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TRHC provides patient-specific, data-driven technology and solutions that enable healthcare
organizations to optimize medication regimens. We improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk. We deliver our solutions through a comprehensive suite of technology-enabled products and services for medication
risk management and risk adjustment.
With 4.3 billion prescriptions filled in the U.S. in 2014, medication treatment
is the most common medical intervention. Its imprecise use represents the
fourth leading cause of death and contributes to an estimated 45 to 50 million adverse drug events, or ADEs, annually. ADEs result in more than
100,000 deaths annually, approximately 125,000 hospitalizations, and one
million emergency room visits. Incidence of ADEs is highly correlated to the
number of medications an individual is taking and to non-adherence, and
thus is particularly relevant to populations with complex healthcare needs.
As the U.S. healthcare market continues to evolve from fee-for-service to valuebased models of care, healthcare organizations require new and emerging technologies to optimize treatment and manage risk on a patient-specific, customized basis. Our solutions are targeted to at-risk organizations that are clinically
and financially responsible for the populations they serve.
Our suite of cloud-based software solutions provides prescribers, pharmacists
and healthcare organizations with sophisticated and innovative tools to better
manage the medication-related needs of patients. TRHC offers a prospective
clinical approach to medication risk management, designed to increase patient
safety and promote medication regimen adherence. Furthermore, our medication risk management technology helps healthcare organizations lower costs by
reducing ADEs, enhancing quality of care, and avoiding preventable hospital
admissions.
Our products and services are built around our Medication Risk Mitigation Matrix™. The MRM Matrix™ enables optimization of a patient’s medication regimen by combining
clinical and pharmacology data, population-based algorithms, and extensive patient-specific
data to deliver ‘‘precision medicine.’’ Our team of clinical pharmacists is available to support
prescribers at the point of care through our proprietary technology platform.
Increased Complexity in Healthcare
In any given month, 48% of Americans take a prescription drug and 11% take five or more.
Prescription use in the U.S. is increasing as the number of medication therapies rises, the population ages, and chronic diseases become more prevalent. The pervasive and rising use of medications is increasing the complexity of medication management for healthcare organizations
and making adherence to medication regimens more difficult for patients.
Imprecise Use of Medication → ADEs
Given the extensive and increasing use of medication, the potential for adverse drug events
(ADEs) and for patient medication non-adherence presents a critical patient safety and public
health challenge. The Alliance for Human Research Protection reports that 2.5 to 4 million serious, disabling or fatal ADEs occur on an annual basis. In 2009, the New England Healthcare
Institute estimated that medication non-adherence is responsible for $290 billion in otherwise
avoidable medical spending annually in the U.S. alone. ADEs contribute an additional $3.5 billion to healthcare costs on a yearly basis, according to the Institute of Medicine.
Need for Personalization, Medication Risk Mitigation™
Research suggests that a majority of ADEs are preventable. The current tools for medication
safety produce inconsistent results and are widely viewed as ineffective. Personalized and precision-based methods are absent in prevailing trial-and-error approaches to medication selection.
A provider’s ability to deliver optimal patient care is limited by insufficient data at the point of
prescribing.
Industry Dynamics
The shift to value-based healthcare has increasingly placed healthcare organizations at financial
risk related to imprecise medication usage, providing new incentives to reduce costs and improve quality. Rising healthcare costs and strained budgets have driven government agencies to
expand the role of value-based capitated payment models, shifting incentives toward quality
and value. In these at-risk models, providers are incentivized to deliver efficient care: lowering
costs and improving care quality, safety, and the patient experience.
As a result of this transition, data on patient-specific disease states and co-morbidities, clinical
and quality outcomes, resource utilization and individualized patient information have become
increasingly relevant to healthcare delivery. Accurate coding of medical procedures and diagnoses is increasingly complex and is required for proper reimbursement and regulatory compliance. In at-risk value-based care models, coding-based risk scoring is a significant factor in determining premium reimbursement rates and payments in many government-sponsored
healthcare programs. In addition, government agencies regularly audit healthcare organizations
to validate coding practices.
TRHC’s medication risk management solution set, which includes our cloud-based software
applications EireneRx® and MedWise Advisor®, provides solutions for a range of payors, providers and other healthcare organizations. The MRM Matrix helps externalize sophisticated
logic and expertise by combining clinical and pharmacology data, population-based algorithms,
and extensive patient-specific data (medical history, lab results, genomic information, etc.) to
deliver precision medicine.
Our suite of technology products is built on a powerful rules engine that houses comprehensive pharmacotherapy profiles, provides drug- and risk-alerts, and includes a combination of
proprietary decision-support tools, real-time secure messaging, e-prescribing, and advanced
precision-dosing functionality, among other functions. TRHC software applications help reduce ADEs, enhance medication adherence and quality of care, and improve medication safety
at the patient level. Adherence-packaging prescription fulfillment services, risk adjustment services and pharmacy cost management services also help our clients increase patient medication
adherence, achieve correct reimbursement, maintain regulatory compliance and optimize pharmacy spend.
Precision-Based Approach → Better Outcomes
We are at the forefront of precision medicine with solutions that help our clients tailor medical
treatment to the individual characteristics of each patient. Our cloud-based software solutions
are designed to identify high-risk individuals, detect susceptibility to ADEs and embed proper
dosing guidelines.
By offering solutions that improve outcomes in a cost-effective manner, we align with organizations transitioning to value-based healthcare. Our clients have reported that our medication
risk management services have resulted in significant reductions in hospital admissions, length
of hospital stays, and emergency room visits for their patients, thereby reducing their medical
expenditures. Our pharmacy cost management services saved our clients more than $44 million
in recovered or prevented overpayments in 2014, and our risk adjustment clients realized revenue increases of approximately $350 per patient per month on average in 2014.