UHC Now Offers Outpatient Encounter Data To Help Members Better Understand and Manage Care Across the Continuum

New Data Provides Opportunities to Improve Care Coordination for Complex Patients

Feb 08, 2012, 15:55 ET from UHC

CHICAGO, Feb. 8, 2012 /PRNewswire/ -- UHC announced it now includes outpatient encounter data and reports as part of its Clinical Data Base/Resource Manager™ (CDB/RM). The new data are available for various outpatient settings to help UHC members improve the efficacy and cost-effectiveness of care across the continuum.

"We have been working closely with members to address the dramatic shift in services to outpatient settings and the need to coordinate outpatient and inpatient care," said David Levine, MD, UHC associate vice president of informatics and medical director. "These outpatient encounter data represent a major leap forward toward our goal of giving members a complete picture of a patient's entire episode of care."

The first phase of the outpatient encounter launch was the release of three report templates—Patient Outcomes, Summary of Charges, and Case Profiles—that are available in the CDB/RM's Report BUILDER beginning with data for first quarter 2009. UHC is quickly adding to and building out its data sets, which currently include the following encounter types:

  • Ambulatory surgery center, freestanding
  • Ambulatory surgery center, hospital-based
  • Emergency department (not admitted to inpatient)
  • Emergency department observation (not admitted to inpatient)
  • Observation
  • Other (e.g., chemotherapy, radiation therapy, gastrointestinal laboratory and urology procedures, clinic visits)


UHC members can analyze this information to gain insights into outpatient capacity and resource utilization. For example, reports using outpatient data can help physicians or administrators identify patients with a given disease state (e.g., colon cancer) and analyze the services they received (imaging, pharmacy, laboratory testing, etc.).

"The more info we can give to providers about their patients, the better those providers can be at providing quality care," said Levine. "The access to this data and the ability for hospitals to act upon it can potentially help decrease overall costs and increase patient satisfaction."

"Pharmacy administrators are excited to use these data given the great amount of attention focused on pharmaceutical utilization for outpatients," said Doug Smith, PharmD, UHC senior director, Capital Resource Program and Supply Chain Services. "Information on variations in drug use within specific clinical populations can help these administrators eliminate waste as well as set and manage appropriate budgets."

During the next several months, enhancements to outpatient encounter data will include additional data on observed direct and total costs and the availability of online data-quality reports. Also in development are risk-adjusted values and algorithms to help members identify complications and analyze patient returns and/or readmissions.

Outpatient encounter data are available to all CDB/RM subscribers.

About UHC

UHC is an alliance of the nation's leading nonprofit academic medical centers, which are focused on delivering world-class patient care. Based in Chicago, Ill, UHC fosters collaboration with and among its 116 academic medical center and 258 affiliated hospital members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. UHC helps its members achieve excellence in quality, safety, and cost-effectiveness. Formed in 1984, UHC's membership includes more than 90% of the nonprofit academic medical centers in the United States. For more information, visit uhc.edu.