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The Importance of Rules

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By Jacqueline Mitus, MD, Senior Vice President, Product Strategy; Steve Silverstein, MD, FACEP, Vice President, Chief Clinical Architect; and Matthew Zubiller, Vice President, Decision Management, McKesson Health Solutions

Clear, consistent and reproducible rules logic is at the core of translating information into actionable content. In other words, rules make content more intelligent by tying disparate pieces of information together — for example, heart failure codes and care guidelines — so that a conclusion can be drawn, a recommendation can be made or an action can occur. In so doing, the content becomes meaningful and can drive the right, timely intervention or behavior. 

Value Driven

Rules do not have to be complex to drive value. A very simple rule can be very actionable: for example, an automated reminder to both member and physician about annual mammograms.

Simple or complex, transforming clinical content into reproducible, actionable rules is a highly precise endeavor. Consider how nuance and meaning can be lost in any translation and the time and effort that can be spent debating an author’s original intent. In healthcare, the stakes are significantly higher in “getting it right,” and shades of gray in meaning can affect the intended outcome.

For example, concepts such as “worsening,” “severe” and “over time” are common parameters that need specific definition to become actionable and measurable.

“Rules” for a good rule:

• Is complete, meaning that it has fully considered all the cases relevant to that circumstance
• Similarly understands all the exceptions that can still allow a case to meet the rule
• Considers elements such as timing and time spans, number of activities required before the rule comes into action, inclusions and exclusions
• Is as transparent as possible to support a clear relationship between the input of data and the generation of recommendations
• Is specific and unambiguous

Assessment

To learn more, download the full white paper on Actionable Content: A Framework for Better Decision-Making.

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Filed under: Experts Invited, Practice Management | Tagged: Jacqueline Mitus MD, Making Medical Content Actionable, Matthew Zubiller, McKesson Health Solutions, Steve Silverstein MD | Leave a comment »