is sent via EDI to the provider’s secure internet address.