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Carrum Health Achieves a Leap Forward in Provider Quality Evaluation of High Cost Procedures

Carrum Health, the first digital health company connecting employers and employees to Centers of Excellence (COEs) through a technology-powered platform, announced a leap forward with its industry-leading quality algorithm to help patients make well-informed decisions when selecting surgeons. Combining its seven years of real-world patient outcome data with comprehensive commercial claims, clinical and Medicare data sets, integrated with a machine learning platform, Carrum Health can now offer unprecedented insights into the three most impactful aspects of quality: appropriateness, functional outcomes and traditional readmission/complication metrics.

“Despite all the innovation in digital health and a wealth of data available, patients continue to make important healthcare decisions in a vacuum. They often rely on word of mouth or directories to pick which doctor they’ll rely on for surgery, despite the significant impact that choice could have on their quality of life,” said Sach Jain, CEO and founder of Carrum Health. “Carrum Health is demystifying the process by delivering a clearer quantitative picture on provider quality and helping patients match with the best surgeons to achieve the best outcomes.”

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Typically provider quality algorithms are limited, ignoring whether the prescribed treatment or surgery was necessary and how patients fared after the procedure. Instead, they rely only on billing records or claims data that represents only a portion of a surgeon’s business, or focus on metrics that are too broad or not relevant to specific procedures. Additionally, hospitals or departments are ranked in the aggregate, despite performance differences materially across individual surgeons in the same high-performing department.

Carrum Health’s quality algorithm addresses these shortcomings by utilizing the most comprehensive data sets to provide information across all geographies, service lines and patient types. In addition, the algorithm has been trained on reliable data: Carrum Health’s quality evaluation of more than a half million procedures and 1,000 surgeons, as well as electronic health data for hundreds of millions of patient encounters spanning more than half of all hospitals in the country.

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Carrum Health’s algorithm is the only quality tool available in the market that factors in appropriateness and patient reported outcomes, while utilizing procedure-specific quality metrics developed by experts in each of its COE surgical and non-surgical specialties.

“As a physician, it’s important to partner with organizations that share our commitment to high quality patient care,” said Nicholas Theodore, M.D., director of the Neurosurgical Spine Center and professor of Neurosurgery at Johns Hopkins University School of Medicine. “By measuring quality as well as appropriateness, Carrum Health is setting a higher standard by creating a system of measurement and enabling patients to identify best-in-class providers. At the same time, it allows providers to focus on providing care to patients who truly need it, ultimately driving better outcomes.”

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