Insight to action: using automation to manage population health
Population Health Management (PHM) is an increasingly popular way of improving outcomes and reducing the costs associated with readmissions and chronic care. But have providers got the right software tools to deliver an integrated, actionable strategy?
Effective PHM requires the ability to segment your population based on risk profile and proactively manage patient journeys across the care continuum. High-risk individuals receive focused, coordinated attention and all patients are encouraged to self-manage beyond the four walls of the hospital setting.
The problem is that a lot of software won’t allow providers to easily exchange data, or track patients beyond each clinic or hospital. Furthermore, once insights have been gathered on a population level, it can be difficult to action and coordinate change.
Lumeon Care Pathway Manager is a cloud-based platform that provides a single, real-time point of reference across the care continuum, integrating data from patients, remote health monitoring devices, EMRs and EHRs and telemedicine software.
We work with providers to help them understand the people, process and technology that needs to be coordinated in order to use automation as a tool for PHM. Providers can then create their own automated pathways that are easy to update, and help maintain a huge volume of citizens.
Effective care coordination
Create workflows that automate activities or send event-based tasks to the right people at the right time. Staff have a complete view of the patient care journey including which events should happen next and the current patient risk status.
Single view of patient journey across the care continuum
Care Pathway Manager can integrate clinical, financial and administrative data onto one platform, for a consolidated real-time view of the patient journey. We use HL7 and FHIR to help integrate with existing software.
Automated risk profiling and alerts
By setting data thresholds which must not be exceeded, you can request data from patients and alert physicians to individuals who need additional support. This allows you to scale your ability to manage patients.
Engage patients with dynamically personalized wellbeing plans
Patients can be allocated to high, medium and low risk automated pathways that vary the frequency of interaction, sensitivity of thresholds or intervals between follow-up. They can also be set personal goals (e.g. lowering BMI by certain levels) and sent automatically tailored activities and resources.
Close the gap between insight and action
Controlling your outpatient pathways through a single master mechanism allows you to collate integrated data, analyze this across different patient cohorts then rapidly update your automation rules to see improved results.
Consolidated and individual view of outcomes data
Care Pathway Manager allows users to pinpoint individual progress or analyze data across entire geographies and cohorts in near real-time. Our Analytics module also lets you compare performance by practitioner or type of digital wellness plan.
Get in touch/request a demo
If you would like to find out more about Lumeon Care Pathway Manager, please get in touch.