Digital offers the ability to deliver behavioral health care, support a patients’ spiritual coping, and maximize their benefits (e.g., financial navigation, social needs, spirituality and mindfulness, behavioral health resources)

Whole person patient care

Digital offers the ability to create a more seamless and personalized experience for patients to engage in administrative transactions and clinical interactions (e.g., provider search and match, appointment coordination, virtual visits and remote monitoring, patient payments)

Core patient interactions

Stakeholders can more easily connect with leading experts for second opinions and expand patient access to clinical trials (e.g., virtual/video second opinion consultations, simplified scheduling, records and specimen sharing, digital concierge services)

Oncology Navigation

Providers can supplement care with symptom management between clinic visits, efficiently manage complex care plans, and engage in shared decision-making with patients and their loved ones (e.g, virtual check-ins, reminders and notifications, patient education, care coordination documentation, metrics collection, actionable insights, population-level reports and analytics )

Oncology Treatment management

Cancer providers can leverage digital to develop effective programs to support the needs of survivors, while survivors can connect with others and enjoy a supportive community (e.g., follow-up care planning and data collection tools, survivor discussion boards and chat rooms)

Oncology Survivorship

Digital capabilities allow caregivers to meaningfully and actively participate in the cancer care journey (e.g., Caregiver skills training, education, community resources, coping resources, emotional and grief counseling)

Caregiver Support

Digital capabilities to optimize care team workflows and improve care team experience (e.g., Care coordination, remote monitoring, virtual tumor boards, clinical decision support, clinical and quality analytics, care team communication)

Care Team Workflow Optimization

Ability for patients to generate specific details on cost including out-of-pocket expenses for visits, providers, etc. Includes consumer criteria and generate specific detail on cost (including out-of-pocket expenses) based on the patient’s eligibility and preferences.

Self-service out-of-pocket estimator

Ability for consumers to receive their statements digitally based on their communication preferences (text, email, etc.). Ability for consumers to go paperless in their receipt of statements and to set the preferred frequency and modality.

Digital statementing

Ability for guarantors to review and consolidate billing information across a household and demonstrate balance totals and charge detail. Ability to render a single balance for the guarantor with breakdown of costs.

Statement consolidation

Ability for consumers to automatically reconcile their health system statements with their EOB information and flag the discrepancies for guarantor review.

EOB reconciliation

Ability for patients to configure their payment for healthcare expenses using the method of their choosing, including multiple payment options such as IVR, credit card, HSA, PayPal, etc.

Post-service patient payment

The ability for individuals to use digital technology to share biometric and other health data in real-time from outside a hospital or clinic with their care team as a part of an ongoing provider-directed program of care

Data Collection

The ability to identify patients who are at risk of a worsening condition/potential hospitalization

Analytics

The ability to synchronously and/or asynchronously communicate between the patient and care team 24/7

Bidirectional Communication

The ability to reach and engage any eligible patient, including those with limited technical skills, health literacy, and language skills

Accessibility & Equity

The ability to use ready-made, condition-specific, customizable care plans and pathways for clinical decision support and patient engagement

Pre-Built Care Plans

The ability to seamlessly fit within IT infrastructure to improve the user experience

Integration & Interoperability

The ability to support patients and care team with frictionless logistics management, staff training, and patient onboarding, and ongoing tech support, enhancing and not exacerbating the clinician experience

Operational Support

The ability to leverage AI and/or live coaches with specialized training to educate and engage patients by providing tracking, goal-setting and incentives to support behavior change

Patient Education & Coaching

Process to verify the necessity of submitting a prior authorization request is automated. If a prior authorization is required, solution can identify payer-specific rules.

Requirements Identification

Prior authorization requirements knowledge base is continually and automatically maintained. There should be minimal (if any) effort required of health systems to support this function.

Requirements Knowledge Base

Prior authorization forms completion is augmented with automation, populating appropriate fields through leveraging structured and unstructured data from the EHR.

Form Completion

Where necessary, payer-specific forms can be created/maintained.

Forms Library

Necessary documentation can be attached to satisfy the prior authorization request.

Documentation Collection

Prior authorization request can be submitted on behalf of the health system (through e-fax, payer portals, third party sites, etc.).

Request Submission

Prior authorization request status is monitored in near real-time and can be pushed back, along with other relevant information (e.g., tracking numbers, supporting text), into the appropriate work queues and fields within the EHR.

Status Monitoring

Ability to capture patient behavioral health status, inclusive of substance use disorders, using evidence-based assessments.

Behavioral Health Screening

Ability to coordinate across a healthcare delivery system or network to provide patients with behavioral health services in inpatient and outpatient sites of care.

Behavioral Health Integration

Ability to deploy ED-based interventions for treatment initiation and referrals to appropriate services for individuals with mental health needs across the acuity spectrum.

ED-based Mental Health Interventions

Ability to deploy ED-based interventions for treatment initiation and referrals to follow-up treatment for individuals with SUD.

ED-based SUD Interventions

Ability to provide on-demand services and resources that address diagnosed behavioral health needs across the acuity spectrum, either synchronously or asynchronously.

On-demand Behavioral Health Support

Ability to connect a patient with SUD to individuals with either lived experience or appropriate training to support a patient's long-term recovery.

Peer Support Services

Ability to virtually deliver psychiatry (i.e. telepsychiatry) and/or therapy (i.e. teletherapy) and prescribe medication as applicable.

Telemental Services

Ability to virtually deliver medication-assisted treatment (MAT).

Tele-MAT Services

Multimodal delivery options that allow patients to choose how to engage. Options include desktop, mobile apps, text messaging, and other connected devices.

Multimodal delivery options

Personalized care plans that deliver customizable treatment. Leading solutions offer libraries of evidence-based medical and psychosocial intervention pathways. Content is delivered in accessible, personable language to meet patients where they are.

Personalized care plans

Connected FDA-approved devices as needed to monitor specific conditions. Devices should support automatic and/or patient-triggered data upload.

Connected FDA-approved devices

Real-time data collection and response with AI-driven coaching. In addition, health systems must work with solution companies to determine where this data flows and the associated care pathways.

Real-time data collection

Integration and interoperability with EHR and other relevant software. Leading solutions are accessible to providers in their native workflow and easily exchange data with other solutions, such as prescribing software.

Integration and interoperability

Ability to provide multilingual and omni-channel options. No app download or authentication required for patients/members. Navigation and scheduling through existing channels, with provider launch from the EHR. Allow for patient link distribution to family members. Proxy support is provided.

Access & Scheduling

Ability to handle digital form upload & intake. Integrated symptom checking.  Waiting room accessible to patients, providers, and staff. Patient/member queueing. Patient can share images or videos. Integration with connected devices for vitals collection. Patient/member contact/chatting. Content for patients to interact with in the waiting room. Notify patient when provider is ready to start visit. Tool for patient to test tech feasibility 

Intake & Virtual Waiting Room

Ability to provide high-resiliency, high-latency video with ability to toggle to phone/audio and support for multi-party video. Patient education that can be annotated. Enable a consumer to alternate between modalities (text/chat/in-app messaging/secure portal). Asynchronous interview (including integrated symptom checking/virtual triage). Ability to “step up” to video visit or in person care if needed. Integration with connected devices, support for file sharing, screen sharing, and group chat. Notification for patients when provider has responded and vice versa. Ability to obtain patient feedback post encounter

Virtual Encounter

Ability to leverage existing patient demographic/medical info. Support for documentation within the EHR. Auto-generation of clinical documentation. Review, confirm, or revise diagnosis, treatment options (including escalation to a higher acuity care setting), and care plan in a timely manner and within existing provider workflow tools. Photo integration, recording integration, and ability to push AVS to patient portal.

Diagnosis & Documentation

Ability to support eligibility, prescription, lab, order, and referral integration with core, host systems. Ability to provide access to real-time benefits and eligibility, show pricing options based on RTE or self-pay, and apply discounts or differential pricing. Ability to generate claims and collect patient payment. Ability to offer automated follow up & referrals on treatment, adherence, or re-engagement. Care handoffs for consumers hitting escalation or exit points (i.e, direct scheduling)

Billing, Orders, & Follow Up

Ability to provide phone-based support for patients/members and providers. Ability to provide chat or text-based support for patients/members and providers.

Technical Support

Ability to guide to relevant providers based on coverage. Queuing to meet SLAs for 3rd party providers. Analytics on provider utilization/ productivity. Flex staffing based on supply and demand. Provider pooling to fill underutilized capacity.

Flexible Staffing

Ability to provide robust analytics such as provider utilization/productivity, average time per visit, most commonly treated conditions, resolution vs. escalations, volume by day and time, and patient feedback / where patient would have gone.

Content is accurate, in the best interest of the patient, and without commercial bias by provider, insurer, or supplier. Content is continuously updated to reflect the latest studies or findings, and reviewed by appropriate standards boards so patients feel confident in their decision-making. Content is relevant and pinpointed to meet a patient’s immediate needs.

Accurate & Relevant

Captures and tracks what information has been provided to the patient, what education they did or did not understand, whether they are reading the tools, etc. Recording dates of when education materials were received helps ensure they don't repeatedly get the same information. Historical context prompts clinicians to reinforce critical messages to ensure the patient sticks to their care plan.

Records Historical Context

Delivered via a variety of formats (e.g. video, audio, print, etc.) and modalities (e.g. website, mobile apps, etc.) to capture patient attention and improve comprehension. Drag-and-drop type functionality allowing patients to visualize their own medical conditions. In-the-moment reminders through augmented reality helps steer patients to make the right changes or choices. Interfaces that are as easy to use (such as YouTube) so patients can find videos around topics they're interested in and quickly get to them.

Interactive & Multimodal

Guided journeys for a specific condition helps providers understand what stage of behavior change the patients is in to better personalize, inform, and guide the next steps in the care plan and whether there is a need for targeted intervention. Personalized materials enable patients to learn about the risks and benefits of different options, form preferences, and share in the decision-making on treatment options.

Guided & Personalized

Tailors content based on comprehension checks and health literacy level. Medical illustrations that simplify concepts, and easy-to-understand text regardless of reading level. Applies the latest health literacy principles to help clarify diagnoses, support shared decision-making, and build a trusted physician-patient relationship. Translatable to other languages based on patient’s preferred language to ensure accuracy and comprehension.

Easy & Simple to Understand

Reduces steps for physicians prescribing education to patients and aligns with existing workflows (e.g. content suggestions per the patient's health history, favorites tagging, and folder access). Care managers can easily access content, while marking their favorites and organizing it into folders shared across the team and so they can easily see what other managers have shared with patients too. Care coordinators can find and use relevant health information in real-time, in preparation for a call, during an encounter, or to send as follow-up.

Seamless Care Team Workflows and Accessibility

Uses the patient’s medical record and diagnosis to provide a list of health education specific to the patient’s needs. Efficiently recommends content based on the patient's profile, visit history, and current clinical encounter. Content can be shared directly through patient portal before, during, or after a visit. Supports mix of traditional and custom orders and results interfaces; integrations include but are not limited to HL7.

EHR Integration

The solution should understand and respond to patient inputs in a manner that takes the context into account, providing relevant and accurate information or advice.

Contextual understanding

Conversational AI solutions should seamlessly integrate with the EHR and other existing systems, databases, and digital channels.

Interoperability

Solutions must protect patient privacy and comply with HIPAA and all other applicable regulations.

Data security and privacy

The user experience should mimic human conversation and include an easy, intuitive interface.

Naturalistic interaction

The solution should be capable of handling increasing volumes of interactions as use cases expand and adoption grows.

Scalability

A good solution should keep pace with rapidly evolving AI technology and continuously improve over time.

Adaptability

With information spread across potentially thousands of health plans, health insurance companies need to quickly provide their members or providers with accurate health benefits information to avoid coverage confusion and more costly care.
Sensentia’s proprietary artificial intelligence technology helps healthcare companies deliver an accurate, transparent, and simple customer experience by translating healthcare plan complexity into clear and meaningful information instantly and with near perfect accuracy. Sensentia technology powers customer service call centers, members and providers across an omni-channel experience. 
 You control the source of truth, and our healthcare AI software returns rich, detailed, comparative responses with near-perfect accuracy. 
Benefits-related questions are asked and answered through natural language search, forms, or automated dialogue, transforming your structured and unstructured data into actionable intelligence for internal and external stakeholders. 
Our best-in-class AI technology – deployed via a simple, user-friendly interface or within your own UI – uses natural language search to turn complex data into meaningful information for diverse user groups.

Sensentia

Sensentia's enhanced capabilities improve coordination of benefits for the nation’s 11 million individuals dually-eligible for Medicare and Medicaid – often the highest-need populations in either program. Sensentia supports Dual Eligible Special Needs Plans (D-SNPs) and their members by helping them resolve operational challenges for navigating disjointed benefit systems. This elevates standards of coordinated care and reduces costs and fragmentation within the care system.

Our AI-powered benefits comparison solution displays side-by-side benefits for the plan’s Customer Service Representatives (CSRs). With this benefits comparison solution, plans can resolve member calls more quickly and accurately, improve their readiness and capacity, and better coordinate and integrate Medicare and Medicaid benefits.  

D-SNP Comparison Solution 

Precision medicine is one of the most promising frontiers of medicine, but most health systems have failed to embrace it at the strategic level. The result has been promising yet inconsistent adoption and a failure to capture its true value and transformative potential. For health system leaders, the time to embrace a coordinated enterprise precision medicine strategy is now.

[White Paper] Building an Enterprise Precision Medicine Strategy

Digital therapeutics represent an exciting opportunity for health systems to improve patient engagement, outcomes, and access to care. These software-based solutions use technology like mobile apps, sensors, and data analytics to help prevent, manage, and treat a growing range of medical conditions. However, with an influx of companies offering digital therapeutics, health systems face challenges in identifying the right solutions that are evidence-based, integrate smoothly, and align with organizational goals.

Selecting Digital Therapeutics: A Step-by-Step Framework for Health Systems

From providing quick, relevant, and legitimate responses to health questions to streamlining essential tasks, AI chatbots are revolutionizing how patients interact with healthcare providers and provide unique new opportunities for health systems to enhance operations with digital tools.

Patient Engagement 2.0: How Chatbots Are Revolutionizing Health Queries

It’s a funny question to ask and seems somewhat antithetical, but are AI tools making us think too much? From the standpoint of an AI tool’s output you could argue quite the opposite. But from a UX perspective, the tools themselves may be requiring more effort to use than people are typically used to.


Are AI Tools Making Us Think Too Much?

Patients are empowered to manage their condition through the Engagement, Medication, & Nutrition modules.

VitalTech for Chronic Condition Management

This webinar will help you learn about: Evaluating staffing and provider network needs  Investing in a user-centric experience  Exploring new business and operating models  Piloting innovative care models  Developing asynchronous virtual care strategies

Virtual Visits: Lessons on Growth from 25 Health Systems

Synchronous Virtual Visit Tools

Asynchronous Virtual Visit Tools

Zipnosis

Zipnosis is a telemedicine platform that empowers providers and prioritizes patients. Our white-label virtual care solution increases access for patients and reduces 99% of provider work time. By leveraging asynchronous medical protocols, Zipnosis enables providers to deliver care in under two minutes, creating a better experience for both patients and providers. Zipnosis also enables providers to seamlessly transition into synchronous modes of care, including chat, video, and phone, while triaging and routing patients to in-person care when necessary.

Why Async?:
In-person care and synchronous video-based telemedicine are valuable, but these modalities have efficiency limitations and health equity challenges. A concerted strategy shift that leverages asynchronous telemedicine is key. We’ve done the research and proven that asynchronous telemedicine can solve the biggest challenges facing healthcare:
<ul>
<li>Staffing shortages</li>
<li>Provider burnout</li>
<li>Delayed and avoided care</li>
<li>Consumerism</li>
<li>Health equity</li>
<li>Access to care</li>
<li>Patient leakage</li>
</ul>
If video visits and in-person care were the solutions, we wouldn’t still be dealing with these issues. Health systems that are serious about solving these problems are venturing outside traditional modes of care to implement a solution that prioritizes the only two people who matter in healthcare: patients and providers.

90% Adherence to Clinical Guidelines: The Zipnosis platform leverages patient responses and clinical guidelines to provide efficient, accurate clinical decision support. We have a Clinical Quality Advisory Council made up of 15 healthcare leaders to establish clinical quality best practices for virtual care.

89-Second Provider Work Time: On average, our adaptive patient interviews gather the information a provider needs to make a diagnosis and treatment recommendation in just 89 seconds, compared with 18 minutes for an in-person visit. This gives providers more time to focus their time on patients with more complex needs, while still offering high-quality care for common conditions.

Patients Love the Experience: Patients receive the dual benefits of convenience and efficiency. They can access the system via any web-enabled device and complete their online adaptive interview in a fraction of the time taken by an in-person visit. On average, patients using asynchronous care wait 6:29 minutes for a diagnosis and spend $25 per visit.

Drive Patient Acquisition and Revenue: 40% of Zipnosis virtual visits are net new patients. Those patients are 276% more likely to convert to a health system patient, and the average first-year revenue for each new patient is $2,900. With the lifetime value of a patient expected to exceed a million dollars, a solid digital strategy is a significant competitive advantage – meanwhile, a lack of one poses a threat to organizations.

In-Depth Reporting and Analytics: Our clients capture significant structured data through the online adaptive interview. Using our HIPAA-compliant Statnosis™ reporting and analytics tool, health systems can follow trends related to conditions treated, visit timing, guideline adherence, and triaged patients.

Epic

Cerner

Meditech

Allscripts

NextGen

athena

eClinicalWorks

Zipnosis Virtual Care Platform

Angi  Frary

Michelle Rodgers

Amanda Hammel

Chris DuFresne

Tom Demmer

Pratip Nag

Sam Rosu

Anne LaNova

Nnaemeka Okafor

Ben Chao

Virtual / Remote Scribes

AI-Assisted Virtual Scribes

Intelligent / Ambient Documentation

Augmedix

Augmedix (Nasdaq: AUGX) delivers industry-leading, ambient medical documentation and data solutions to healthcare systems, physician practices, hospitals, and telemedicine practitioners.

Augmedix is on a mission to help clinicians and patients form a human connection by seamlessly integrating our technology at the point of care. Augmedix’s proprietary platform digitizes the natural clinician-patient conversations, which are converted into comprehensive medical notes and structured data in real time. The company’s platform uses automatic speech recognition, and natural language processing, including large language models, to generate accurate and timely medical notes that are transferred into the EHR.&nbsp;

Augmedix’s products relieve clinicians of administrative burden, in turn, reducing burnout, increasing clinician efficiency and improving patient access. Through Augmedix’s proprietary platform and bi-directional communication channel, Augmedix is ideally suited to serve as the vehicle for change at the point of care.

D-SNP Comparison Solution

D-SNP Comparison Solution

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