Care Management Suite

The Care Management Suite is a patient-centric, data- and analytics-driven approach to care management to improve clinical, operational, and financial outcomes. Tools and processes in the suite deliver visibility across the continuum of care for high-risk and at-risk populations, facilitate more streamlined and patient-centric workflows, improve the quality of patient care, and reduce overall costs.

The Care Management Suite consists of three applications in an integrated solution: Population Builder™: Stratification Module, Population Care Flow, and Population Care Insights.

The Care Management Application Suite includes three products to help you stratify patients, manage the process, and analyze care management initiatives.

The problem

With the spiraling cost of healthcare in the U.S., the transition to value-based care is now an imperative—but population health work can seem overwhelming and risky with the ever-changing healthcare environment. Traditional care management tools offer inflexible, black-box point solutions—resulting in distrust of the system and continued challenges with transforming quality, cost, and delivery of care.

As healthcare systems become more integrated and focus on return on investment (ROI), the need to coordinate care across different healthcare environments and teams becomes more critical. This requires a care management platform with integrated, transparent, and comprehensive data (data based on claims, EMR, clinical, and more—not just billing).

Our approach

The Care Management Suite is a comprehensive, data-driven care management solution with an approach to transforming patient care within population health management initiatives. It relies on data analytics to identify appropriate changes in care delivery to improve clinical, operational, and financial outcomes.

Benefits and features

• Optimize the entire workflow process – An end-to-end, integrated, flexible workflow helps drive the organization’s care management work, maximizes operational and clinical data collected through daily assessments and care management activities, and provides ongoing analytic insights.
• Leverage an analytics-first approach to care management – With a focus on analytics, the Care Management Suite is driven by the DOS™ analytics platform and leverages AI and machine learning to track and improve outcomes.
• Aggregate rich sets of claims and clinical data – A set of aggregated claims and EMR data, patient identity management, terminology, DOS Marts™, and the analytics capabilities in DOS (which includes predefined content) is ready-to-use—or customizable to meet healthcare systems where they are.

Use cases

• A care management director has received a request to share outcomes and ROI with leadership. Using the Care Management Suite, the director shares examples of population definitions and population health strategy. The director also shows how the team works together to manage specific complex patients with the longitudinal, holistic patient view provided in Population Care Flow. Using Population Care Insights , the director shows actual results, including metrics around patient identification, team outreach, patient enrollment, and more.

• A care team (care managers, nurses, social workers, analysts, pharmacists, and others) is struggling to manage patients with chronic conditions during the COVID-19 pandemic. With constantly changing testing and treatment guidelines, population definitions, and public health activities—as well as patients in care management programs with missed treatments and those avoiding healthcare offices due to fear of exposure—the team finds their current care management platform inefficient. With the Care Management Suite, they can more readily adapt—they can change the populations in an instant in Population Builder: Stratification Module, collaborate to provide optimal care for patients in Population Care Flow, and monitor results and patient engagement in Population Care Insights. As the healthcare system begins to recover from COVID-19, the care team relies on financial measures and care planning to safely get patients back into the office.