Spiras Health is the premier next generation care management organization delivering nurse practitioner led in-home specialty care, utilizing predictive analytics and employing smart use of technology for members with advanced chronic conditions, specifically COPD and CHF made more complicated by co-morbidities and SDoH. The Spiras Health Solution combines monthly in-home services, telehealth, 2-way digital communications, and remote monitoring longitudinally. By treating patients with a whole-person approach through multiple modalities, developing clinician/patient relationships, and extending specialty services such as pulmonology, cardiology and palliative care into the home, Spiras Health is able to support adherence to treatment plan, coordinate care, communicate and collaborate with PCP/SCP and other care team members. The results are enhanced quality of life, improved patient/provider satisfaction, total cost of care reduction, and increased communication, coordination and collaboration among care team, patient, caregivers and community and referral back into a health system's ecosystem for continuity.

Spiras Health, headquartered in Brentwood, TN, provides longitudinal care services to complex, chronically ill patients, specifically COPD and CHF. The Spiras Health approach combines home-based services, telehealth, 2-way digital communications, and remote monitoring. This multi-modal approach allows the patient access to care, regardless of situational complexities, in the mode that suits their preferences, needs, and risk. This also provides ongoing data, from a multitude of sources, to Spiras Health for accurate and efficient interventions. Spiras Health creates value to patients by improving quality of life and to health system/payor partners by reducing total cost of care by addressing avoidable costs and supporting quality metrics. Spiras Health utilizes/provides: 1. Multi-disciplinary team approach consisting of MDs, NPs, RRTs, RNs and community resources 2. Predictive modeling and machine learning to identify patients at highest risk for avoidable costs 3. Patient activation strategy for ongoing engagement, goal setting, treatment plan adherence, and behavior modification 4. Multi-modal approach to care delivery 5. Provider collaboration process to partner with patient's PCP and specialists, bridging care from physician office to home 6. Improved clinical and financial outcomes

The Rimidi Platform is a disease management tool that allows the patient and his or her physician to effectively manage diseases together. The comprehensive solution includes remote patient monitoring and chronic care management capabilities, clinical decision support tools, disease management insights, and patient engagement tools, enabling healthcare providers to identify gaps in care management and the steps needed to close those gaps.

Rimidi combines patient-generated health data from connected devices with clinical data from EHRs to drive patient-specific clinical insights and actions via embedded clinical decision support cards. The platform integrates with glucometers, CGMs, blood pressure cuffs, scales, pulse oximeters, digital inhalers, and more.

Rimidi's platform supports disease management for the following conditions: 

• Diabetes
• Hypertension
• Heart Failure
• Obesity
• Chronic Kidney Disease
• Maternal Health, including antepartum and postpartum hypertension or diabetes
• COPD
• Asthma
• Fatty Liver

Created by clinicians, for clinicians, Rimidi is a digital health company that supports healthcare providers in the delivery of remote patient monitoring and chronic disease management with EHR-integrated software, services, and connected devices. By combining clinical data from the EHR with data from connected devices and patient surveys, Rimidi enables guideline-based management and prioritization of highest-need patients. 

Spiras Health is a next generation care management and care delivery provider bringing specialized services to members at home. Spiras focuses on members at highest risk of incurring avoidable spend due to unnecessary utilization of ER and hospital, primarily as a function of poor adherence to treatment plan and uncontrolled symptom exacerbations.

This solution begins by targeting patients with diseases of the heart and lungs (CHF/COPD) made more complicated by multiple co-morbidities and social determinants of health. However, care for all conditions is provided - with a whole-person approach.

Spiras is distinguished by:

• Predictive models that identify avoidable spend
• Specialty care delivery - in-home with multi-modal use of technology
• Longitudinal vs acute/episodic
• Ability to take risk for specialty care

In the sales process, we often hear “Doesn’t Epic (or other EHR) do that?” Rimidi is not built to replace the EHR, but to enhance it by bringing in additional data sets, providing more efficient workflows, and improving the user experience. Rimidi can install and configure its platform within 3-6 weeks which is significantly faster and more cost effective than onsite EHR teams can build and support enhancements to meet clinical needs. Rimidi’s modern technology stack enables rapid cycle innovation and iteration post-go live.

Rimidi’s cardiometabolic platform is most often compared to other Remote Patient Monitoring solutions, but the platform-approach to RPM allows Rimidi to do so much more. Some key differentiators of the Rimidi platform are: (1) tight integration with leading EHRs via SMART on FHIR, (2) the breadth of the comorbid disease states we cover, (3) our incorporations of patient-reported outcomes and social determinants of health measures and (4) our Clinical Decision Support engine. Rimidi’s CDS cards support almost any insight or intervention a client wants: RPM data alerting and interventions, referral management, lab or medication recommendations, clinical trial identification, and more.