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The entire database is interrogated monthly by HID’s proprietary
DURBase® Version 3 software, taking into account the various
risk scores that are calculated and the various criteria which generate
over 122,000 different “rules” by which the pharmaceutical
claims are studied. This interrogation is an automated process which
ascertains Therapeutic Criteria Exceptions (TCEs). These TCEs are
instances in which the system finds that one of the over 122,000
rules have been violated. These TCEs are then printed in the Initial
Criteria Exception Report (ICER™). For a typical database,
this report can list over 60,000 TCEs and can run about 80 pages
in length. The ICER™ lists each TCE and the risk category
of high, medium or low assigned to it. This enables the clinician
who is reading the ICER™ to judge which TCEs to study in more
detail. Of the 60,000 or so “hits,” the clinician usually
will choose about 3,000 to study in more detail aided by the generation
of a profile for each. The number of profiles chosen to print is
totally at the discretion of the client. These choices are keyed
into the system and patient profiles are generated.
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