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How Disease and Care Management Tools Complement EMR Population Health Tools

July 24, 2019
January 17, 2024

A major challenge in healthcare is the ability to reinforce continuity of care when the patient is transitioned from hospital to home. Strategies to connect patients, families, and providers with services and resources are needed to support coordinated, continuous care for populations with special care needs.

Connecting Patients and their Families to Health Systems

Electronic health records (EHRs) are becoming a common tool for health systems as a mechanism for patient engagement, care management, data aggregation, and analytics. Despite widespread their widespread use, a series of user interviews published by KLAS found that leading EHRs received only average approval for their population health management capabilities, such as data aggregation and analytics, patient engagement, and care management. That said, it’s important to address what’s needed beyond the EHR.

To truly understand the whole patient and whole population, organizations should supplement their EHRs with a care collaboration platform. Coupled together, these two platforms can foster a collaborative planning of care and shared decision-making to ensure successful care coordination.

To increase communication and the exchange of information between the patient, family, and provider, Veta Health built a digital health solution that integrates with existing EHR systems. With communication tools and workflow features, the platform ensures consistency and quick access to the latest patient information. Users receive appropriate notifications, alerts, and content information to better understand the care pathway.  

Care Collaboration Empowers Providers

Increased connectedness between the provider, patient, and care partner facilitates a “staying healthy” approach, allowing preventative rather than reactive care. To drive better connections across the healthcare continuum, we offer care management tools to help patients adhere and comply with treatment plans. In return, providers better understand patient needs, identify and mitigate risks, and improve follow-up care. 

Automation: The Veta Health platform is an automated mechanism that helps clinicians routinely track patients. In addition, the platform automates care pathways by reading different event dates in the EMR such as appointment date, time of year, birthdate, etc. Once the care pathway is set up, it doesn’t require a clinician to manually order content or a survey to be triggered.

Interpretation: Our solution looks at underlying analytics to help health systems understand what is most effective in terms of optimizing for better health outcomes. We offer advanced tools for escalation management and graphical representations of patient-reported data and outcomes so users don’t have to interpret the raw data themselves. 

Configuration: Each health system is different and has varying use cases, so our care pathways can be set up to meet varying institutional needs - the content, duration, and modules are configurable. Unlike many EHR care pathways that cater only to adults and are provided only upon discharge, our solutions are also designed with pediatric care in mind and are introduced at the beginning of treatment. 

Omni-Channel Engagement: Increasing care plan adherence requires that information is delivered to patients in an accessible manner. In order to create the most accurate and effective care narrative, we created a multi-channel solution that allows for patient and family engagement via app, SMS, and web interfaces.

And the Benefits of Treatment Plan Adherence Can be Huge: Pediatric Asthma Example

Compliance with treatment plans is proven to reduce absenteeism in schools, which is a critical marker of a child’s success and good health in the future. In particular, absences are associated with lower test scores and higher dropout rates, while higher education levels are tied to better health outcomes.

Our solution has significantly improved health outcomes and management for pediatric populations: children with asthma who used our platform were able to reduce missed school days by 75% per month and emergency department visits by 50% per year. Third party contributors such as school nurses, teachers, and physical therapists can provide direct feedback via web-based questionnaires, all of which become part of the patient's care narrative within Veta Health.

Veta Health is committed to meeting patients where they are, which is why we created a care management tool that delivers information via the appropriate channels every step of the way.

If you’re interested in learning more about Veta Health and how we connect providers with patients outside of care facilities, check out our page here.

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