Order Entry Rules Engine Scheduling and Patient Routing Document Exchange and Results Sharing Patient Messaging Appointment Preparation Interoperability Business Intelligence

The Power of Rules

As an 'intelligent' referral ordering system, IRIS works with an ordering physician to construct one or more interrelated orders to be placed and scheduled into the client's scheduling system. In the process of performing these tasks, IRIS will identify the occasion when a rule should be engaged, bring that rule forward into the order entry process, and facilitate the interaction between the rule and the user as well as between the rule and various external databases. The rules cause an immediate and direct interaction with the user, resulting in immediate feedback. This capability allows issues like clinical appropriateness, provider/insurance acceptance, preauthorization requirements, appointment scheduling, documentation requirements and clinical priority determination to be addressed at the time of referral order entry. This 'intelligent' way of handling referrals avoids all the costs and delays due to the duplication and rework steps prevalent in today's referral processes.

Clinical Rules

Providing clinicians with immediate treatment recommendations based on the clinical rules means better care for the patient and attainment of lower costs as inappropriate, misdirected and duplicate referrals are avoided. Clinicians interact directly with the clinical rules while making referrals, providing them with immediate feedback. As an 'intelligent' referral ordering system, IRIS ensures selection of the 'right' service for the patient's condition. Based on information provided by the referring physician, IRIS will engage the appropriate clinical rule and prompt the referring physician with questions regarding the patient's condition. IRIS then assigns the appropriate urgency and routes the referral to the appropriate clinician.

Administrative Rules

Far too often, patients arrive for a specialty consultation with incomplete or unavailable clinical workup information for a productive consultation. This leads to wasted appointments, delayed medical care for the patient, and increased cost as the appointment is often times rescheduled until the proper workup is performed. IRIS ensures a productive consultation by allowing each provider to clearly delineate their workup requirements and enforces the compliance of the ordering provider. As a result, the cost and lost time associated with these problems are avoided. In addition to assisting with clinical effectiveness we also help you configure administrative rules regarding your health plan contracts, specifically tracking whether a service requires an authorization so that your staff can efficiently and effectively submit and receive your authorization number.

Our Unique Platform

A unique aspect of the IRIS system is the treatment of all rules as 'data'. This means that any client's rules are separate from the IRIS product and can be developed and maintained with no dependency on IRIS product modifications. Rules can be copied from a publicly available pool and modified to fit the needs of a client.

IRIS provides a complete rule management module that handles rule testing and validation, documentation of validation testing, controlled rule activation and a complete rule version control sub system.