Informatics & Analytics

Case Management Information Systems (CMIS)

Case Management Information Systems (CMIS) is a web-based case management information system supports the case manager’s efforts and contains useful tools, such as uniform screenings and assessments for targeted disease initiatives (e.g., quality of life assessment for enrollees with Chronic Obstructive Pulmonary Disease).

Community Oriented Approach to Coordinated Healthcare (COACH)

The Duke Division of Community Health developed this care management system in collaboration with Topsail Technologies to support the information needs of providers serving Medicaid beneficiaries in the Durham County Carolina Access II program.

COACH is also used by LATCH (Local Access to Coordinated Health), the Duke Health Population Health Management Office's’s care management program for the uninsured.

The COACH database manages thousands of patients, millions of patient encounter records, and supports hundreds of users.

Provider Portal

The Provider Portal application is provided to improve patient care and care coordination for North Carolina Medicaid recipients. Providers in primary care practices, hospitals, and other settings may use this secure portal to access care team contact information, visit history, and pharmacy claims history for their Medicaid-enrolled patients. Population management and quality reporting is also available for Community Care of North Carolina practices.

Video: Using Provider Portal at point of care - 3 cases in 6 minutes

Go to Provider Portal

To inquire about access to the Provider Portal or if you need assistance, please contact your local Community Care of North Carolina Network Account Manager

Evaluation Tools

Community Care of North Carolina (CCNC) has contracted Treo Solutions to develop a set of population management and evaluation tools for the fourteen networks statewide.  Treo’s algorithm divides the North Carolina Carolina Access--II population into clinical risk groups (CRGs) based off of claims data, then creates baseline rates for health system utilization so subpopulations (e.g. by network, county, practice) can be compared while disease severity is held constant.

This gives Northern Piedmont Community Care an inside look into our network’s performance on inpatient admission rate, readmission rate, Emergency Department (ED) rate, and per member per month (PMPM) Medicaid spend. 

In addition, this algorithm allows us to focus down to the patient level and identify patients that are utilizing the health care system at rates above expected given their disease state and severity. These identified patients are often good candidates for care management interventions, patient education, and linkages to social support