Health Cloud Risk Scoring Data Tables

Several Health Cloud tables hold the information that is used to aggregate and calculate patient data. Once calculated, this information appears in CRM Analytics dashboards so that your company can make informed care decisions.

Health Cloud delivers tables that store the data used to calculate patient risk scores.

• Risk Score Medicaid Interactions: Disease interaction scores and originally disabled interactions for patients who are enrolled in both Medicare and Medicaid.
• Risk Score Disease Interaction: Disease interactions used to calculate risk scores.
• Risk Score HCC Code: Mappings between HCC codes and risk scores.
• Risk Score Age Band New Enrollee: Mapping used to calculate risk score for age groups of patients who are newly enrolled in Medicare. For example, patients who are between 35–44 years old and patients who are 60–64 are in two different age bands.
• Risk Score Age Band Continued Enrollee: Mappings used to calculate risk score for age groups for patients who have been enrolled in Medicare for more than a year. For example, patients who are between 35–44 years old and patients who are 60–64 are in two different age bands.

• Manage Mappings Between Conditions and HCC Codes
  Salesforce provides the most current mappings between International Classification of Diseases (ICD) and Hierarchical Condition Category (HCC) codes. These codes are used to calculated patient risk for the Analytics for Health Cloud: Risk Scoring app. You can add or edit these mappings, but doing so can affect the accuracy of your results.
• Manage Programs
  Use the Programs tab to manage the relevant data about the programs a patient or member participates in that are tracked or monitored in Health Cloud.
• Manage Program-Patient Affiliations
  Manage the associations between patients and the programs they’re enrolled in. This record can also link a person with the providers who care for them within their enrolled programs. Implement a custom integration or use Data Loader to import historical medical records from the EHR system. Then map it to the fields that appear in this tab.
• View Program Patient Summary Information
  View a patient’s risk score and other summary information about the patient and affiliated programs using CRM Analytics dashboards. The person's risk score, along with demographic information such age, gender, disability status, conditions, Medicaid eligibility, HCC codes, and other items appear in the dashboard.
• Manage Provider Information
  Manage the current healthcare provider names based on information from the EHR Practitioner object, or related contact and user records.
• Manage Procedures
  Use the EHR Procedures tab to manage the relevant data about the medical procedures a patient or member undergoes that are tracked or monitored in Health Cloud.
• Manage Procedure Performer Records
  Use the Procedure Performer tab to manage the relevant data about the practitioners who perform a procedure on a patient or member.
• Manage Procedure Requests
  Use the EHR Procedure Requests tab to manage the relevant data about requests for a patient or member to undergo a medical procedure.