Maccabi
Background
Maccabi Healthcare Services is the second largest HMO in the Israel providing all-inclusive health services based on a decentralized organizational approach. Maccabi members benefit from access to over 3500 physicians, 150 branches, 250 diagnostic centers, 600 pharmacies and public & private hospitals and facilities.
Challenge
The integration of the entirety of Maccabi's information systems has led to a digital information overload. Maccabi had no procedures in place to assist in the filtration of the vast amounts of data and few means by which to incorporate facts and figures. Atypical circumstances went by and large unnoticed while Maccabi practitioners and care givers, barely received any online recommendations or alerts to support their decision making process and were left to rely merely on their expertise.
Solution
Clinical, as well as administrative, alerts & recommendations for any Maccabi member, are provided by MediRule. MediRule assists staff in making the correct treatment and medication choices based on medical history while guaranteeing strict adherence to care and medication policy. MediRule helps eliminate the human error factor and provides an added layer of caution necessitated by the ever rising healthcare expenses and malpractice insurance rates. In addition, MediRule effectively evaluates eligibility up front, enabling Maccabi to determine insurance coverage, services entitlement and the deductibles and co-pays of the policy.
Results
MediRule has presented Maccabi with real-time alerts & recommendations for the provision of crucial insights derived from the EMR. MediRule affords each directory (diabetes, hypertension, eating disorders etc.) with a relevant set of rules resulting in specific, personalized guidelines. Furthermore, in instances of prescribed medications, MediRule carries out contra-indicator inspections, raising all potential medication exclusions.
MediRule is maintained by non technical personnel (physicians and administrative personnel) and has facilitated Maccabi in maintaining an optimum relationship with its patients. MediRule has significantly improved Maccabi's quality of healthcare for a better and healthier future, providing preventive healthcare as well as dramatically superior cost effectiveness.