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Palliative care and service-delivery for the aging population
Coalescing service providers, patients and insurers onto a common platform, and applying machine learning
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Description
Provides a connected care platform that:
  • Enables providers to achieve clinical and financial success through a for connected care communities focused on patients with advanced illness
  • Helps providers to securely connect and collaborate with various disciplines within the care team
  • Empowers them to provide appropriate and timely services to their shared patient population while meeting the requirements of value-based care
  • Encompasses analytics, artificial intelligence, machine learning, workflow management and patient engagement tools which help in:
    • analyzing and segmenting patient populations based on health history, demographics, and behavioral indicators
    • identifying and predicting (with 95% accuracy) prognosis for patients who could benefit from a more appropriate plan of care
    • ensuring that patients—especially the sickest and most vulnerable—receive comprehensive, high-quality, person- and family-centered care
  • Demonstrates savings by helping to avoid costly, unnecessary and non-beneficial interventions
Empowers providers to improve clinical and non-clinical outcomes
  • Provides insight into the entire continuum of care for patients—i.e. records of SNF, IP, LTC, DME and specialty professional services
  • Facilitates success in value-based care programs through proactive, preventive and coordinated care that leads to shared savings and bonuses while minimizing financial loss
  • Enables them to reduce ER utilization and inpatient readmissions resulting from improved transition of care services
  • Helps them increase revenues from targeted programs to drive enhanced care management and better financial outcomes from the total patient panel
  • Provides Palliative Performance Score (PPS) estimates that measure disease burden for all the patients, without a physical examination
  • Helps in building cohorts for targeted referral programs by refining the eligible patient list using palliative indicators like mortality risk, frailty flags, risk of hospitalization, psychosocial issues, etc
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