hls provider practice: care gaps demo · context-specific knowledge provider/facility search the...
TRANSCRIPT
HLS Provider Practice: Care Gaps DemoJim Rogers, RN, BSN
Director, Healthcare [email protected]
Matt Gretczko, VP, Head of Healthcare
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PROVIDER RELATIONSHIP MANAGEMENT
CONSUMER & PATIENT
ENGAGEMENT
AMBULATORY CARE COORDINATION
TRANSITIONSIN CARE
SPECIALTY CARECOORDINATION
Build Provider & Clinic/Facility Profiles
Manage ACO & Integrated Networks
Create Tiered System Relationships
Track Onboarding & Credentialing
Provider Program Participation
Provider & Care Team Engagement
Patient Access Center
Referral Navigation
Concierge Care Models
Symptom-Based 24/7 Nurse Triage
Targeted Patient Education
Patient Engagement Journeys
Track and Manage Risk & Cost
Coordinate Care via Care Plans
Complex Care Management (CCM)
Care Gaps Management - HEDIS
Medicare Innovation Program Management
Ambulatory Care Journeys
Manage Acute Discharges to PCP
Transition Care Management (TCM)
Proactive Readmission Prevention
Discharge Assessment & Triage
Step-down Care Management
Post-Acute Patient Journeys
Patient Community for Onboarding
Oncology Navigation Programs
Joint Replacement Programs
International/Travel Care Models
Bariatric Surgery Programs
Care Management Patient Journeys
SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Roadmap For Success + Marketing Automation Journeys
SILVERLINE HEALTHCARE AND LIFE SCIENCES
○ Agent/Role-Driven Patient 360
○ Dynamic Call Routing, Call Scripting, Task Management
○ Omni-Channel Engagement
○ Scheduling Management
○ Referral Management
○ Next Best Offer/Action
○ Context-Specific Knowledge
○ Provider/Facility Search
○ RSVP - Campaign/Event Registration
The foundation for patient engagement begins with an agent workflow-centric access or contact center and a 360° view of the patient. Maximizing member engagement requires omni-channel communication, and the introduction of patient journeys.
Access/Contact Center○ Align communication to “best” or
“preferred” channel
○ Consumer to Patient Conversion
○ Patient Loyalty and Satisfaction
○ Condition-Specific Knowledge Enablement
○ Patient-Centric Wellness Journeys
○ Billing/Claims Status Updates
○ Care Pathway Engagement
○ Mobile and Community Engagement
○ Longitudinal Care Timeline View
○ Data Analytics-Driven Risk Scoring
○ Real-time Care Gap Identification and Mitigation
○ Chronic Condition Care Management
○ Dynamic Care Plan Templates
○ Cost Avoidance Strategies
○ Social Determinants Integration
○ Manage Care Transitions
○ Service Line Care Management Pathways
Patient Journeys Care Management
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Our Patient Engagement POV
SILVERLINE HEALTHCARE AND LIFE SCIENCES
● Utilizes Health Cloud Care Gaps record type that is linked to a Campaign, a Services record and a HEDIS Quality Measure
● Outreach Campaign can be managed through multiple channels, including phone, email, or web for greater self-service
● HEDIS Quality Measure record consolidates specific information about the appropriate quality measure including eligibility criteria, options for closing the care gap, and best practice
● Leverages Provider Search and Provider Directory Accelerators● Referral links to Services record that includes description, patient education and FAQ’s● Provides a framework to embed other workflows, such as referral management, scheduling,
RSVP for campaign and event registration
Care Gaps Management
Care Gap Management in Health Cloud allows healthcare organizations to address health maintenance or gaps in care to improve the health of its patients and meet quality standards that impact revenue.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Care Gaps Management
Annie Sawyer is a 62 year old female with a breast cancer screening care gap that was identified from the EHR.
• She meets screening criteria based on the related HEDIS Measure Screening.
• She receives an email notification regarding the care gap with scheduling instructions.
Roxanne Green is a 60 year old female with a colorectal cancer screening care gap that was identified by her PCP.
• She receives an email explaining what a colonoscopy is and why it is needed.
• She calls the Patient Engagement Center to ask questions and schedule.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Care Gaps Management
An agent can educate the patient, find a provider and schedule the appointment from a Care Gap record.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Care Gaps Management
An agent utilizes provider search to find the most appropriate provider and facility.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Care Gaps Management
Using the Scheduling Accelerator, the the agent schedules the specialist consult for the patient.
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