How does the Pearl Platform work?
The Pearl Platform prioritizes patients who would likely benefit from care and helps you take appropriate action for them. The platform uses an algorithm to determine which patients may need your attention, and recommends care coordination actions based on data analysis. Taking action and recording it in the platform are crucial for success in value-based care models and for improving the platform's insights.
Pearl Platform Alerts identify and prioritize patients with actionable opportunities to improve care, leading to better health outcomes and lower costs. Each alert includes a description of why the patient was identified and suggests a care coordination action based on clinical guidelines and data-driven insights. You can then review the suggested action and use your clinical judgment to determine the best course of action.
What do the Urgency Reasons indicate?
The urgency score, denoted by the color of each hexagon, is a quantitative measure that helps practices prioritize patients based on the projected benefit of proactive actions. We’ve streamlined urgency scores into four categories:
Do Now: Interventions most likely to improve outcomes and denoted by a red hexagon
Do Next: Actionable interventions denoted by a pink hexagon
Awareness: New information or activity, but Pearl hasn’t identified an actionable, high-value activity to complete. Denoted by a light blue hexagon
Nothing Pending: No pending activity identified denoted by a dark blue hexagon
By taking actions for patients denoted as Do Now or Do Next, the urgency reason will change to a blue color and these actions will be reflected in your proactive management pillar. You can filter by urgency reason by selecting Reason for Urgency at the top of the panel to focus on a specific category (screenshot below)
What are the main categories of Pearl Platform alerts?
The three categories are listed below as well as a description and the alerts that fall into each category
Transitions of Care:
Taking actions on these alerts lowers healthcare costs and prevents readmissions.
Discharged (Transitional Care Management Eligible)
Discharged (Timely Follow-Up QM Eligible)
Discharged
Presented to ER
Transferred
Admitted
Predictive Alerts:
Taking actions lowers preventable utilization and decreases healthcare costs
Preventable ED visit predicted
Unplanned admission predicted
Unplanned Admission Predicted (Chronic Care Management suggested)
Proactive Management:
Improve patient health, benchmark accuracy, and risk coding
Chronic Care Management Opportunity
Advance Care Planning Eligible (with or without HCC coding review)
High Priority Annual Wellness Visit (HCC coding review suggested)
Annual Wellness Visit Eligible
CMS GUIDE Dementia Program Eligible
Overdue Touchpoints
More details on these alerts linked in the pages below: