Care Management – NAVIGATE

EagleDream Health’s NAVIGATE software effectively supports the daily workflow of care management teams and helps them proactively close gaps in care using a pre-visit planning dashboard for a population of patients.

Incorporated into the software are multiple risk assessment tools to stratify patients on provider schedules according to risk, thereby enabling the appropriate allocation and assignment of care management resources.  Functionality includes:

  • Gaps in Care including detailed drill down for performance enhancement
  • Pre-visit Planning allowing visualization of gaps in care and facilitating care management interventions.
  • Predictive Analytics including cost projections and risk stratification across condition registries, both at the individual patient and aggregate population levels

Gaps in Care

With EagleDream Health’s software, users are provided the necessary tools incorporating descriptive and predictive analytics enabling you to focus scarce care coordination efforts on the patients most in need of these interventions.

Gaps in care for quality measures are available at the system as well as individual provider and practice level.    Gaps in Care classify those patients that may have or will have a gap in care based on the metrics established.  It allows the identification of metrics that are near due within the next 30 to 60 days or passed due.  Users have the capability to drill-down to critical gaps in care, and display gaps as opportunities for improvement. Providers, care managers, care team members, and administrators are able to visualize data and generate role-based reports.

Pre-visit Planning

EagleDream Health’s Pre-visit Planning tool helps Care Management teams effectively manage their workflows to close patients’ gaps in care in advance of their next provider appointment.  Our flexible dashboard includes the ability to sort according to a number of options including:

  • Next appointment date ranges
  • Condition registry participation
  • Risk scores
  • Gaps in care

In addition, all views can be filtered according to any Initiatives employed in the software.

Predictive Analytics

EagleDream Health’s predictive analytics facilitate the allocation of care management resources and the precise targeting of the highest risk patients in your population as well as guiding specific intervention based on care coordination flags, frailty flags, pharmacy non-adherence flags, etc.

Since users will be able to stratify populations into key subpopulations defined by predictive risk characteristics this will enable care management teams the opportunity to formulate tailored and precise care plans.  Users are provided concurrent predictive risk reports with cost projections and display risk stratification across diseases registries.

Risk Stratification

EagleDream Health’s software enables risk stratification of patients through the incorporation of powerful predictive risk algorithms.  These algorithms enable the accurate assigning of appropriate care team resource interventions to the right patients at the right time.

Integration of these algorithms allows patient level as well as population views of risk and other patient and population characteristics.

For organizations to be successful in risk contracting, you must be able to identify the highest risk patients that have the potential to impact your quality and financial performance.  Our solution will provide you the visibility you need to drive any necessary intervention to achieve your targeted outcomes.