Clinical Expertise

Guiding the way to better health care, one person at a time

At Resolution Health, our mission is to translate health information to personal health care guidance, connecting more knowledgeable patients with better informed doctors and health care managers to improve the quality and cost effectiveness of health care for each individual.

The Best Health Care Practices Library

Our desire to improve health outcomes has led us to compile evidence-based care guidelines and clinical best practices, sourced from independent accreditation organizations (NCQA), medical specialty societies (AHA, ADA), government agencies (CDC, FDA), clinical literature and health care experts.

This Best Health Care Practices Library is continually updated. It represents evidence-based, state-of-the art health care knowledge regarding:

• Beneficial disease and condition treatments and medications
• Potentially harmful medication interactions, including drug-drug, drug-condition, drug-age and drug-dose
• Medication regimens and non-compliance
• Physician or health care provider

The Personal Health Scan

Our Personal Health Scan™ analyzes data from an individual’s Personal Health Picture™ and compares it to evidence-based best practices to identify opportunities to improve the quality of health for each individual. We have developed “clinical rules” to power the Personal Health Scan™.

Clinical rules are logical combinations of specific diagnosis codes and individual considerations. These algorithms characterize a number of situations, including an individual’s disease or condition, disease severity or health resource utilization; and can also predict future resource utilization. Other economic rules identify situations where an individual can save money by switching to a formulary-preferred, generic or over-the-counter drug or to mail order delivery.

The Personal Health Scan determines whether an individual is currently receiving the best possible health care, following the best possible preventative health regimen. It identifies the appropriate action that would return an individual to compliance with best practices, such as starting a new medication, enrolling in a disease management program or becoming more aware of disease symptoms or triggers.

Proprietary computer algorithms power the Personal Health Scan

The Resolution Health Personal Health Scan™ uses more than 1,000 proprietary computer algorithms to continually analyze personal health data for millions of health plan members and compare the data to evidence-based best practices, one person at a time.

The health data analyzed through our Personal Health Scan includes an individual’s doctor, hospital and emergency room visits, diagnoses, lab test results, filled prescriptions and health risk factors.

We use computer algorithms to identify and address actionable opportunities to improve health care quality and safety, and to reduce health care costs. Our algorithms are derived from the evidence-based health care guidelines, clinical best practices and health care expert insights that comprise our Best Health Care Practices Library.