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

Our evidence-based care programs are built with clinicians to anticipate patient needs and proactively offer additional support during key points in care journeys where things could go off track — such as right before or after surgery, after the birth of a child, or being newly diagnosed with a chronic condition. We offer this support to patients through conversational, two-way texting that feels as simple as chatting with friends and family, but is backed by AI and natural language processing to intelligently answer common questions and triage concerns to the care team directly into the EHR or Memora’s own dashboard. Clinicians can see message history and jump seamlessly into the conversation with the patient or chat in-thread, provider-to-provider, to coordinate care — helping patients feel more satisfied with their care, and clinicians more valued in how they deliver it. 

Memora Health, the leading intelligent care enablement platform, helps clinicians focus on top-of-license practice while proactively engaging patients along complex care journeys. Memora partners with leading health systems, health plans, and digital health companies to transform the care delivery process for care teams and patients. Our platform digitizes and automates high-touch clinical workflows, supercharging care teams by intelligently triaging patient-reported concerns and data to appropriate care team members and providing patients with proactive, two-way communication and support. Memora Health reduces care team notifications by as much as 40% and improves patient engagement and clinical outcomes across diverse populations.

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

Existing options at health systems today likely do not impact patient experience and clinical care to the degree the organization desires. Memora Health offers a modernized solution that can take your under-performing systems and tools, and supercharge them to meet patients where they are.

Memora Health offers an innovative way to support patients outside the clinic setting through its AI-powered platform that intelligently combines device-based and patient-reported data to comprehensively monitor patient performance. Beyond just device-based data collection, Memora’s communication platform includes care pathways that are deployed through an intelligent SMS-based communication engine, as well as virtual visit and phone call capabilities to fully support patients in a home-based setting.