How to manage chronic care post-COVID on a FHIR-enabled Data Activation Platform?

The coronavirus has affected care for patients across the country. As in-person visits have been limited and non-urgent medical care has been put on hold for many, COVID-19 has forced healthcare providers to move care beyond the clinical setting. 

There is an increasing concern about ensuring quality chronic disease management and patient care access amongst primary care providers and clinician teams across the country. The pandemic has completely changed the lives of patients battling chronic conditions. Many patients are unable to access essential services required for regular care, and patient-provider interactions are more challenging due to reduced visits and social distancing.

An April 2020 report from Evidation showed that about half of patients with a chronic illness are worried about visiting their provider’s office for a non-coronavirus healthcare need. Ten percent of those respondents said they were so concerned they would forego care altogether.

As the response to the pandemic settles in for a long haul, the impact of reduced visits and care intervention can not be ignored. Providers and health systems have to find innovative ways to resume practice and renew attention toward chronic care patients. 

Many patients who have multiple chronic conditions are at high risk should they come into contact with coronavirus. Due to the compromised immune systems of patients who are battling high-risk diseases, coronavirus can be extremely dangerous for these individuals. 

Providers must continue to engage in routine care with their chronically ill patients as much as possible through improved and enhanced chronic care management plans.

The initial step for tackling chronic diseases in the COVID-19 era is developing a real-time clinical registry to identify and monitor high-risk and rising-risk patients. Health systems can easily build such cohorts or registries on a data activation platform that assists in planning by providing actionable insights for improved care management. The registry offers communication tools to bulk-assign tasks to care, team members, perform direct patient outreach, place referrals, and order relevant laboratory tests and diagnostic tests for thousands of patients simultaneously.

Registries can combine healthcare data as well as data relevant to social determinants of health, bringing complex insights necessary for improved care under one umbrella. 

The Advanced Query Builder on Innovaccer’s Registry Builder allows the users to build complex queries and provides deep analytics through the FHIR-enabled Data Activation Platform.

The initial months of COVID-19 saw an unprecedented increase in virtual visits. As an alternative to general care delivery, virtual visits allowed for patient-provider interaction and closed some gaps that reduced in-patient visits had opened. 

Many previous barriers that were in place for the use of telehealth were lifted due to  COVID-19. Providers can complete their monthly comprehensive visit with their eligible patients over telehealth to ensure they are still getting the much-needed attention they deserve. It is expected that many of the patients who are trying telehealth for the first time, due to COVID-19, will continue to use it once the pandemic is over. Setting up a virtual visit architecture for two way communication is essential in a care management plan in the new normal. 

Seamless virtual visits and chart-on-the go feature for improved care delivery and connectivity on Innovaccer’s FHIR-enabled Data Activation Platform.

Patients with a chronic condition who cannot visit practices may find their conditions worsening over time without those critical check-ins and touchpoints with their provider. Remote patient monitoring (RPM) enables providers to routinely monitor and manage their patients with acute or chronic conditions between in-person visits. RPM, combined with virtual check-ins, can replace many of the current in-person visits related to adjusting and managing treatments. Remote patient monitoring coupled with a healthcare data platform can help providers get a holistic and comprehensive picture of a person’s health. The deeper understanding of how a patient’s health has evolved over time aids in making the patient feel supported and drives the quality of care.

Efficiently communicate with your patients and keep them engaged through their preferred means of communication through Innovaccer’s outreach and engagement solution.

The development of synchronous and asynchronous virtual platforms is an essential piece of quality chronic care management. The goal of these platforms should be able to overcome social and economic barriers. These platforms are essential for educating the patient populace and expanding the reach and impact of healthcare interventions.

The most important area of focus for a new-age chronic care management system is big data tools. To harness the power of analytics and predictive models health systems require a simple to use yet advanced healthcare data platform. A data platform utilizes complex models to simplify decision making and resource management. It can assist in bringing complex tasks such as outreach, workflow management, registry building and much more, down to the press of a button. 

Innovaccer’s FHIR-enabled Data Activation Platform is a comprehensive tool that integrates all your virtual care efforts. From outreach to analytics the platform empowers your teams to care as one.

Dynamic shifts of the economy and health care system make it essential but challenging for health systems to evolve and provide the best care to patients at all times. With the onset of technological assistance in nearly all aspects of care, the onus shifts to us to maintain equity in care and maintain the human touch. Cutting-edge technology allows providers and care teams to always be prepared and ready to provide care through any medium possible. A healthcare data platform unifies these initiatives and helps all stakeholders connected to care as one.

To find out more about how a FHIR-Enabled Data Activation Platform can transform your practice get a demo here.