OnCare360 collects a wide range of data, including clinical information such as vital signs, diagnoses, medications, and post-discharge details; care management data like time spent on coordination and care plan updates; and patient-generated health data from RPM and RTM devices. It also gathers social determinants of health (SDOH) data, including housing, transportation, and other socioeconomic factors, along with behavioral health metrics such as mental health screenings and care plans. Preventive care data, such as Health Risk Assessments (HRA), Fall Risk Assessments (FRA), and Advance Care Planning (ACP) directives, are also collected, as well as engagement data from patient portals, communication logs, and reminders. Additionally, OnCare360 tracks billing and compliance data, including CPT codes and audit-ready documentation.

OnCare360 provides advanced analytics to support comprehensive care management and decision-making. These analytics include real-time dashboards for tracking patient outcomes, care plan adherence, and program performance across RPM, CCM, TCM, and other CMS programs. Risk stratification tools identify high-risk patients for targeted interventions, while utilization metrics assess resource efficiency and care delivery effectiveness. The platform also offers insights into social determinants of health (SDOH), highlighting barriers to care and tracking the impact of interventions. Additionally, OnCare360 generates compliance reports, billing accuracy metrics, and CPT code utilization summaries to ensure regulatory alignment and optimize reimbursements. This robust analytics suite enables providers to measure outcomes, improve workflows, and deliver data-driven care.

OnCare360 enables seamless bidirectional communication between healthcare providers, patients, and care teams to enhance coordination and engagement. The platform integrates secure messaging, patient portals, and real-time alerts to facilitate ongoing interactions. Providers can send care plan updates, educational materials, appointment reminders, and alerts to patients directly through the system, while patients can respond with questions, upload health data, or report symptoms via the portal or integrated communication tools. For care teams, OnCare360 supports collaborative workflows, allowing providers, nurses, and social workers to share updates, assign tasks, and communicate in real time. This two-way communication ensures that all stakeholders stay informed and aligned, fostering timely interventions and better care outcomes.

OnCare360 ensures providers can engage eligible patients through cellular-connected devices, eliminating the need for Wi-Fi and enhancing accessibility for underserved populations. For patients with higher technical literacy, OnCare360 offers an intuitive mobile app to streamline access to care plans, reminders, and educational resources. This combination ensures tailored engagement for diverse patient needs.

OnCare360 offers pre-built, condition-specific care plans and pathways that are fully customizable to meet the unique needs of each patient. These templates are designed to support clinical decision-making and streamline patient engagement, providing actionable guidance for care delivery. Integrated directly into the platform, these care plans align with automated workflows, ensuring seamless implementation while enabling providers to personalize interventions, enhance adherence, and optimize outcomes with ease.

OnCare360 seamlessly integrates with existing EHR systems, supporting both HL7 file-based integration and SMART on FHIR protocols. This interoperability ensures smooth data exchange, enabling providers to synchronize patient information, care plans, and clinical workflows directly within their EHR environment. By leveraging industry-standard frameworks, OnCare360 enhances operational efficiency and reduces duplication of effort, allowing healthcare teams to focus on delivering high-quality, coordinated care.

OnCare360 streamlines logistics management, staff training, patient onboarding, and ongoing tech support to enhance the clinician and patient experience. The platform provides intuitive workflows that simplify patient onboarding, ensuring smooth enrollment in care programs with minimal administrative effort. Staff training modules offer step-by-step guidance on using OnCare360’s features, enabling care teams to adopt the platform quickly and effectively. Additionally, the system includes robust tech support, with dedicated resources to address patient and provider needs, reducing disruptions and ensuring seamless operation.

OnCare360 leverages AI-based assistants, tailored learning content, and educational materials to engage patients and support behavior change. The platform delivers personalized insights, automated reminders, and easy-to-understand resources, empowering patients to track progress, set goals, and stay motivated in achieving better health outcomes.

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.