HealthHelp’s clinical guidelines are developed from collaborative efforts between practicing clinicians and renowned academic centers. Following a formal and unbiased process for evaluating peer-reviewed literature and general practice recommendations, our evidence-based guidelines are designed to deliver optimal patient care and outcomes.
Dynamic Program Design
HealthHelp’s Consult platform includes a dynamic program design that visually and seamlessly modifies or captures new practice guidelines and protocols. This provides our medical directors direct control over the best practices utilized within each specialty and the ability to update guidelines in real-time
based on the latest published
Educational Behavior Reform
By supporting and educating providers about safety, quality, and appropriateness of tests and treatments for each specialty under management, HealthHelp drives voluntary compliance and alters patterns in procedure requests. These behavior changes eliminate unnecessary utilization and increase savings. We also offer incentive plans to further encourage provider engagement.
Automated Decision Support
Our web-based Consult system and decision support tools allow providers to seamlessly receive guidance for performing the most appropriate tests and procedures, based on the relevant patient clinical criteria. Providers are guided to the best alternatives to the original test or procedure request. If the initial request is unable to be resolved, further review and guidance is offered in a clinical consult to explore special circumstances surrounding a patient’s care.
Specialty Nurse Consult
HealthHelp nurses evaluate requests and provide approvals for treatments within clinical guidelines. For procedures that fall outside of these criteria, nurses will collaborate with physicians to discuss alternative care pathways. Nurses also provide education to the ordering physician about clinical guidelines relevant to the patient’s case.
HealthHelp conducts peer-to-peer reviews and consultations using leading physicians matching the specialty of the ordering physician. Our method facilitates discussion for each case openly and without bias. After consultation, HealthHelp’s specialty physician and the ordering provider determine the best course of action, which results in agreement, change, or withdrawal of the initial test or therapy request. Disagreements are recorded for collaborative provider educational initiatives we undertake including Continuing
Medical Education credits for completed
Specialty Benefits Management
The HealthHelp model applies an intuitive and consultative approach to specialty benefits management. For transparency between HealthHelp and the payor, we regularly provide performance reports with clear metrics including analysis of safety and quality improvements in patient care and resulting cost savings and ROI. HealthHelp’s proven model helps to curtail specialty-specific utilization and spending and brings a layer of management that is unsurpassed in the industry.
Quality, Safety, and Cost Savings
Our clinical support and education motivates behavior changes. Physicians learn to request the most appropriate treatments for patients, resulting in improved savings, credibility, safety, and long-term outcomes. HealthHelp’s clinical outcomes research team conducts retrospective studies jointly with the payor, to determine opportunities for improvement in safety, quality, and outcomes. We use the feedback as a model for creation of new programs.