FEASIBILITY STUDY OF A PERFORMANCE ASSESSMENT SOFTWARE PRODUCT FOR MANAGED CARE ORGANIZATIONS

QUALITY MANAGEMENT IN HEALTH CARE IS AT THE FOREFRONT OF THE NATIONAL REFORM AGENDA. THE ABILITY TO ASSESS CONDITION-SPECIFIC OUTCOMES, CONDUCT COMPARATIVE ANALYSES, AND INTERPRET THE CLINICAL RELEVANCE, WILL SHAPE AND DEFINE THE HEALTH CARE INDUSTRY'S RESPONSE TO QUALITY IMPROVEMENT INCENTIVES TO CHANGE. TO ENHANCE THE ABILITY TO MANAGE QUALITY, MIKALIX & COMPANY (M&C) PROPOSES THE DEVELOPMENT OF CAP GUIDELINES QUALITY(TM) WILL SUPPORT PERFORMANCE ASSESSMENT ACTIVITIES BY PROVIDING MANAGED CARE ORGANIZATIONS WITH THE ABILITY TO SELECT MEDICAL REVIEW CRITERIA TO EVALUATE PRACTICE GUIDELINE CONFORMANCE, ORGANIZE THE AGGREGATE REVIEW DATA, FORMULATE PERFORMANCE RATES, AND APPLY THESE RATES TO STANDARDS OF QUALITY. THE OBJECTIVES OF M&C'S PROPOSED PHASE 1 RESEARCH WILL DEMONSTRATE THE NEED FOR CAP GUIDELINES QUALITY(TM) AND IDENTIFY A SELECT NUMBER (1-3) OF PRACTICE GUIDELINES IN THE PUBLIC DOMAIN TO BE USED AS THE BASIS FOR PHASE 2 SOFTWARE DEVELOPMENT. PHASE 1 RESEARCH WILL ASSESS PRACTICE GUIDELINE USE AND PERFORMANCE ASSESSMENT METHODS USING A QUALITATIVE RESEARCH INTERVIEW METHOD, DEFINE THE SYSTEM REQUIREMENTS FOR SOFTWARE DESIGN AND IMPLEMENTATION, AND IDENTIFY THE STRATEGIES AND RESOURCES NECESSARY TO ASSURE SUCCESSFUL PRODUCT INTRODUCTION TO THE MANAGED CARE MARKET.