The Krames clinical content team does continuous review of standards in clinical literature, guidelines, and best practices to keep our content current. As we look to develop content and maintain our existing content library, we ensure clinical accuracy by our team working in conjunction with our in-house research director and together we continually monitor over 180 guideline associations; which include organizations like AWHONN, ACOG, American Academy of Pediatrics, CDC, NIH, American Diabetes Association, American Academy of Emergency Medicine, just to name a few. Based on review we update content to reflect current standards – at three levels: 1. The first level is “Proactive”: Where all content is reviewed on a 24-month cycle 2.The second level is “Responsive”: All relevant content is reviewed when we’ve identified a change in standards 3.The third and final level is “Emerging”/new research: This is the real-time creation of new content describing emerging clinical issues (e.g. COVID-19, Vaping, ZIKA) Our process for content review includes: - Health content, including interactive or self-management tools and multimedia content, has two external medical reviews. - Health content enters its “first” medical review two (2) months prior to the expiration of the last review date and the medical review process - two medical reviews, one editorial review, QA, and translation - may take several months to complete. Dates of medical reviews are tracked and stored in the Krames UCR. Certain diseases and conditions that have ongoing medical research and frequent updates to treatment guidelines are medically reviewed more often, as an off-cycle review, to remain current with emerging standards of care. - Content is updated immediately, as an off-cycle update, when significant new medical knowledge or change(s) in medical guidelines occur, and when content errors (not spelling or grammar) are identified. - Two medical reviews are performed on health content. At least one of the medical reviewers is an expert or specialist in the area pertaining to the disease, condition, or topic under review. - Experts or specialists in the area pertaining to the disease, condition, or topic under review consist of physicians, advanced practice registered nurses (APRN), physician assistants (PA), and other clinicians with a specialty focus on the specific subject matter. - Our in-house clinical team finalizes the medical review process by validating each content review to ensure consistency and accuracy across our library.

Yes, writes back to most EHR's.

We offer optionality in terms of delivery for our content to truly meet patients in their preferred modality, wherever they are in the patient journey! (Our healthsheets and collection of over 1,450 videos can be integrated in EPIC clinical references & MyChart, mobile, pre/post procedure SMS, TV channels, online, pre-printed booklets, interactive guidebooks, AI physicians assistant, etc..)

Krames takes an individualized approach as we engage patients in their healthcare journey. We deliver engaging Krames patient education in digital, video, or print formats, based on each patient's unique learning style. It applies the latest health literacy principles to help clarify diagnoses, support shared decision-making, and build a trusted physician-patient relationship. Our Digital Content is comprised of not just written content, but also image only, animations, and videos that assist healthcare professionals in educating their patients in the style that fits the patient. We use the Health Literacy Advisor software, which can calculate reading scores using a variety of scales and we record Gunning-Fog and Flesch-Kincaid reading ease in our database. Our digital, video, and print content contains diverse, culturally sensitive images that appeal to many different populations and demographics. We have an extensive video collection that ranges across the continuum of healthcare. Additionally, Krames has 1,500+ "Easier-to-Understand" healthsheets which are at a 4th grade reading level and below and over 100 "animation only" healthsheets that provide step-by-step instructions using only images at reading level (0).

Krames patient education integrates in to EHR's via traditional integration uploads, API, FHIR, HL7 to most EHR's (including EPIC, Cerner, Meditech, Allscripts, etc.) In early 2017, Epic introduced the Epic App Orchard, which opened up their platform to developers to create apps that use SMART and FHIR technology to integrate into Epic. This is an evolution to the traditional quarterly update integration that Epic began offering a number of years earlier. In developing Krames On FHIR, Krames’ Product Team conducted many interviews with existing clients to see what were their “pain points” and looked for suggestions to improve upon or eliminate those pain points. The Krames On FHIR results have been truly impressive: Benefits for Patients · Provide the right content in the right format to the patient anywhere along their healthcare journey from Discovery to Recovery and beyond! · Access easy to understand content on thousands of topics in English and Spanish, with content available in up to 15 additional languages and over 1,450 videos · Gain knowledge and tools to effectively adhere to treatment plans, take medications properly, and self-manage conditions outside the health system to reduce readmissions · Receive suggested patient education content, customized by their physician, in their preferred format - print, digital or video – accessible through their MyChart Patient Portal, Bedside or Mobile app with the ability to revisit or share the education with loved ones and care givers · Pre/post procedure automated education via SMS to improve outcomes and ensure medication adherence. Benefits for Clinical Teams · Access to regularly updated patient education in clear, plain language developed using Krames evidence-based methodologies in multiple modalities · Suggest the most relevant encounter education (including our vast video collection) to reduce clinical efforts and clicks. · Deliver Krames patient education to your patients through MyChart Portal, Bedside or Mobile app or even through your Care Plans teaching points · View the dates of the education materials that the patient has previously received and see how the patient has interacted with the content · Improve clinical workflows by reducing the number of clicks and making patient education easier to find via suggested content, personal favorites and organizational or departmental folders · Providing multiple formats of education (print, video, digital, etc.) addressing SDOH issues and positively affecting HCAHPS Benefits for IT Teams · Eliminate quarterly uploads of patient education, reducing the technical resources needed for maintenance and support · Piloted Epic’s Tesseract with Epic to reduce and simplify API integrations · Adhere to the latest industry standard SMART on FHIR API standards · Facilitate implementation using our pre-approved app · Follow a detailed project plan and how-to guide for implementation, provided by EPIC · Adhere to regulatory requirements, as the application allows clinicians to share information to the Patient Portal and write data back into the EHR

Once digital tools are ordered, Xealth can manage all elements of delivery and enrollment, either by sending them directly via email or SMS or via the patient portal (stock or custom-built). As patients use these programs, Xealth tracks engagement and can send reminder notifications.

Tthe Xealth platform has successfully deployed a wide variety of connected device solutions within its digital health formulary across the client base. Remote Patient Monitoring solutions deployed include both broad-based RPM such as VitalTech and Harmonize, and also focused RPM solutions such as Babyscripts, Force Therapeutics, Glooko, and Rimidi. Xealth enhances the native capabilities of each of these RPM solutions through its unique integration within the EHR, allowing for the ordering and monitoring of the RPM solution based on configurable use cases. This integration creates a seamless experience for both patients and clinicians. Xealth’s proprietary dashboard provides insights to the impact of digital solutions, allowing for health systems to gain a better understanding if the solutions they have deployed are having the intended impact.

Xealth brings data and real-time monitoring information back into the health system so care teams can follow the patient’s progress or drive interventions. Digital Care embeds third-party dashboards inside the EHR, making it easy for clinicians to see their patient’s progress without leaving the patient record. Discrete patient data, like PHQ9 scores or blood pressure readings, can be written into the chart and stored alongside similar data. Downstream workflows like notifications, best practice alerts, and patient flags can also be generated within the record.

Xealth’s platform aggregates and organizes digital health tools and related data within the EHR for easy deployment and oversight. Xealth’s core platform is the Digital Care SMART on FHIR app, which can be downloaded from Epic App Market (formerly App Orchard) or Cerner Code Gallery and configured by the health system team to launch directly in the provider’s charting workflow. Xealth’s clinical decision support rules engine can automatically distribute tools, assets, and program enrollment information to patients, as well as present relevant solutions within the patient record in the EHR for manual prescribing. Xealth brings monitoring information back into the health system so care teams can follow the patient’s progress or drive interventions. Digital Care embeds third-party dashboards inside the EHR, making it easy for clinicians to see their patient’s progress without leaving the patient record. Discrete patient data, like PHQ9 scores or blood pressure readings, can be written into the chart and stored alongside similar data. Downstream workflows like notifications, best practice alerts, and patient flags can also be generated within the record.

Xealth streamlines and enables dynamic control of data captured and collected by third party vendors. As organizations use Xealth to connect patients with Apps and RPM tools to collect and monitor patients, Xealth's integrated infrastructure enables the health system to have complete access to that data in a variety of manners. Xealth embeds third-party dashboards inside the EHR, making it easy for clinicians to see their patient’s progress without leaving the patient record. Discrete patient data, like PHQ9 scores or blood pressure readings, can be written into the chart and stored alongside similar data. Downstream workflows like notifications, best practice alerts, and patient flags can also be generated within the record.

Xealth’s platform aggregates and organizes digital health tools and related data within the EHR for easy deployment and oversight. Xealth’s core platform is the Digital Care SMART on FHIR app, which can be downloaded from Epic App Market (formerly App Orchard) or Cerner Code Gallery and configured by the health system team to launch directly in the provider’s charting workflow. Xealth enhances the native capabilities of each digital vendor through its unique integration within the EHR, allowing for the ordering and monitoring of the RPM solution based on configurable use cases. This integration creates a seamless experience for both patients and clinicians. Xealth’s proprietary dashboard provides insights to the impact of digital solutions, allowing for health systems to gain a better understanding if the solutions they have deployed are having the intended impact. Through its extensive Vendor Ecosystem, Xealth has worked collaboratively with over 40 industry recognized providers of digital health applications, clinical content, RPM and others. Maintaining excellent working relationships with vendors embedded in Xealth use cases is part of Xealth’s foundational model for achieving success across the client community.

Xealth’s Digital Command Center provides engagement data for digital tools and content deployed through Xealth. Health systems can see how many patients open an email/text message, click on a card in digital care, and watch or view content. This allows the health system to see if content is being used by patients. Health systems can change the time of deployment of a solution (send sooner or later) and/or send reminders, when there is a lower level of engagement than expected. Xealth’s monitor tab, which is integrated into Epic, displays third party application dashboards within Epic, providing a seamless experience for the clinician. The clinician is also able to see engagement data for content, such as videos/pdfs.