Quality Improvement

Healthcare Analytics

Caradigm delivers the business and clinical intelligence to generate insights and drive better decisions.


As more healthcare organizations participate in value-based reimbursement models, they have an increased responsibility to report on and improve quality measures. To support population health, your organization needs analytics that deliver retrospective review, ongoing surveillance and predictive modeling.

  •    Retrospective review delivers performance and activity reporting – including patient attribution utilization,    variation in care, and total cost of care.
  •    Current or near real-time reporting supports care management, identifying gaps in care and alerting physicians    and patients for care planning from a population view.
  •    With risk stratification and predictive modeling, you can classify patients by health risk to deliver cost-effective    interventions and predict and prevent readmissions.

Caradigm offers a number of analytics solutions designed to identify the insights within the complexity of healthcare. Caradigm’s offerings include solutions that report retrospective activity, monitor current activity and predict future activity, as well as provide the tools for root-cause analysis.


Caradigm Quality Improvement application helps healthcare organizations more efficiently compute various quality measures including those within ACO, HEDIS, MIPS and PQRS measures sets. It helps track and compare performance against industry-standard or customer-specific quality measures at both a measure-set level and an individual-measure level, perform root cause analysis to identify non-compliance and quality-measure gaps for a facility, provider or patient cohort. Quality Improvement also provides users with a unified longitudinal view of a patient’s measures based on aggregated data, and enables those users to create and track programs or campaigns, enroll patients, take actions for a group of patients and track compliance for individual patients.

Examples of out of the box supported measures:
   •    ACO-Care Coordination/ Patient Safety – Risk Adjusted Claims-based Measure
   •    ACO-Care Coordination/Patient Safety
   •    ACO-Preventative Health
   •    ACO-At Risk Populations
   •    ACO-At Risk Populations -Non-Risk Adjusted Claims-based Measure
   •    ACO-Patient/Caregiver Experience – Consumer Assessment of Healthcare Providers and systems (ACO-CAHPS)
   •    HEDIS CCS
   •    HEDIS CHL
   •    HEDIS CDC
   •    HEIDS AWC
   •    HEDIS W15
   •    HEDIS W34

Advanced Computation Engine

Core to the Caradigm Quality Improvement application is the Advanced Computation Engine (ACE), This measures computation engine uses industry standard quality measure definitions–Health Quality Measure Format (HQMF), maintained by HL7–to evaluate patient data and compute a patient compliance value.

A number of patient-specific views organized by content modules, are available as part of the core configuration to help healthcare organizations identify and manage gaps in quality measure performance. Examples of content modules supported include:
   •    Measures Compliance
   •    Allergies
   •    Diagnosis
   •    Medications
   •    Immunizations
   •    Labs
   •    Demographics
   •    Vitals

Patients can subsequently be enrolled into specific campaigns where it can help you understand a patient’s overall performance.

Measuring performance relative to benchmarks or organization-specific targets is a way for organizations to track performance on associated quality measures over time. Caradigm Quality Improvement provides interactive performance benchmarks and targets to support you in this area.


How it works



Key Features

   •    Advanced Computation Engine
   •    Performance Benchmarking
   •    Quality Gaps Analysis
   •    Patient-Centric Quality Management
   •    QI Programs and Campaigns Tracking
   •    Configurable User Roles


Key Benefits

  •    Track and compare performance against customer-specific quality measures or industry-standard quality    measures such as ACO, HEDIS, and MIPS
  •    Compute quality measure types including proportion, ratio, continuous variable, and composite scores
  •    Perform root cause analysis to understand measure performance and quality gaps at a facility, provider and    patient level
  •    Provide users with a longitudinal view of a patient’s information based on aggregated data from many source    systems
  •    Create and track programs or campaigns, enroll patients, take actions for a group of patients and track measure    performance over time
  •    Customize user profiles to support provider-specific views of data
  •    Enable care managers to generate and manage care tasks based on quality measures performance