Abstract: A computer implemented method for identifying records that deviate from a preferred prescribed course of care for a particular disease state includes receiving a transaction message including data related to a disease state and updating a database based on the received transaction message. Records related to a physician are identified within the updated database and records associated with a provider network are identified. A regional treatment plan for the disease state is determined based on the records related to the physician, and an impact record is generated based on the regional treatment plan for the disease state and the records associated with the provider network. Records that deviate from the preferred prescribed course of care are identified based on the impact record.