Quality Navigator

NLP-Assisted Reporting and Tracking for Quality Outreach Teams and Providers

Quality Navigator uses NLP to analyze HEDIS®-specific clinical events in the medical record, flag members in the relevant cohort, and group them to enable efficient, targeted outreach strategies for Quality Teams and Providers.

Timely Intervention for Hard-to-Move Measures

Star ratings for measures like OMW (Osteoporosis Management in Women who had a fracture) are notoriously difficult to move. That’s because Quality teams rely on claims data that appear weeks after the event when outreach efforts face significant friction. For OMW and measures like it, timely outreach, and intervention are key.

Quality Navigator’s reporting tools can identify OMW and other time-sensitive gaps weeks before the claim, allowing early QI intervention and increased compliance.

Key Benefits

Targeted Quality Improvement Opportunities

Astrata’s clinically focused NLP pinpoints specific types of “leads” – for example, an order for a colonoscopy with no documentation of results – and groups members with those lead types together.

Flexible Reporting

Outreach managers can design reports that slice and dice member outreach lists into effective groupings and deliver them to the teams best equipped to manage them, maximizing available Health Plan and provider resources.

Tracking Dashboard

Review team progress month over month.

Quality Improvement Opportunities	BCS	CCS	OMW	COL
True open gaps
No date for procedure
Ordered, no results
Due next year
True gaps with recent fracture