The Health Summary is a record of a Person’s claims, authorization, and care management data from a selected payer. It presents a historical view of the conditions for which a Person has been treated. In addition, it displays real-time care management plans, clinical indicators, medications, lab test results, visits, cost summaries, and current and past conditions.

* Access to Utilization Management or Care Management * Permission to access a Person's Comprehensive Person View (CPV)

When gathering information on a Person to gain knowledge on the Person’s entire health history in a quick and efficient manner. Information provided in Health Summary provides data necessary for offering personalized Care Management based on each Person’s different needs and health history.

Navigate to a Person's Comprehensive Person View, CPV.

You can view the Health Summary page in either a split screen or full page mode:

You can also view data from a predefined period or select a custom date range.

Health Summary is accessible from within the Comprehensive Person View (CPV). Click the arrow to expand the panel.

_(Alternate)_ The Health Summary can also be accessed from within a Program or a request.

Health Summary can be viewed in a split screen or full page by clicking on the arrow to expand.

Click the arrow to expand the view of the Health Summary to full page mode. A new browser tab opens.

The Health Summary Details section includes the Health Status Measure and Chronic and Acute Conditions.

Note: The data displayed is defaulted to the past 12 months. However, you have the option of either viewing data from a predefined period or selecting a custom range.

The **Health Status Measure** is a proprietary Medecision score from 1 (low) to 10 (high) derived by the analytic system. The score represents a risk for the member for ongoing health and medical costs relative to the population. The overall score for a Person is listed on the far right-hand side.The Health Status Measure calculation considers both observed and predicted outcomes.

Both **Chronic** (conditions expected to last at least 12 months or until death) and **Acute** (condition that develop suddenly and have a short duration, usually days or weeks) conditions reported for a Person are found here.

Note: Sections can be collapsed and expanded by using the arrows on the right-hand side of each section.

The Recent Activity section shows a summary of recent activities in the members’ care management and is defaulted to last 30 days. It highlights visits to the ED, IP Facility, PCP or Specialist, medication scripts, and abnormal lab values.

Clicking on the drop-down menu on the right-hand side and selecting the desired time frame, allows you to filter and access recent activity from the last 30, 60, or 90 days.

_Note:_ The Recent Activity timeframe filter does not apply to the data displayed on the Health Summary tabs.

The Overview tab displays a list of Clinical Indicators and a graph of Cost Summary data associated with the Person.

Clicking the graph type icons

allows you to change the view of the displayed data.

The Care Management tab displays real-time care management plans. It includes plan of care data grouped by open or reopened program name or date, open program goals, goal start dates and descriptions, as well as interventions and descriptions. Severity icons are displayed after each program.

Note: All programs are displayed by the earliest start date or by program. If a program has goals and interventions, the goals and interventions display in the order entered.

The Clinical Indicators tab is used to evaluate the quality of patient care and support services. It is intended to identify gaps in care and improve patient outcomes. This data is populated when Clinical Intelligence Rules (CIR) are executed against claims data. This section also includes patient findings, which indicate activity, admissions and treatment. Severity icons display after each description.

You can display information by sorting based on either Type or Date. This means that you can easily view Clinical Indicators categorized under the following:

Additionally, you can sort the information based on the date of entry, allowing for easy access to the most recent updates.

Note: The rules displayed in this section are configured per your company’s requirements.

The Medications tab displays medication information that has been added via claims or manually input. Seemanual-medication-entry.md for information regarding entering medications manually.

Medication information can be sorted by listing All Medications, Manual Medications, or Medications from Claims by using the tabs seen here.

The Lab Tests section displays lab and professional service claim information. It includes lab, procedure and test results for the Person. Results are grouped by Lab Results and Procedures.

Click the filter buttons to group this section by Type or Date.

The Visits section includes information about all visits during the specified reporting period. Visits are broken down into four categories: Emergency Department, Inpatient Admission, PCP and Specialist. They can also be sorted by Type and Date by selecting the desired tab.

The Cost Summary section is a graphical view of a Person’s cost metrics. The cost summary shows Professional, Facility, Prescription, and total costs.

Clicking the graph icons

changes the display.

The Conditions section displays conditions that are derived from claims data and Truven’s Medical Episode Grouper. They are broken down into Chronic and Acute categories. Severity icons are displayed after each condition. This information is viewable from this tab as well as at the top of the Health Summary page under the Details section.

The Providers section displays a list of Providers during the timeframe selected and last visit details. It also displays key information for the PCP and other associated specialists to include name, phone number, provider ID, NPI, date of last service and place of service.

The UM section displays real-time authorizations associated with requests through Care Management to include prior authorizations, inpatient authorizations, and referral authorizations.

The icon you select to close the Health Summary depends on whether you are viewing the spilt screen or expanded version.

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