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Care Insights delivers actionable, informative insights to help providers and care teams identify and address care opportunities at the point-of-care.
Insights span multiple use cases — including quality measures, risk adjustment coding, utilization management, risk mitigation, care management, and more — and are designed to support patient engagement while making point-of-care documentation easier and more accurate.
Each interaction captures structured feedback that’s sent back to the data source, whether that is the payer, ACO, analytics vendor, etc. When applicable, relevant ICD and CPT codes are automatically written back to your EHR, streamlining documentation and reducing manual entry.
Why It Matters
Engaging with Care Insights workflows may help providers and care teams:
- Engage patients in optimizing health outcomes by reducing missed opportunities
- Improve coding accuracy and clinical documentation
- Support risk adjustment, quality measure compliance, and care management goals
- Enable data-driven feedback that improves future insights
- Streamline point-of-care actions across data sources, reducing administrative burden
Workflows
1. Agree & Select Workflow
What It Is
Allows providers or care team members to confirm or update diagnosis codes and relevant procedure codes during a patient encounter — ensuring accurate, current documentation at the point of care.
How It Works
When a diagnosis gap or quality insight appears, you may see an “Agree & Select” option. Selecting it opens a list of ICD or CPT codes for review.
You can:
- Confirm the pre-selected codes
- Uncheck or replace the codes
- Search for and add new codes that better represent the patient’s condition, status, and/or services delivered
When to Use It
You can only use Agree & Select during the patient encounter.
What It Does
- Writes confirmed ICD codes back to the patient’s Assessment and Problem List. or CPT codes back to the encounter’s billing section.
- Displays a notation confirming acceptance.
- Agree and Select response is sent back to the data source.
2. Agree Workflow
What It Is
The Agree workflow is used when a provider or care team member confirms that the presented gap or insight is actioned, supported by documentation entered into the patient’s chart.
How It Works
You may see an “Agree” option on a quality measure or other insight.
Selecting Agree confirms that you’ve reviewed the item, taken action to address the opportunity, and entered documentation in the EHR as appropriate.
What It Does
- Displays a notation below the insight confirming acceptance
- Sends an Agree response back to the data source, closing the loop on that insight
3. Dismiss Workflow
What It Is
The Dismiss workflow allows care teams and providers to remove insights that don’t require further action or are not able to be actioned, cleaning up measure denominators and providing relevant feedback to the data source. Some data sources may require you to select a dismiss reason when submitting the response.
When to Use It
- In the patient chart: Care team members can dismiss insights during quality chart reviews, pre-visit planning, and other workflows to curate insights to only those that are actionable, ensuring other care team members only see what needs attention when the patient’s visit occurs.
- During the encounter: Providers can dismiss insights in real time as part of clinical review.
What It Does
- Sends a Dismiss response back to the data source
- When applicable, dismiss reasons inform whether a gap may be resurfaced in future encounters or should be removed from being an actionable opportunity.